Suture instrument, and positioning instrument and system for suture

JP2025035688AActive Publication Date: 2025-03-14KABUSHIKI KAISHA TAKE WING
View PDF 1 Cites 0 Cited by

Patent Information

Application Number
JP2023142904
Authority / Receiving Office
JP · JP
Patent Type
Applications
Current Assignee / Owner
Filing Date
2023-09-04
Publication Date
2025-03-14
Estimated Expiration
2043-09-04

AI Technical Summary

Benefits of technology

【0006】 請求項1の発明は、半筒状あるいはへら形状の所定長さを有する直線状または弯曲形状の回収部材1の先端部に、回収部材1の長さ方向に対する交差方向に開口する開口部3を設けているので、手技スペースの狭い関節包内に回収部材1を容易に挿入でき、これにより、回収部材1の交差方向から縫合糸5を挿入すると、縫合糸5を半月板Hを直進させるだけで、回収部材1の一対の開口部3に挿入させることができ、回収部材1への縫合糸5の挿入作業および回収作業を容易にできる。 請求項2の発明は、回収部材1の内面上には嵌合溝6Aを設け、嵌合溝6Aに回収部材1の基部側から軸棒形状の挿入体8を嵌合挿入する構成としたので、回収部材1の一対の開口部3に挿入した縫合糸5を挿入体8の外面と回収部材1の内面とにより挟んで体外に引き出すことができ、体外での縫合糸5の結紮作業を容易にできる。 請求項3の発明は、回収部材1の先端は先端壁9を立ち上げ、先端壁9より基部側の回収部材1に回収部材1の長さ方向に所定長さを有する開口部3を設けたので、回収部材1に嵌合挿入させた挿入体8は回収部材1の先端壁9に当接して回収部材1内の縫合糸5を挟むことができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項4の発明は、回収部材1の先端壁9は、回収部材1の基部側から嵌合溝6Aに挿入した挿入体8の先端部10が当接する当接部11に形成したので、回収部材1に挿入した挿入体8の先端部10は回収部材1の当接部11に当接して挿入体8の先端部10と回収部材1の当接部11とにより回収部材1内の縫合糸5を係止することができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項5の発明は、挿入体8の先端部10と回収部材1の当接部11とは、相対的に、先端部10の外面が当接部11の内面に当接して縫合糸5の抜落を防止する構成としたので、回収部材1に嵌合挿入させた挿入体8の先端部10は回収部材1の当接部11に当接して挿入体8の先端部10と当接部11の内面とにより縫合糸5を挟むことができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項6の発明は、少なくとも、挿入体8の先端部10は柔軟性を有して形成し、挿入体8の先端部10が回収部材1の開口部3の部分を通過する際に縫合糸5の切断を防止する構成としたので、縫合糸5の切断を防止しつつ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項7の発明は、回収部材1の開口部3は、少なくとも、縫合糸5および/またはニードル16を挿通する大きさを有して形成したので、回収部材1の開口部3に縫合糸5を通すことができ、縫合糸5の回収部材1への挿入を容易にする。 請求項8の発明では、中空筒状の所定長さを有する直線状または弯曲形状の回収部材1の先端部に、回収部材1の軸心方向に対する交差方向に開口する開口部3を設けているので、半月板Hの患部(断裂部損傷部D)に対して回収部材1を平行状態となるように挿入し、この状態で回収部材1の交差方向から縫合糸5を挿入すると、縫合糸5を半月板Hを直進させるだけで、回収部材1の一対の開口部3に挿入させることができ、回収部材1への縫合糸5の挿入作業を容易にできる。 請求項9の発明では、回収部材1の内部には挿通空間6を設け、回収部材1の基部側に設けた基部側挿入口7から、軸棒形状の挿入体8を挿入する構成としているので、回収部材1の一対の開口部3に挿入した縫合糸5を挿入体8の外周面と回収部材1の内周面とにより縫合糸5を体外に引き出すことができ、体外での縫合糸5の結紮作業を容易にできる。 請求項10の発明では、回収部材1の先端は先端壁9で閉塞し、先端壁9より所定長さ回収部材1の基部側の回収部材1に回収部材1の長さ方向に所定長さを有する開口部3を、回収部材1の長さ方向に対して交差方向に対峙するように設けているので、回収部材1に挿入した挿入体8は回収部材1の先端壁9に当接して回収部材1内の縫合糸5を挟持することができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項11の発明では、回収部材1の先端壁9は、回収部材1の基部側から挿通空間6に挿入した挿入体8の先端部10が当接する当接部11に形成しているので、回収部材1に挿入した挿入体8の先端部10は回収部材1の当接部11に当接して挿入体8の先端部10と回収部材1の当接部11とにより回収部材1内の縫合糸5を係止することができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項12の発明では、挿入体8の先端部10と回収部材1の当接部11とは、相対的に、先端部10の外面が当接部11の内面に当接して縫合糸5の抜落を防止する構成としているので、回収部材1に挿入した挿入体8の先端部10は回収部材1の当接部11に当接して挿入体8の先端部10と当接部11の内面とにより回収部材1内の縫合糸5を挟持することができ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項13の発明では、少なくとも、挿入体8の先端部10は柔軟性を有して形成し、挿入体8の先端部10が回収部材1の開口部3の部分を通過する際に縫合糸5の切断を防止する構成としているので、縫合糸5の切断を防止しつつ、縫合糸5の体外への引き出し作業を容易にでき、体外での縫合糸5の結紮作業を容易にできる。 請求項14の発明では、回収部材1の開口部3より基部側部分は、挿入体8を挿入する挿入部15とし、挿入部15の内径は挿入体8の外径より大径に形成しているので、回収部材1への挿入体8の挿入を容易かつ円滑に行え、挿入体8の先端部10の回収部材1の先端部10への嵌合を容易にでき、縫合糸の体外への引き出し作業を容易にでき、体外での縫合糸の結紮作業を容易にできる。 請求項15の発明では、回収部材1の開口部3は、少なくとも、縫合糸5を挿通する大きさを有して形成して構成しているので、回収部材1の開口部3に縫合糸5を通すことができ、縫合糸5の回収部材1への挿入を容易にする。 請求項16の発明では、回収部材1の開口部3は、半月板Hを貫通する縫合糸5を装着したニードル16が通過できる大きさに構成しているので、回収部材1の開口部3にニードル16ごと縫合糸5を通すことができ、縫合糸5の回収部材1への挿入を容易にする。 請求項17の発明では、回収部材1の先端壁9は、側面視において円弧形状に形成しているので、関節包内への挿入を円滑·容易に行うことかできる。 請求項18の発明では、内部に挿通空間6を設けた中空の所定長さを有する直線状または弯曲形状の回収部材1の先端を、先端壁9で閉塞し、先端壁9より基部側の回収部材1に回収部材1の長さ方向に所定長さを有する開口部3を、回収部材1の長さ方向に対して交差方向に相対峙するように設け、開口部3は縫合糸5またはニードル16を挿入しうる大きさに開口させ、回収部材1の基部側には挿入体8を挿入する基部側挿入口7を形成し、回収部材1の先側には、挿通空間6に挿入した挿入体8の先端部10が当接して挿入した縫合糸を当接係止する当接部11に形成しているので、半月板Hの裏側に形成した進入路に(体外)関節外から回収部材1の当接部11を挿入し、半月板Hの断裂部損傷部Dの奥側に回収部材1の開口部3を位置させ、一方、半月板Hの表側の進入路から半月板Hの損傷部Dを貫通させるように、ニードル16および縫合糸5を進入させ、ニードル16または縫合糸5の何れか一方または両方を回収部材1の開口部3に貫通させ、同様に、もう一本の縫合糸5を開口部3に貫通させ、2本の縫合糸5の先端を回収部材1外に残した状態で、回収部材1の挿通空間6に挿入体8を挿入し、回収部材1の当接部11に挿入体8の先端部10を当接させ、2本の縫合糸5の先端ごと、回収部材1を体外に引き出し、取り出した2本の縫合糸5を結紮し、どちらか一方の縫合糸5の基部を引いて、もう一方の縫合糸5が残り、2本の縫合糸5のその両端を関節外で結紮することで半月板Hの損傷部Dを縫合する。 請求項19の発明では、半月板Hの奥側に挿入した、回収部材1の外径より大径の直線状の中空筒状のケーシング20に、回収部材1を挿入可能に構成しているので、半月板Hの患部(断裂部損傷部D)に(平行状態)で関節包を通すことで関節外から関節内に容易にアクセスする目的でケーシング20を挿入し、このケーシング20に回収部材1を挿入させ、ケーシング20の先端より先側に回収部材1の開口部3を突出させて、回収部材1の開口部3に縫合糸5および/またはニードル16を挿入して、回収部材1の先端に縫合糸5の先端を係止させ、この状態でケーシング20を体内に留置させたまま、回収部材1を体外に取り出し、縫合糸5を体外に引き出して体外での縫合糸5の結紮作業を行うことができる。そして、再び、ケーシング20に回収部材1を挿入すると、半月板Hの近傍に回収部材1の開口部3を位置させて、縫合糸5を回収部材1に係止させて、半月板Hの損傷部Dの縫合作業を容易に反復させることができる。 すなわち、半月板Hの患部(断裂部損傷部D)を複数箇所を縫合するに際し、ケーシング20により回収部材1を挿入·引出を容易にし、半月板Hの損傷部Dの縫合作業を容易に反復させることができる。 請求項20の発明では、挿入体8は、回収部材1の挿通空間6に挿入した際に、回収部材1の先端部10まで挿入体8の先端が届くように、ビニル·シリコン等の柔軟性と剛性を有する素材で形成しているので、挿入体8の挿入を容易に行うことができる。 請求項21の発明では、回収部材1の開口部3は幅が(1~2ミリメートルで長さが12~20ミリメートル)2ミリ前後で長さが10から20ミリの長方形のスリット形状に形成しているので、交差方向からの縫合糸5の挿入を容易にすることができる。 請求項22の発明では、先端に開口部3を有し縫合糸5を挿通する回収部材1を、取付ける取付筒23を設けた一方側ハンドル24と、半月板Hの損傷部D付近に縫合糸5とニードル16を、取付ける取付筒25を設けた他方側ハンドル26とを固定具固定具27により固定してハンドル30を構成しているので、ハンドル30を持って、回収部材1に挿入体8の挿入作業をすることができ、挿入体8の挿入作業を容易にする。 請求項23の発明では、一方側ハンドル24と他方側ハンドル26とは、一方側ハンドル24と他方側ハンドル26との重なり長さを調節することにより、回収部材1とニードル16とを任意の角度で交差する状態で固定するように構成しているので、回収部材1の開口部3への縫合糸5の挿入を容易にすることができる。 請求項24の発明では、取付筒23と取付筒25とは、半月板H付近の所定位置に回収部材1の開口部3が位置する状態で、開口部3に交差するようにニードル16の先端を位置させるように、互いに配置させているので、ハンドル30に取付けた回収部材1とニードル16とは互いに体内で交差するように位置決めされ、回収部材1およびニードル16の挿入作業を容易にする。 請求項25の発明では、ハンドル30の取付筒23と取付筒25とは、半月板H付近の所定位置に回収部材1の開口部3が位置する状態で、開口部3に交差するようにニードル16の先端を位置させるように、互いに配置させているので、予め、半月板Hの損傷部Dに対してニードル16と縫合糸5が挿入されるであろう予測された位置を設定し、この設定箇所に回収部材1の開口部3が位置するように、ハンドル30の取付筒23の向きを設定し、次に、回収部材1の開口部3が位置するであろう位置にニードル16の先端が挿入されるであろう角度に他方側ハンドル26の取付筒25が位置するように、一方側ハンドル24と他方側ハンドル26を組み合わせて固定する。 すなわち、回収部材1とニードル16はdefault(初期設定)の状態では開口部3と交差するように設定されており、これは、開口部3を基準として一方側ハンドル24と他方側ハンドル26を伸縮移動させて回収部材1とニードル16の成す角度を変えても、特段の調整を要することなく、常にニードル16は開口部3と交差するようになっており、そして、一方側ハンドル24と他方側ハンドル26での調整では、本来、回収部材1の開口部3とニードル16とが直角に交差させることが望まれるが、関節包内のスペースの問題で角度を変更しなければならないことがあり、回収部材1を半月板Hの向きに合わせる目的で曲げることができることとなる。 したがって、体外で予め、半月板Hの損傷部Dと回収部材1の開口部3とニードル16の先端位置との配置関係をシミュレーションすることができ、このシミュレーションに基づいて、回収部材1とニードル16を体内に挿入し、回収部材1の開口部3にニードル16から縫合糸5を挿入係止させればよいので、縫合作業を頗るように短時間で行うことができる。 請求項26の発明では、半月板の断裂を修復するためのシステムであって、回収部材1とニードル16とハンドル30とを含む半月板修復テバイスであって、回収部材1は、その内部に挿通空間6を有し、挿通空間6内に挿入配置される挿入体8を有し、挿入体8は回収部材1の挿通空間6を通って進入可能であり、ニードル16は、その内部に挿通空間17を有し、挿通空間17に配置された縫合糸5を有し、縫合糸5は、ニードル16の挿通空間17を通って進入可能であり、ニードル16は、組織に少なくとも部分的に通されるように構成される、ある長さの縫合糸5を含み、縫合糸5は、ニードル16内へと装着され、ニードル16は半月板を貫通後開口部3を通過、あるいは、ニードル16内から進出した縫合糸5は回収部材1の開口部3を通って回収部材1外に突出した状態で挿入体8により保持され、保持された縫合糸5は回収部材1と共に体内から取り出されるように構成され、ハンドル30は、回収部材1を回収部材1の長さ方向に移動させて所望位置にて固定する取付筒23と、取付筒23を取付けた一方側ハンドル24と、ニードル16をニードル16の長さ方向に移動させて所望位置にて固定する取付筒25と、取付筒25を取付けた他方側ハンドル26とを有し、一方側ハンドル24と他方側ハンドル26の取付位置を変更してニードル16から進出した縫合糸5が回収部材1の開口部3に向かうようにした位置決め器具Kと、を含む、システムとしているので、半月板Hの縫合を容易にすることができる。

✦ Generated by Eureka AI based on patent content.

Smart Images

  • Figure 2025035688000001_ABST
    Figure 2025035688000001_ABST
Patent Text Reader

Abstract

To disclose a suture method in which conventionally, a case is provided with two needles, the two needles are inserted into a meniscus, in this state, one of the two needles passes a suture thread whose one end is formed into a loop shape, the other passes a linear sewing thread, and the other linear sewing thread passes a loop of one sewing thread in a joint capsule; and to solve the problem that although publicly known, it is very difficult to pass the other straight sewing thread in the loop of one sewing thread in the joint capsule, it takes time for suture operation and gives to a patient a large burden; because the two needles are inserted into the meniscus in a parallel state, a part where the meniscus can be sewn is limited.SOLUTION: In a suture instrument, on a tip end part of a linear or curve-shaped recovery member 1 in a semi-spherical or spatula-shape that has a prescribed length, an opening 3 that opens in a cross direction with respect to a lengthwise direction of the recovery member 1 is provided.SELECTED DRAWING: Figure 3
Need to check novelty before this filing date? Find Prior Art

Description

[Technical field]

[0001] SUTURE POSITIONING DEVICE AND SYSTEM FIELD OF THEINVENTION The present invention relates to suturing and suture positioning devices and systems. [Background technology]

[0002] A suturing method has been disclosed and is known in the art, in which two needles are provided in a case, the two needles are inserted into the meniscus, a suture with a looped tip is passed through one of the needles in this state, a straight suture is passed through the other needle, and the straight suture is passed through the loop of one of the sutures within the joint capsule (Patent Document 1). [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2010-440418 A Summary of the Invention [Problem to be solved by the invention]

[0004] In the above-mentioned known example, it is very difficult to pass one straight suture through the loop of the other suture within the joint capsule, and the suturing operation takes time and places a heavy burden on the patient. In addition, since the two needles are inserted into the meniscus while remaining parallel to each other, there is a problem in that the area where the meniscus can be sutured is limited. The present invention provides a minimally invasive suturing instrument that reduces the burden on the patient. [Means for solving the problem]

[0005] The invention of claim 1 is a suturing instrument having an opening 3 at the tip of a straight or curved recovery member 1 having a predetermined length and being semi-cylindrical or spatula-shaped, the opening 3 opening in a direction perpendicular to the longitudinal direction of the recovery member 1. The invention of claim 2 is a suturing instrument in which an engagement groove 6A is provided on the inner surface of the retrieval member 1, and an axial rod-shaped insertion body 8 is inserted and fitted into the engagement groove 6A from the base side of the retrieval member 1. The invention of claim 3 is a suturing instrument in which the tip of the retrieval member 1 has a tip wall 9 raised up, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the base side of the tip wall 9. The invention of claim 4 is a suturing instrument in which the tip wall 9 of the retrieval member 1 is formed at the abutment portion 11 that abuts against the tip portion 10 of the insertion body 8 inserted into the mating groove 6A from the base side of the retrieval member 1. The invention of claim 5 is a suturing instrument in which the tip 10 of the insertion body 8 and the abutment portion 11 of the recovery member 1 are configured relative to each other so that the outer surface of the tip 10 abuts against the inner surface of the abutment portion 11 to prevent the suture thread 5 from falling out. The invention of claim 6 is a suturing instrument in which at least the tip 10 of the insertion body 8 is formed to be flexible, and is configured to prevent the suture thread 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. In the invention of claim 7, the opening 3 of the recovery member 1 is a suturing instrument formed to have a size for at least inserting the suture thread 5 and / or the needle 16 therethrough. The invention of claim 8 is a suturing instrument having an opening 3 at the tip of a retrieval member 1 which is hollow and tubular and has a predetermined length and a straight or curved shape, the opening 3 opening in a direction intersecting the axial direction of the retrieval member 1. The invention of claim 9 is a suturing instrument configured such that an insertion space 6 is provided inside the retrieval member 1 and an axial rod-shaped insertion body 8 is inserted through a base side insertion port 7 provided on the base side of the retrieval member 1. The invention of claim 10 is a suturing instrument in which the tip of the retrieval member 1 is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 base side of the tip wall 9 so as to face each other in a direction intersecting with the longitudinal direction of the retrieval member 1. The invention of claim 11 is a suturing instrument in which the tip wall 9 of the retrieval member 1 is formed at the abutment portion 11 where the tip portion 10 of the insertion body 8 inserted into the insertion space 6 from the base side of the retrieval member 1 tightly abuts. The invention of claim 12 is a suturing instrument in which the tip 10 of the insertion body 8 and the abutment portion 11 of the recovery member 1 are configured relative to each other so that the outer surface of the tip 10 abuts against the inner surface of the abutment portion 11, thereby preventing the suture 5 located within the abutment portion 11 from falling out. The invention of claim 13 is a suturing instrument in which at least the tip 10 of the insertion body 8 is formed to be flexible, and is configured to prevent the suture thread 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. The invention of claim 14 is a suturing instrument in which the portion of the recovery member 1 base side from the opening 3 is an insertion portion 15 into which an insertion body 8 is inserted, and the inner diameter of the insertion portion 15 is formed to be larger than the outer diameter of the insertion body 8. In the invention of claim 15, the opening 3 of the recovery member 1 is a suturing instrument formed to have a size for at least inserting the suture thread 5 and / or the needle 16 therethrough. The invention of claim 16 is a suturing instrument in which the opening 3 of the recovery member 1 is configured to be large enough to allow a needle 16 having a suture 5 attached thereto that penetrates the meniscus H to pass through. The invention of claim 17 is a suturing instrument in which the distal end wall 9 of the recovery member 1 is formed in an arc shape in side view. The invention of claim 18 is a suturing instrument in which the tip of a hollow, straight or curved retrieval member 1 having a predetermined length and an insertion space 6 therein is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 base side of the tip wall 9 so as to face each other in the crossing direction of the retrieval member 1, the opening 3 being opened to a size that allows a suture 5 and / or a needle 16 to be inserted, a base side insertion port 7 is formed on the base side of the retrieval member 1 for inserting an insert body 8, and a contact portion 11 is formed on the tip side of the retrieval member 1 against which the tip 10 of the insert body 8 inserted into the insertion space 6 abuts to abut and engage the inserted suture 5. The invention of claim 19 is a suturing instrument configured so that the retrieval member 1 can be inserted into a straight, hollow, cylindrical casing 20 having a diameter larger than the outer diameter of the retrieval member 1 and inserted into the deep side of the meniscus H. The invention of claim 20 is a suturing instrument in which the insert body 8 is formed from a material having flexibility and rigidity, such as vinyl silicone, so that the tip portion 10 of the insert body 8 reaches the tip of the recovery member 1 when inserted into the insertion space 6 of the recovery member 1. The invention of claim 21 is a suturing instrument in which the opening 3 of the recovery member 1 is formed in a slit shape having a width of 1 to 2 mm and a length of 12 to 20 mm. The invention of claim 22 is a positioning device for suturing, which comprises a handle 30 consisting of a handle on one side 24 having an attachment tube 23 to which a retrieval member 1 having an opening 3 at its tip is attached, and a handle on the other side 26 having an attachment tube 25 to which a needle 16 for guiding a suture 5 near the damaged area D of the meniscus H is attached, the handles overlapping each other and fixed by a fixing device 27 so that the overlap length can be adjusted. The invention of claim 23 is a positioning device for suturing that is configured so that the recovery member 1 and the needle 16 are fixed in an intersecting state at any angle by adjusting the overlap length between the one side handle 24 and the other side handle 26. The invention of claim 24 is a positioning device for suturing in which the mounting tube 23 and the mounting tube 25 are arranged relative to each other so that the tip of the needle 16 is positioned so as to intersect with the opening 3 of the retrieval member 1 with the opening 3 being positioned at a predetermined position near the meniscus H. The invention of claim 25 is a positioning device for suturing in which the mounting tube 23 and the mounting tube 25 of the handle 30 are arranged relative to each other so that the tip of the needle 16 is positioned so as to intersect with the opening 3 of the retrieval member 1 with the opening 3 being positioned at a predetermined position near the meniscus H. The invention of claim 26 is a system for repairing a meniscus tear, the meniscus repair device including a retrieval member 1, a needle 16, and a handle 30, the retrieval member 1 having an insertion space 6 therein and an insert 8 inserted and disposed within the insertion space 6, the insert 8 being advanceable through the insertion space 6 of the retrieval member 1, the needle 16 having an insertion space 17 therein and a suture 5 disposed within the insertion space 17, the suture 5 being advanceable through the insertion space 17 of the needle 16, the needle 16 including a length of suture 5 configured to be threaded at least partially through tissue, the suture 5 being loaded into the needle 16, and the suture 5 advancing from within the needle 16 being The suture 5 is held by the insert 8 in a state protruding outside the retrieval member 1 through the opening 3 of the retrieval member 1, and the held suture 5 is configured to be removed from the body together with the retrieval member 1. The hand 30 is a system including an attachment tube 23 that moves the retrieval member 1 in the length direction of the retrieval member 1 and fixes it at a desired position, a one-side handle 24 to which the attachment tube 23 is attached, an attachment tube 25 that moves the needle 16 in the length direction of the needle 16 and fixes it at a desired position, and a other-side handle 26 to which the attachment tube 25 is attached, and a positioning device K that changes the attachment positions of the one-side handle 24 and the other-side handle 26 so that the suture 5 advancing from the needle 16 is directed toward the opening 3 of the retrieval member 1. Effect of the Invention

[0006] The invention of claim 1 has an opening 3 that opens in a direction intersecting the longitudinal direction of the retrieval member 1 at the tip of the retrieval member 1, which has a semi-cylindrical or spatula-like shape and a predetermined length. This makes it possible to easily insert the retrieval member 1 into the joint capsule, which has a narrow procedural space. As a result, when a suture 5 is inserted from the intersecting direction of the retrieval member 1, the suture 5 can be inserted into the pair of openings 3 of the retrieval member 1 simply by moving the suture 5 straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1 and to retrieve it. The invention of claim 2 is configured so that an engagement groove 6A is provided on the inner surface of the retrieval member 1, and an axial rod-shaped insert body 8 is inserted and engaged into the engagement groove 6A from the base side of the retrieval member 1. Therefore, the suture 5 inserted into the pair of openings 3 of the retrieval member 1 can be clamped between the outer surface of the insert body 8 and the inner surface of the retrieval member 1 and pulled out of the body, making it easy to tie the suture 5 outside the body. In the invention of claim 3, the tip of the retrieval member 1 has a tip wall 9 raised, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the base side of the tip wall 9.Therefore, the insert 8 fitted and inserted into the retrieval member 1 abuts against the tip wall 9 of the retrieval member 1 and can clamp the suture 5 inside the retrieval member 1, making it easy to pull out the suture 5 outside the body and facilitating the ligation of the suture 5 outside the body. In the invention of claim 4, the tip wall 9 of the retrieval member 1 is formed at an abutment portion 11 which abuts against the tip portion 10 of the insert body 8 inserted into the mating groove 6A from the base side of the retrieval member 1. Therefore, the tip portion 10 of the insert body 8 inserted into the retrieval member 1 abuts against the abutment portion 11 of the retrieval member 1, and the suture 5 inside the retrieval member 1 can be engaged by the tip portion 10 of the insert body 8 and the abutment portion 11 of the retrieval member 1, making it easy to pull out the suture 5 outside the body and facilitating the ligation of the suture 5 outside the body. In the invention of claim 5, the tip portion 10 of the inserter 8 and the abutment portion 11 of the retrieval member 1 are configured such that the outer surface of the tip portion 10 abuts against the inner surface of the abutment portion 11 to prevent the suture 5 from falling out. Therefore, when the tip portion 10 of the inserter 8 is fitted and inserted into the retrieval member 1, it abuts against the abutment portion 11 of the retrieval member 1 and the suture 5 can be clamped between the tip portion 10 of the inserter 8 and the inner surface of the abutment portion 11, which makes it easy to pull out the suture 5 outside the body and also makes it easy to ligate the suture 5 outside the body. In the invention of claim 6, at least the tip 10 of the insertion body 8 is formed to be flexible and is configured to prevent the suture 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. Therefore, while preventing the suture 5 from being cut, it is possible to easily pull the suture 5 out of the body and to easily tie the suture 5 outside the body. In the invention of claim 7, the opening 3 of the recovery member 1 is formed to be at least large enough to pass the suture 5 and / or the needle 16 through, so that the suture 5 can be passed through the opening 3 of the recovery member 1, making it easy to insert the suture 5 into the recovery member 1. In the invention of claim 8, an opening 3 opening in a direction intersecting the axial direction of the retrieval member 1 is provided at the tip of the retrieval member 1 which is hollow and has a straight or curved shape with a predetermined length. Therefore, the retrieval member 1 is inserted parallel to the affected area (torn or damaged area D) of the meniscus H, and when the suture 5 is inserted in this state from the intersecting direction of the retrieval member 1, the suture 5 can be inserted into the pair of openings 3 of the retrieval member 1 simply by moving the suture 5 straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1. In the invention of claim 9, an insertion space 6 is provided inside the retrieval member 1, and an axial rod-shaped insertion body 8 is inserted from a base side insertion port 7 provided on the base side of the retrieval member 1.Therefore, the suture 5 inserted into a pair of openings 3 of the retrieval member 1 can be pulled out of the body by the outer peripheral surface of the insertion body 8 and the inner peripheral surface of the retrieval member 1, making it easy to tie the suture 5 outside the body. In the invention of claim 10, the tip of the retrieval member 1 is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 a predetermined length from the tip wall 9 toward the base side of the retrieval member 1, so as to face the retrieval member 1 in a direction transverse to the longitudinal direction of the retrieval member 1. Therefore, the insert 8 inserted into the retrieval member 1 abuts against the tip wall 9 of the retrieval member 1 and can clamp the suture 5 within the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. In the invention of claim 11, the tip wall 9 of the retrieval member 1 is formed at the abutment portion 11 which abuts against the tip portion 10 of the insertion body 8 inserted into the insertion space 6 from the base side of the retrieval member 1. Therefore, the tip portion 10 of the insertion body 8 inserted into the retrieval member 1 abuts against the abutment portion 11 of the retrieval member 1, and the suture 5 inside the retrieval member 1 can be engaged by the tip portion 10 of the insertion body 8 and the abutment portion 11 of the retrieval member 1, thereby facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. In the invention of claim 12, the tip portion 10 of the insertion body 8 and the abutment portion 11 of the retrieval member 1 are configured relative to each other so that the outer surface of the tip portion 10 abuts against the inner surface of the abutment portion 11 to prevent the suture 5 from falling out. Therefore, when the tip portion 10 of the insertion body 8 is inserted into the retrieval member 1, it abuts against the abutment portion 11 of the retrieval member 1 and the suture 5 inside the retrieval member 1 can be clamped between the tip portion 10 of the insertion body 8 and the inner surface of the abutment portion 11, making it easier to pull out the suture 5 outside the body and easier to ligate the suture 5 outside the body. In the invention of claim 13, at least the tip 10 of the insertion body 8 is formed to be flexible and is configured to prevent the suture 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. Therefore, while preventing the suture 5 from being cut, the operation of pulling the suture 5 out of the body can be facilitated and the operation of tying the suture 5 outside the body can be facilitated. In the invention of claim 14, the portion of the retrieval member 1 closer to the base than the opening 3 serves as an insertion portion 15 into which the insert body 8 is inserted, and the inner diameter of the insertion portion 15 is larger than the outer diameter of the insert body 8. This makes it possible to easily and smoothly insert the insert body 8 into the retrieval member 1, facilitates the engagement of the tip portion 10 of the insert body 8 with the tip portion 10 of the retrieval member 1, facilitates the operation of pulling the suture out of the body, and facilitates the operation of tying the suture outside the body. In the invention of claim 15, the opening 3 of the recovery member 1 is configured to be at least large enough to pass the suture 5 through, so that the suture 5 can be passed through the opening 3 of the recovery member 1, making it easy to insert the suture 5 into the recovery member 1. In the invention of claim 16, the opening 3 of the retrieval member 1 is configured to be large enough to allow the needle 16 attached with the suture 5 that penetrates the meniscus H to pass through, so that the suture 5 can be passed through the opening 3 of the retrieval member 1 together with the needle 16, making it easy to insert the suture 5 into the retrieval member 1. In the invention of claim 17, the distal end wall 9 of the recovery member 1 is formed in an arc shape in a side view, so that insertion into the joint capsule can be performed smoothly and easily. In the invention of claim 18, the tip of the retrieval member 1, which is hollow and has a predetermined length and a straight or curved shape with an insertion space 6 provided therein, is closed by a tip wall 9, and an opening 3 having a predetermined length in the length direction of the retrieval member 1 is provided on the retrieval member 1 on the base side of the tip wall 9 so as to face each other in a direction crossing the length direction of the retrieval member 1, and the opening 3 is opened to a size that allows the suture 5 or needle 16 to be inserted, and a base side insertion port 7 for inserting an insert body 8 is formed on the base side of the retrieval member 1, and an abutment part 11 is formed on the front side of the retrieval member 1, which abuts against the tip part 10 of the insert body 8 inserted into the insertion space 6 and abuts and engages the inserted suture, so that the abutment part 11 of the retrieval member 1 is inserted from outside the joint (outside the body) into the entrance path formed on the back side of the meniscus H, and the abutment part 11 is inserted ... The opening 3 of the retrieval member 1 is positioned, and the needle 16 and suture 5 are advanced so as to penetrate the damaged portion D of the meniscus H from the entrance path on the front side of the meniscus H. Either the needle 16 or the suture 5, or both, are penetrated through the opening 3 of the retrieval member 1. Similarly, the other suture 5 is penetrated through the opening 3. With the tips of the two sutures 5 left outside the retrieval member 1, an insert 8 is inserted into the insertion space 6 of the retrieval member 1, and the tip 10 of the insert 8 is abutted against the abutment portion 11 of the retrieval member 1. The retrieval member 1 is pulled out of the body together with the tips of the two sutures 5. The two sutures 5 thus removed are ligated. The base of one of the sutures 5 is pulled, leaving the other suture 5. The damaged portion D of the meniscus H is sutured by ligating both ends of the two sutures 5 outside the joint. In the invention of claim 19, the retrieval member 1 is configured to be insertable into a straight, hollow, cylindrical casing 20 having a diameter larger than the outer diameter of the retrieval member 1 and inserted into the deep side of the meniscus H. Therefore, the casing 20 is inserted into the affected part (torn or damaged part D) of the meniscus H (in a parallel state) so as to pass through the joint capsule in order to easily access the inside of the joint from outside the joint. The retrieval member 1 is then inserted into this casing 20, the opening 3 of the retrieval member 1 is caused to protrude beyond the tip of the casing 20, the suture 5 and / or needle 16 is inserted into the opening 3 of the retrieval member 1, and the tip of the suture 5 is engaged with the tip of the retrieval member 1. In this state, while leaving the casing 20 in the body, the retrieval member 1 is removed from the body, and the suture 5 is pulled out of the body so that the ligation operation of the suture 5 can be performed outside the body. Then, by inserting the retrieval member 1 into the casing 20 again, the opening 3 of the retrieval member 1 is positioned near the meniscus H and the suture 5 is engaged with the retrieval member 1, allowing the suturing operation of the damaged area D of the meniscus H to be easily repeated. That is, when suturing the affected area (torn and damaged area D) of the meniscus H at multiple locations, the casing 20 makes it easy to insert and pull out the retrieval member 1, and the suturing operation of the damaged area D of the meniscus H can be easily repeated. In the invention of claim 20, the insert 8 is formed from a material having flexibility and rigidity such as vinyl silicone so that the tip of the insert 8 reaches the tip portion 10 of the recovery member 1 when inserted into the insertion space 6 of the recovery member 1, making it easy to insert the insert 8. In the invention of claim 21, the opening 3 of the recovery member 1 is formed into a rectangular slit shape with a width of approximately 2 mm (1 to 2 mm and a length of 12 to 20 mm) and a length of 10 to 20 mm, thereby making it easy to insert the suture 5 from the crossing direction. In the invention of claim 22, one side handle 24 having an attachment tube 23 for attaching retrieval member 1 having an opening 3 at its tip and through which suture 5 is inserted, and the other side handle 26 having an attachment tube 25 for attaching suture 5 and needle 16 near the damaged area D of meniscus H are fixed by fixture 27 to form handle 30, so that insertion body 8 can be inserted into retrieval member 1 by holding handle 30, making the insertion work of insertion body 8 easier. In the invention of claim 23, the one side handle 24 and the other side handle 26 are configured so that the overlapping length between the one side handle 24 and the other side handle 26 can be adjusted to fix the retrieval member 1 and the needle 16 in an intersecting state at any angle, thereby making it easier to insert the suture 5 into the opening 3 of the retrieval member 1. In the invention of claim 24, mounting tube 23 and mounting tube 25 are arranged relative to each other such that opening 3 of retrieval member 1 is located at a predetermined position near meniscus H, and the tip of needle 16 is positioned so as to intersect with opening 3. Therefore, retrieval member 1 attached to handle 30 and needle 16 are positioned so as to intersect with each other inside the body, facilitating the insertion operation of retrieval member 1 and needle 16. In the invention of claim 25, the mounting tube 23 and the mounting tube 25 of the handle 30 are arranged relative to each other so that the tip of the needle 16 is positioned to intersect with the opening 3 of the retrieval member 1, with the opening 3 being located at a predetermined position near the meniscus H. Therefore, the predicted position where the needle 16 and suture 5 will be inserted into the damaged portion D of the meniscus H is set in advance, and the orientation of the mounting tube 23 of the handle 30 is set so that the opening 3 of the retrieval member 1 is located at this set location. Next, the one-side handle 24 and the other-side handle 26 are combined and fixed so that the mounting tube 25 of the other-side handle 26 is positioned at an angle at which the tip of the needle 16 will be inserted into the position where the opening 3 of the retrieval member 1 will be located. In other words, the retrieval member 1 and needle 16 are set to intersect with the opening 3 in the default (initial setting) state, and this means that even if the angle between the retrieval member 1 and needle 16 is changed by extending or retracting the one-side handle 24 and the other-side handle 26 based on the opening 3, no special adjustment is required and the needle 16 will always intersect with the opening 3. Furthermore, when adjusting the one-side handle 24 and the other-side handle 26, it is ideal to have the opening 3 of the retrieval member 1 and the needle 16 intersect at a right angle, but there are cases where the angle must be changed due to space issues within the joint capsule, and the retrieval member 1 can be bent to align it with the direction of the meniscus H. Therefore, it is possible to simulate in advance outside the body the positional relationship between the damaged area D of the meniscus H, the opening 3 of the retrieval member 1, and the tip position of the needle 16.Based on this simulation, the retrieval member 1 and the needle 16 are inserted into the body, and the suture 5 is inserted and secured through the needle 16 to the opening 3 of the retrieval member 1, allowing the suturing operation to be performed in an extremely short time. In accordance with claim 26, there is provided a system for repairing a tear in a meniscus, the meniscus repair device including a retrieval member 1, a needle 16, and a handle 30, the retrieval member 1 having an insertion space 6 therein and an insert 8 inserted and disposed within the insertion space 6, the insert 8 being advanceable through the insertion space 6 of the retrieval member 1, the needle 16 having an insertion space 17 therein and a suture 5 disposed within the insertion space 17, the suture 5 being advanceable through the insertion space 17 of the needle 16, the needle 16 including a length of suture 5 configured to be threaded at least partially through tissue, the suture 5 being loaded into the needle 16, the needle 16 passing through the opening 3 after penetrating the meniscus, or the suture advancing from within the needle 16. The suture 5 is held by the insert 8 in a state where it protrudes outside the retrieval member 1 through the opening 3 of the retrieval member 1, and the held suture 5 is configured to be removed from the body together with the retrieval member 1. The handle 30 has an attachment tube 23 that moves the retrieval member 1 in the length direction of the retrieval member 1 and fixes it at the desired position, a one-side handle 24 to which the attachment tube 23 is attached, an attachment tube 25 that moves the needle 16 in the length direction of the needle 16 and fixes it at the desired position, and a other-side handle 26 to which the attachment tube 25 is attached, and a positioning device K that changes the attachment positions of the one-side handle 24 and the other-side handle 26 so that the suture 5 advancing from the needle 16 is directed toward the opening 3 of the retrieval member 1, thereby making it easy to suture the meniscus H. [Brief description of the drawings]

[0007] [Figure 1] 1A is a side view and a front view of a recovery member, FIG. 1B is a side view and a front view of another embodiment of the same, FIG. 1C is a side view and a front view of another embodiment of the same, and FIG. [Diagram 2] 1A is a longitudinal sectional side view and a plan view of a recovery member, FIG. 1B is a view of another embodiment of the recovery member, and FIG. [Diagram 3] 1A is a schematic plan view of a state in which a suture is inserted through an opening of a recovery member, and FIG. [Figure 4] (A) is a schematic plan view showing a state in which a second suture 5 has been inserted; (B) is a view showing another embodiment of the same. [Diagram 5] 1A is a side view of the retrieval member with a suture thread inserted through an opening therein, (B) a view of another embodiment of the same, and (C) a view of another embodiment of the same. [Figure 6] 1A is a longitudinal sectional side view of a state in which a suture is inserted through an opening of a retrieval member, (B) a view of another embodiment of the same, and (C) a view of another embodiment of the same. [Figure 7] 1A is a longitudinal sectional side view of the insertion body inserted into the recovery member, and FIG. 1B is a longitudinal sectional side view of the insertion body abutting against an abutment portion of the recovery member, and FIG. [Figure 8] 1A is a longitudinal sectional side view of a state in which the retrieval member is inserted into the affected area, (B) is a longitudinal sectional side view of another embodiment of the same, and (C) is a longitudinal sectional side view of the same embodiment. [Figure 9] (A) is a diagram showing a state in which the suture is retrieved by the retrieval member, (B) is a diagram showing another embodiment of the same. [Figure 10] FIG. 13 is a schematic plan view of the state in which the suture is pulled in after connection. [Figure 11] 13 is a schematic plan view of the state in which the suture is further pulled in after being connected. FIG. [Figure 12] 13 is a schematic plan view of the state in which the suture has been connected to suture the affected portion of the meniscus. FIG. [Figure 13] 1A is a schematic plan view of a suturing handle in use, and FIG. 1B is a schematic plan view of a positioning device for a retrieval member according to another embodiment in use. [Figure 14] FIG. 2 is a schematic perspective view of a needle inserted into a needle barrel. [Figure 15] FIG. [Figure 16] 1 shows an exploded longitudinal view and an assembled longitudinal view of a suture handle. [Figure 17] 4A and 4B are longitudinal exploded and assembled views of a suturing handle according to another embodiment. [Figure 18] 1A is a front view of a jig for bending a retrieval member, and FIG. 1B is a side view, a front view, and a view of a state in which a jig for bending a retrieval member according to another embodiment is used. [Figure 19] Schematic diagram of the needle contacting the joint capsule. [Figure 20] Schematic diagram of a needle and suture passing through an opening in a retrieval member. [Figure 21] Schematic diagram of the needle and suture passing through an opening in the retrieval member. [Figure 22] Schematic diagram showing the state where only sutures are placed. [Diagram 23] FIG. 13 is a schematic diagram showing the state in which the insert is inserted into the retrieval member and holds the suture. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0008] An embodiment of the present invention will be described below with reference to the drawings. Reference numeral 1 denotes a retrieval member for retrieving suture 5 that has been used to suture an affected area (damaged area D) of meniscus H in joint capsule (inside joint cavity) S. The retrieval member 1 is configured to be formed in a straight or curved shape having a predetermined length in a semi-cylindrical or spatula shape, and an opening 3 is provided at the tip of the retrieval member 1, opening in a direction perpendicular to the longitudinal direction of the retrieval member 1. Therefore, the retrieval member 1 can be easily inserted into the joint capsule, which has a narrow procedural space. As a result, when the suture 5 is inserted from the crossing direction of the retrieval member 1, the suture 5 can be inserted into a pair of openings 3 of the retrieval member 1 simply by moving the suture 5 straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1 and to retrieve it. In other words, the meniscus H is located between the femur and the tibia, and they are normally in contact with each other. During surgery, space is created by manually opening the space between the femur, tibia, and meniscus H, and the retrieval member 1 is then inserted into this space.

[0009] When cleaning tissue inside a joint, surgery is performed by inserting a cylindrical instrument with a diameter of about 3.5 mm, but the spatula-shaped retrieval member 1 allows for greater flexibility and makes suturing easier. FIG. 1B shows another embodiment of a spatula-shaped retrieval member 1, in which the opening area of ​​the opening 3 is reduced, thereby improving the rigidity of the retrieval member 1 against bending. As shown in FIG. 2A, a fitting groove 6A is provided on the inner surface of the retrieval member 1, and a semi-axial rod-shaped insertion body 8 is inserted and fitted into the fitting groove 6A from the base side of the retrieval member 1. Therefore, the suture 5 inserted into the opening 3 of the retrieval member 1 can be pulled out of the body while being held in engagement between the outer surface of the insert 8 and the inner surface of the retrieval member 1, making it easy to tie the suture 5 outside the body. A tip wall 9 is raised at the tip of the retrieval member 1 (FIG. 2A), and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the base side of the tip wall 9.

[0010] Therefore, the insert 8 fitted and inserted into the retrieval member 1 can abut against the tip wall 9 of the retrieval member 1 to clamp the suture 5 inside the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. The distal end wall 9 of the retrieval member 1 constitutes an abutment portion 11 against which a distal end portion 10 of the insertion body 8 inserted into the fitting groove 6A from the base side of the retrieval member 1 abuts (FIG. 2A). Therefore, the tip 10 of the insertion body 8 inserted into the retrieval member 1 abuts against the abutment portion 11 of the retrieval member 1, and the suture 5 inside the retrieval member 1 can be held and locked by the tip 10 of the insertion body 8 and the abutment portion 11 of the retrieval member 1, making it easy to pull out the suture 5 outside the body and easy to tie the suture 5 outside the body.

[0011] The tip portion 10 of the insertion body 8 and the contact portion 11 of the recovery member 1 are configured so that the outer surface of the tip portion 10 contacts the inner surface of the contact portion 11 to prevent the suture thread 5 from falling off. Therefore, the tip 10 of the insertion body 8 fitted and inserted into the recovery member 1 abuts against the abutment portion 11 of the recovery member 1, allowing the suture 5 to be clamped between the tip 10 of the insertion body 8 and the inner surface of the abutment portion 11, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. At least the tip 10 of the insert 8 is formed to have flexibility so as to prevent the suture 5 from being cut when the tip 10 of the insert 8 passes through the opening 3 of the recovery member 1.

[0012] Therefore, when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1, the suture 5 is prevented from being cut by the edge of the opening 3, while the operation of pulling the suture 5 out of the body can be easily performed, and the operation of tying the suture 5 outside the body can be easily performed. The opening 3 of the recovery member 1 is formed to have at least a size to allow the suture 5 and / or the needle 16 to pass therethrough. Therefore, the suture 5 can be easily passed through the opening 3 of the retrieval member 1 , making it easy to insert the suture 5 into the retrieval member 1 . The cross-sectional shape of the recovery member 1 may be selected from a variety of shapes with different arcs or curvature angles, ranging from a semi-cylindrical arc shape formed by cutting a circular tubular member to a spatula shape.

[0013] Furthermore, the angle of the tip wall 9 of the recovery member 1 may be any angle at which the tip 10 of the insertion body 8 can abut, and may be any angle from 90 degrees (right angle) to about 30 degrees horizontally. FIG. 1C shows another embodiment of the retrieval member 1, in which the retrieval member 1 is formed into a straight or curved shape having a predetermined length like a hollow cylinder, and a pair of openings 3 are provided at the tip of the retrieval member 1, which open in a direction perpendicular to the axial direction of the retrieval member 1. Therefore, the retrieval member 1 is inserted into the joint capsule so that it is parallel to the position of the affected area (damaged area D) of the meniscus H, and in this state, the suture 5 is inserted from the cross direction of the retrieval member 1.The suture 5 can be inserted into the pair of openings 3 of the retrieval member 1 simply by moving it straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1. The material of the recovery member 1 may be any material, but it is preferable that the recovery member 1 be made of a metallic cylindrical member having a diameter of about 3.5 mm.

[0014] An insertion space 6 is provided inside the retrieval member 1, and an axial rod-shaped insert 8 is inserted from a base insertion port 7 provided on the base side of the retrieval member 1. Therefore, the suture 5 inserted into the pair of openings 3 of the retrieval member 1 can be pinched between the outer peripheral surface of the insert 8 and the inner peripheral surface of the retrieval member 1, and the suture 5 can be pulled out of the body, making it easy to knot the suture 5 outside the body. The opening 3 is closed by a distal wall 9 of the retrieval member 1, and has a predetermined length in the longitudinal direction of the retrieval member 1, and is provided on the retrieval member 1 on the base side of the distal wall 9 so as to face each other in a direction crossing the longitudinal direction of the retrieval member 1 (FIGS. 1C and 1D). Therefore, the insert 8 inserted into the retrieval member 1 abuts against the tip wall 9 of the retrieval member 1 and can clamp the suture 5 inside the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body.

[0015] The tip 10 of the inserter 8 and the inner surface of the tip wall 9 of the retrieval member 1 are configured so that the outer surface of the tip 10 closely abuts against the inner surface of the tip wall 9 to prevent the suture 5 from falling out. Therefore, the tip 10 of the inserter 8 inserted into the retrieval member 1 abuts against the inner surface of the tip wall 9 of the retrieval member 1 to clamp the suture 5 inside the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. That is, an abutment portion 11 is provided at the tip of the retrieval member 1 against which the tip portion 10 of the insertion body 8 abuts, and the tip portion 10 of the insertion body 8 abuts against the abutment portion 11 to clamp and lock the suture 5 inserted into the retrieval member 1. It is preferable that distal end wall 9 of recovery member 1 is formed in an arc shape in side view (FIG. 1C), since this prevents suture 5 from being damaged when suture 5 is brought into contact with contact portion 11.

[0016] In other words, the tip 10 of the insertion body 8 and the abutment portion 11 of the recovery member 1 are configured such that the outer surface of the tip 10 abuts closely against the inner surface of the abutment portion 11 to prevent the suture 5 from falling off. Therefore, the tip 10 of the insertion body 8 inserted into the retrieval member 1 can abut against the inner surface of the abutment portion 11 of the retrieval member 1 to clamp the suture 5 inside the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. At least the tip 10 of the insertion body 8 is made flexible so as to prevent the suture 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. Therefore, when the tip 10 of the insert 8 abuts the suture 5 against the abutment portion 11, the suture 5 is prevented from being damaged by the end of the opening 3 and the tip of the insert 8 in a so-called guillotine-like manner.

[0017] The portion of the recovery member 1 on the base side from the opening 3 serves as an insertion portion 15 into which the insertion body 8 is inserted, and the inner diameter of the insertion portion 15 is formed to be larger than the outer diameter of the insertion body 8 . Therefore, the insertion body 8 can be easily and smoothly inserted into the retrieval member 1, the tip 10 of the insertion body 8 can be easily abutted against the inner surface of the tip wall 9 of the retrieval member 1, the operation of pulling the suture 5 out of the body can be easily performed, and the operation of tying the suture 5 outside the body can be easily performed. The opening 3 of the recovery member 1 is formed to have at least a size to allow the suture 5 to pass therethrough, but is also configured to have a size to allow the needle 16 having the suture 5 attached thereto, which penetrates the meniscus H, to pass therethrough. Therefore, the suture 5 can be passed through the opening 3 of the retrieval member 1 together with the needle 16, making it easy to insert the suture 5 into the retrieval member 1. The needle 16 may have any configuration as long as it can pass the suture 5 through so that the suture 5 can penetrate and suture the affected area (damaged area D) of the meniscus H. In this embodiment, the needle 16 is formed from a hollow member and is configured so that the suture 5 can be passed through a hollow needle 16B of 16 to 18G (Figure 14).

[0018] Therefore, the needle 16 may be formed from a single hollow member, but it may also be configured as a double-cylinder configuration in which the suture 5 is passed through a hollow needle 16B, and the needle 16B with the suture 5 passed through it is inserted into the needle 16, and the suture 5 is passed through the opening 3 of the recovery member 1 (Figure 14). Furthermore, the suture 5 need not be special and may be any suture normally used for suturing the meniscus H, but it is preferable that the suture 5 has the minimum necessary rigidity to allow the base side of the suture 5 to be fed into the needle 16 and the tip to be inserted into the opening 3 of the recovery member 1. Furthermore, although not shown, since tying inside the body is not necessary, a needle may be attached to the tip of the suture 5, making it easier to insert the recovery member 1 through the opening 3. In addition, in the present invention, the retrieval member 1 is used to retrieve the sutures 5, and the two sutures 5 are connected outside the body and returned to the body for ligation. Therefore, the tips of the two sutures 5 are both formed straight, but to make it easier to connect the two sutures 5 outside the body, the tip of one of the sutures 5 may be formed into a loop (Figure 5B). In addition, the tip of the hollow, straight-shaped recovery member 1 having a predetermined length and with an insertion space 6 provided therein is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the recovery member 1 is provided on the base side of the recovery member 1 from the tip wall 9, facing opposite the longitudinal direction of the recovery member 1, and the opening 3 is opened to a size that allows a suture 5 or needle 16 to be inserted. A base side insertion port 7 for inserting an insert body 8 is formed on the base side of the recovery member 1, and an abutment portion 11 is formed beyond the opening 3 of the recovery member 1, against which the tip portion 10 of the insert body 8 inserted into the insertion space 6 abuts.

[0019] For this purpose, the distal wall 9 of the retrieval member 1 is inserted from outside the body into the approach path formed on the back side of the meniscus H, and the opening 3 of the retrieval member 1 is positioned on the rear side of the torn and damaged part D of the meniscus H. Meanwhile, the needle 16 and the suture 5 are advanced from the approach path on the front side of the meniscus H so as to penetrate the damaged part D of the meniscus H, and either or both of the needle 16 and the suture 5 are penetrated into the opening 3 of the retrieval member 1, and similarly, the other suture 5 is penetrated into the opening 3. Then, with the tips of the two sutures 5 remaining outside the retrieval member 1, an insert body 8 is inserted into the insertion space 6 of the retrieval member 1, tip portion 10 of the insert body 8 is abutted against abutment portion 11 of the retrieval member 1, and the retrieval member 1 together with the tips of the two sutures 5 is pulled out of the body. One of the two sutures 5 is then passed through (ligated) the loop-shaped suture 5 of the two sutures 5, the base of the loop-shaped suture 5 is pulled, and the damaged portion D of the meniscus H is sutured with the other suture 5.

[0020] In this case, the tip of one of the two sutures 5 is looped and the other suture 5 is straight, but this is to facilitate the ligation procedure outside the body and is not a requirement of the present invention; either tip of the two sutures 5 may be straight. Incidentally, it is preferable that the tip portion 10 of the insertion body 8 is formed in an arc shape in side view, since this prevents damage to the suture 5 when the suture 5 is pushed forward inside the opening 3. The retrieval member 1 may be curved to have an arc shape in side view. In this case, it is preferable that the retrieval member 1 is formed to have a rigidity that allows it to penetrate into tissue, and a flexibility that allows it to be curved during treatment, which makes treatment easier. In addition, it is preferable that the flexibility of the retrieval member 1 is irreversible flexibility, which ensures the rigidity that allows it to penetrate into tissue.

[0021] In other words, due to space issues within the joint capsule, the position of the opening 3 of the retrieval member 1 may not match the orientation of the meniscus H, but the opening 3 can be positioned in an appropriate position by bending (curving) the retrieval member 1. Furthermore, when the retrieval member 1 is curved, it is adjusted in advance so that the retrieval member 1 and the needle 16 cross each other. Furthermore, for example, the retrieval member 1 is curved by two protrusions 12A of a jig 12 as shown in FIG. The jig 12 can be used in any manner, but it is preferable to use it by gradually changing the bending position so that the entire retrieval member 1 draws an arc, thereby avoiding bending the retrieval member 1 in a concentrated manner at one point.

[0022] Figure 18B shows another embodiment of the jig 13, in which the jig 13 has an insertion groove 13A with a curved surface 13B therein, and the tip of the recovery member 1 inserted into the insertion groove 13A is curved to follow the curved surface 13B while protruding from the insertion opening 13C. Figure 1C shows another embodiment of the retrieval member 1, in which the tip wall 9 of the retrieval member 1 is arc-shaped, and a pair of openings 3 having a predetermined length in the longitudinal direction of the retrieval member 1 are provided on the retrieval member 1 a predetermined distance from the tip wall 9 toward the base side of the retrieval member 1, facing each other in a direction transverse to the longitudinal direction of the retrieval member 1. FIG. 1D shows another embodiment of the retrieval member 1, in which the tip wall 9 of the retrieval member 1 is angular in shape, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 a predetermined length from the tip wall 9 toward the base side of the retrieval member 1, facing opposite the longitudinal direction of the retrieval member 1 in a direction transverse to the longitudinal direction of the retrieval member 1, and the side of the retrieval member 1 beyond the opening 3 is formed as a fitting portion 11A into which the tip portion 10 of the insertion body 8 inserted into the insertion space 6 fits.

[0023] Therefore, tip 10 of inserter 8 inserted into retrieval member 1 fits into fitting portion 11A of retrieval member 1 so that suture 5 inside retrieval member 1 can be clamped between the lower and upper surfaces of fitting portion 11A and the inner surface of tip wall 9, facilitating the operation of pulling suture 5 out of the body and facilitating the operation of tying suture 5 outside the body. Tip 10 of inserter 8 and fitting portion 11A of retrieval member 1 are configured so that the outer surface of tip 10 fits tightly into the inner surface of fitting portion 11A to prevent suture 5 located inside fitting portion 11A from falling out. Therefore, tip 10 of inserter 8 inserted into retrieval member 1 fits into fitting portion 11A of retrieval member 1, and the suture 5 inside retrieval member 1 can be clamped between the lower surface of fitting portion 11A, the inner surface of tip wall 9, and the upper surface of fitting portion 11A, facilitating the operation of pulling suture 5 out of the body and facilitating the operation of tying suture 5 outside the body. Opening 3 of retrieval member 1 is formed to have at least a size to pass suture 5 through, but is configured to be large enough to allow suture 5 and needle 16 that penetrates meniscus H to pass through.

[0024] Therefore, the suture 5 can be passed through the opening 3 of the retrieval member 1 together with the needle 16, making it easy to insert the suture 5 into the retrieval member 1. The tip of a hollow, straight-shaped retrieval member 1 having a predetermined length and an insertion space 6 therein is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the base side of the retrieval member 1 a predetermined length from the tip wall 9, facing opposite the longitudinal direction of the retrieval member 1, and the opening 3 is opened to a size that allows a suture 5 or needle 16 to be inserted. A base side insertion port 7 for inserting an insert body 8 is formed on the base side of the retrieval member 1, and a fitting portion 11A is formed beyond the opening 3 of the retrieval member 1 into which the tip 10 of the insert body 8 inserted into the insertion space 6 fits (Figure 2).

[0025] For this purpose, the fitting portion 11A of the retrieval member 1 is inserted from outside the body into the access path formed on the back side of the meniscus H, and the opening 3 of the retrieval member 1 is positioned on the rear side of the torn and damaged portion D of the meniscus H. Meanwhile, the needle 16 and the suture 5 are advanced from the access path on the front side of the meniscus H so as to penetrate the damaged portion D of the meniscus H, and either or both of the needle 16 and the suture 5 are advanced through the opening 3 of the retrieval member 1, and similarly, the other One suture 5 is passed through the opening 3, and while leaving the tips of the two sutures 5 outside the retrieval member 1, an insert body 8 is inserted into the insertion space 6 of the retrieval member 1, the tip portion 10 of the insert body 8 is tightly fitted into the fitting portion 11A of the retrieval member 1, the retrieval member 1 together with the tips of the two sutures 5 is pulled out of the body, the two removed sutures 5 are ligated, the base portions of the sutures 5 are pulled, and the damaged portion D of the meniscus H is sutured with the two sutures 5. That is, when the tip portion 10 of the insertion body 8 is fitted into the fitting portion 11A, the suture 5 is retained within the fitting portion 11A, and the suture 5 is retrieved.

[0026] The retrieval member 1 is configured to be insertable into a linear hollow cylindrical casing 20 having a diameter larger than the outer diameter of the retrieval member 1, which is inserted into the back side of the meniscus H (FIG. 8). Therefore, the casing 20 is inserted parallel to the affected area (damaged area (torn area D)) of the meniscus H, the retrieval member 1 is inserted into this casing 20, the opening 3 of the retrieval member 1 is caused to protrude beyond the tip of the casing 20, the suture 5 or needle 16 is inserted into the opening 3 of the retrieval member 1, the tip of the suture 5 is engaged with the tip of the retrieval member 1, and while leaving the casing 20 in place inside the body, the retrieval member 1 is removed to the outside of the body, the suture 5 is pulled out to the outside of the body, and the connection work can be performed outside the body by passing the non-loop suture 5 through the loop suture 5. Then, by inserting the retrieval member 1 into the casing 20 again, the opening 3 of the retrieval member 1 can be positioned near the meniscus H and the meniscus can be retrieved, and a second suturing can be performed. In this manner, the suturing operation of the damaged portion D of the meniscus H can be easily repeated. Reference numeral 18 denotes a connecting portion where two suture threads 5 are connected (FIG. 11).

[0027] The casing 20 is a member into which the retrieval member 1 is inserted, and FIG. 8 shows an example of use of the retrieval member 1 of an embodiment having a different shape. The insert 8 is formed from a material having flexibility and rigidity, such as vinyl silicone, so that the tip of the insert 8 reaches the tip 10 of the recovery member 1 when inserted into the insertion space 6 of the recovery member 1. The opening 3 of the recovery member 1 is formed in a rectangular slit shape with a width of about 2 mm and a length of 10 to 20 mm. The positioning device K in Figure 13 is configured to have a handle 30 fixed by a fixing device 27 to one side handle 24 having an attachment tube 23 for attaching a retrieval member 1 having an opening 3 at its tip and through which a suture 5 is inserted, and a handle 26 on the other side having an attachment tube 25 for attaching a needle 16 that guides the suture 5 to be inserted near the damaged area D of the meniscus H.

[0028] Therefore, the insertion body 8 can be inserted into the recovery member 1 by holding the handle 30, making the insertion body 8 insertion operation easier. The positioning device K positions the mounting tube 23 and the mounting tube 25 relative to each other so that the opening 3 of the retrieval member 1 is positioned at a predetermined position near the meniscus H, and the tip of the needle 16 is positioned so as to intersect with the opening 3. Therefore, the retrieval member 1 attached to the handle 30 and the needle 16 are positioned to cross each other inside the body, facilitating the insertion of the retrieval member 1 and the needle 16 . That is, the handle 30 is composed of a one-side handle 24 having the mounting tube 23, and a other-side handle 26 which is attached to the one-side handle 24 so as to be freely movable, and the base of the one-side handle 24 and the base of the other-side handle 26 are overlapped and fixed by a fastener 35. This makes it possible to adjust the length of the handle 30 between long and short lengths, improving operability and workability.

[0029] The attachment configuration of the retrieval member 1 to the mounting tube 23 is arbitrary, but as one example, a fastener 33 is provided on the mounting tube 23, and the retrieval member 1 is inserted into the mounting tube 23 and then fixed by the fastener 33. The other side mounting cylinder 25 is attached to the base side of the other side handle 26, and the cylinder 16 is detachably attached to the mounting cylinder 25. The other side mounting cylinder 25 is attached to the base side of the other side handle 26, and the needle 16 is detachably attached to the mounting cylinder 25. Therefore, when the tip of the needle 16 is inserted so as to contact the damaged area D of the meniscus H and the suture 5 is inserted into the needle 16, the suture 5 is guided by the needle 16 and can be reliably inserted into the damaged area D of the meniscus H.

[0030] The positioning device K positions the mounting tube 23 and the mounting tube 25 of the handle 30 relative to each other so that the opening 3 of the retrieval member 1 is positioned at a predetermined position near the meniscus H, and the tip of the needle 16 is positioned so as to intersect with the opening 3. Therefore, the predicted position where the suture 5 will be inserted into the damaged area D of the meniscus H is set in advance, and the orientation of the mounting tube 23 of the handle 30 is set so that the opening 3 of the retrieval member 1 is located at this set location.Next, the one-side handle 24 and the other-side handle 26 are combined and fixed so that the mounting tube 25 of the other-side handle 26 is positioned at an angle where the tip of the needle 16 will be inserted into the position where the opening 3 of the retrieval member 1 will be located.

[0031] Therefore, it is possible to simulate in advance outside the body the positional relationship between the damaged area D of the meniscus H, the opening 3 of the retrieval member 1, and the tip position of the needle 16.Based on this simulation, the retrieval member 1 and the needle 16 are inserted into the body, and the suture 5 is inserted and secured through the needle 16 to the opening 3 of the retrieval member 1, allowing the suturing operation to be performed in an extremely short time. In other words, the retrieval member 1 and needle 16 are set to intersect with the opening 3 in the default (initial setting) state, and this means that even if the angle between the retrieval members 1 and 16 is changed by extending or retracting the one-side handle 24 and the other-side handle 26 based on the opening 3, no special adjustment is required and the needle 16 will always intersect with the opening 3. Furthermore, when adjusting the one-side handle 24 and the other-side handle 26, it is ideal to have the opening 3 of the retrieval member 1 and the needle 16 intersect at a right angle, but it may be necessary to change the angle due to space issues within the joint capsule, and the retrieval member 1 can be bent to align it with the direction of the meniscus H.

[0032] Therefore, it is possible to simulate in advance outside the body the positional relationship between the damaged area D of the meniscus H, the opening 3 of the retrieval member 1, and the tip position of the needle 16.Based on this simulation, the retrieval member 1 and the needle 16 are inserted into the body, and the suture 5 is inserted and secured through the needle 16 to the opening 3 of the retrieval member 1, allowing the suturing operation to be performed in an extremely short time. The movement configuration between the handle 24 on one side and the handle 26 on the other side of the handle 30 is arbitrary. As an example, a moving groove 36 is formed in either the handle 24 on one side or the handle 26 on the other side, and a moving body 37 that engages with the moving groove 36 and moves is provided in the other one (Figure 16). In this case, as shown in Figure 17, if the opening 38 of the movable groove 36 is made narrower than the groove bottom 39 and the cross-sectional shape of the movable body 37 is made trapezoidal, the one-side handle 24 and the other-side handle 26 can be simply slid without coming off, making operation easier.

[0033] The present invention also provides a system for repairing a meniscus tear, the meniscus repair device including a retrieval member 1, a needle 16, and a handle 30, the retrieval member 1 having an insertion space 6 therein and an insert 8 disposed within the insertion space 6, the insert 8 being advanceable through the insertion space 6 of the retrieval member 1, the needle 16 having an insertion space 17 therein and a suture 5 disposed within the insertion space 17, the suture 5 being advanceable through the insertion space 17 of the needle 16, the needle 16 including a length of suture 5 configured to be threaded at least partially through tissue, the suture 5 being loaded into the needle 16 and the suture 5 advancing out of the needle 16. is held by the insert 8 in a state where it protrudes outside the retrieval member 1 through the opening 3 of the retrieval member 1, and the held suture 5 is configured to be removed from the body together with the retrieval member 1, and the handle 30 has an attachment tube 23 that moves the retrieval member 1 in the length direction of the retrieval member 1 and fixes it at a desired position, a one-side handle 24 to which the attachment tube 23 is attached, an attachment tube 25 that moves the needle 16 in the length direction of the needle 16 and fixes it at a desired position, and a other-side handle 26 to which the attachment tube 25 is attached, and a positioning device K that changes the attachment positions of the one-side handle 24 and the other-side handle 26 so that the suture 5 advancing from the needle 16 is directed toward the opening 3 of the retrieval member 1.

[0034] The needle 16 may have any configuration. As one example, the needle 16 may be configured by forming an insertion space 17 inside a metallic tubular member into which the suture thread 5 can be inserted. In addition, while in one example of this embodiment the needle 16 is formed from a single tubular member (Figure 3, etc.), it may also be configured as a double-tube structure, with the base side of the outer mounting tube 16A fixed to the mounting tube 25, the needle 16 inserted into the mounting tube 16A, and the suture 5 inserted into the needle 16. In addition, when performing surgery on the meniscus H, the method of using the needle 16 is also arbitrary. The needle 16 may be inserted directly through the meniscus H, or the tip of the needle 16 may be abutted against the meniscus H and the suture 5 may be inserted through an insertion hole (not shown) formed in the meniscus H. Furthermore, although not shown in the figures, the tip of the mounting tube 16A may be abutted against the meniscus H, and the hollow needle 16B may be inserted directly through the meniscus H, and the suture 5 protruding from the hollow needle 16B may be fed and inserted into the opening 3 of the recovery member 1.

[0035] That is, the tip of the mounting tube 16A is only brought into contact with the joint capsule, and is not pierced or inserted into the joint capsule or meniscus tissue. Alternatively, the mounting tube 16A may be passed through the mounting tube 25, the tip of which is brought into contact with the outside of the joint capsule, and the needle 16B and suture 5 may be passed through the mounting tube 16A, piercing the joint capsule and meniscus H, and passing through the opening 3. In other words, the mounting tube 16A is abutted against the joint capsule S, and the needle (needle 16B) 16 passes through the opening 3 on the opposite side of the joint capsule, meniscus, and retrieval member 1, and if the needle (needle 16B) 16 has passed through the opening 3 on the opposite side, the suture 5 has also penetrated the opening 3 on the opposite side. In this state, the needle (needle 16B) 16 is pulled out leaving only the suture 5 behind, and then the needle (needle 16B) 16 loaded with the next suture 5 is inserted, and the above procedure is repeated. FIG. 19 is a schematic diagram for easily understanding the configuration of the present invention, showing a state in which the needle 16 (16A) is in contact with the joint capsule S. FIG. 20 shows the needle 16 (16B) and suture 5 being passed through the opening 3 of the retrieval member 1. FIG. 21 shows the needle 16 (16B) and suture 5 having been passed through the opening 3 of the retrieval member 1. FIG. 22 is a schematic diagram showing a state in which the needle 16 (16B) has been removed and only the suture thread 5 is left in the joint capsule S. FIG. 23 shows a state in which an insert 8 is inserted into the insertion space 6 of the recovery member 1 to hold the suture thread 5. For ease of understanding, in Figures 22 and 23, the needle 16 (16B) is shown to be removed, however, the suture thread 5 may be held by the insert 8 before the needle 16 (16B) is removed.

[0036] (Operation of the embodiment) The present invention has the above-mentioned configuration, and an arthroscope (endoscope) is inserted into the joint to confirm the damaged area D observed in the MRI examination, and a decision is made as to whether or not the meniscus H can be sutured. The skin of the joint capsule is incised according to the damaged area on the posterior side of the meniscus H to unfold the joint capsule, and the optimal area of ​​the joint capsule is incised. The recovery member 1 is inserted into the joint through this incision and placed parallel to the damaged area D as far as possible. Next, the fixing device 27 of the handle 30 is loosened, and while the one side handle 24 and the other side handle 26 can freely extend and retract, the tip of the needle 16 and the opening 3 of the retrieval member 1 are placed against the outside of the joint capsule so that they are perpendicular to each other to the extent possible, and temporarily fixed. Once the temporary fixing position is reached, the one side handle 24 and the other side handle 26 are fixed together with the fixing device 27, and then the mounting tube 16A inserted into the mounting tube 25 of the other side handle 26 is pressed against the joint capsule to fix the one side handle 24 and the other side handle 26 with the fixing device 27. The suture 5 is passed through the insertion space 17 of the needle 16B inserted into the mounting tube 16A, and the needle 16B is further advanced into the meniscus H, penetrating it directly through the opening 3 of the retrieval member 1 (Figure 14).

[0037] In this state, the insertion body 8 is inserted from the base side insertion port 7 of the retrieval member 1 and the tip portion 10 of the insertion body 8 is brought into contact with the abutment portion 11, thereby locking the tip of the suture 5 to the retrieval member 1. In this state, the needle 16 is removed, leaving only the suture thread 5 within the joint capsule. This procedure is repeated until a second suture 5 is inserted into and secured to the opening 3 of the retrieval member 1 . Once the two sutures 5 have been fixed to the retrieval member 1 by the insert 8, the retrieval member 1 is pulled out of the joint, whereby the sutures 5 are taken out of the joint and retrieved. The tips of the two retrieved sutures 5 are connected outside the joint, and the base of one of the sutures 5 is pulled out, resulting in the other suture 5 coming out from outside the joint, through the joint capsule, meniscus, damaged area, to the surface of the meniscus, then folding back and passing through the damaged area, meniscus, and joint capsule in that order.

[0038] Next, both ends of the two sutures 5 are ligated on the front side of the meniscus H to adhere the damaged area D and promote repair. In this case, the retrieval member 1 can optionally be curved to allow the opening 3 of the retrieval member 1 better access to the indicated site and facilitate suturing and ligation procedures. In this way, even though two parallel sutures 5 have been passed through the meniscus H, they can be easily inserted into the opening 3 of the retrieval member 1 located on the back side of the meniscus H in a direction intersecting with the two sutures 5, significantly shortening the time required for the insertion operation, avoiding the need for ligation within the joint capsule, and reducing the invasiveness to the patient. In addition, if the tip of one of the two sutures 5 is looped and the tip of the other suture 5 is straight, then the straight suture 5 can be passed through one of the loops and connected, which makes it easier to connect the two sutures 5.

[0039] In this case, the tip of the retrieval member 1, which has a straight or curved shape and a predetermined length and is semi-cylindrical or spatula-shaped, is provided with an opening 3 that opens in a direction intersecting the longitudinal direction of the retrieval member 1, so that the retrieval member 1 can be easily inserted into the joint capsule, which has a narrow procedural space.As a result, when the suture 5 is inserted from the intersecting direction of the retrieval member 1, the suture 5 can be inserted into the pair of openings 3 of the retrieval member 1 simply by moving the suture 5 straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1 and to retrieve it. In addition, an engagement groove 6A is provided on the inner surface of the retrieval member 1, and an axial rod-shaped insert body 8 is inserted and fitted into the engagement groove 6A from the base side of the retrieval member 1.Therefore, the suture 5 inserted into the pair of openings 3 of the retrieval member 1 can be clamped between the outer surface of the insert body 8 and the inner surface of the retrieval member 1 and pulled out of the body, making it easy to tie the suture 5 outside the body.

[0040] In addition, the tip of the retrieval member 1 has a tip wall 9 raised, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the part of the retrieval member 1 base side of the tip wall 9. Therefore, the insert 8 fitted and inserted into the retrieval member 1 abuts against the tip wall 9 of the retrieval member 1 and can clamp the suture 5 inside the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body. In addition, the tip wall 9 of the retrieval member 1 is formed at an abutment portion 11 which abuts the tip portion 10 of the insert body 8 inserted into the mating groove 6A from the base side of the retrieval member 1. Therefore, the tip portion 10 of the insert body 8 inserted into the retrieval member 1 abuts against the abutment portion 11 of the retrieval member 1, and the suture 5 inside the retrieval member 1 can be engaged by the tip portion 10 of the insert body 8 and the abutment portion 11 of the retrieval member 1, making it easy to pull out the suture 5 outside the body and facilitating the ligation of the suture 5 outside the body.

[0041] In addition, the tip portion 10 of the insertion body 8 and the abutment portion 11 of the retrieval member 1 are configured relative to each other so that the outer surface of the tip portion 10 abuts against the inner surface of the abutment portion 11 to prevent the suture 5 from falling out. Therefore, when the tip portion 10 of the insertion body 8 is fitted and inserted into the retrieval member 1, it abuts against the abutment portion 11 of the retrieval member 1 and the suture 5 can be clamped between the tip portion 10 of the insertion body 8 and the inner surface of the abutment portion 11, making it easy to pull out the suture 5 outside the body and easy to ligate the suture 5 outside the body. Furthermore, at least the tip 10 of the insertion body 8 is formed to be flexible and configured to prevent the suture 5 from being cut when the tip 10 of the insertion body 8 passes through the opening 3 of the recovery member 1. This makes it possible to easily pull out the suture 5 outside the body while preventing the suture 5 from being cut, and also makes it easy to tie the suture 5 outside the body.

[0042] In addition, the opening 3 of the retrieval member 1 is formed to be at least large enough to pass the suture 5 and / or the needle 16 therethrough, so that the suture 5 can be passed through the opening 3 of the retrieval member 1, facilitating insertion of the suture 5 into the retrieval member 1. In another embodiment of Figure 1B, an opening 3 that opens in a direction intersecting the axial direction of the retrieval member 1 is provided at the tip of a linear retrieval member 1 having a predetermined length and a hollow cylindrical shape. Therefore, the retrieval member 1 is inserted parallel to the affected area (damaged area D) of the meniscus H, and when a suture 5 is inserted in this state from the intersecting direction of the retrieval member 1, the suture 5 can be inserted into the pair of openings 3 of the retrieval member 1 simply by moving the suture 5 straight through the meniscus H, making it easy to insert the suture 5 into the retrieval member 1.

[0043] An insertion space 6 is provided inside the retrieval member 1, and an axial rod-shaped insertion body 8 is inserted from a base side insertion port 7 provided on the base side of the retrieval member 1.The suture 5 inserted into the pair of openings 3 of the retrieval member 1 can be pulled out of the body by the outer peripheral surface of the insertion body 8 and the inner peripheral surface of the retrieval member 1, making it easy to connect the suture 5 outside the body. The tip of the retrieval member 1 is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 base side of the tip wall 9, so as to face the retrieval member 1 in a direction transverse to the longitudinal direction of the retrieval member 1. Therefore, when an insert 8 is inserted into the retrieval member 1, it abuts against the tip wall 9 of the retrieval member 1 and can clamp the suture 5 within the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body and facilitating the operation of tying the suture 5 outside the body.

[0044] In another embodiment of Figure 1C, the side beyond the opening 3 of the retrieval member 1 is formed as a fitting portion 11A into which the tip portion 10 of the inserter 8 inserted into the insertion space 6 fits. Therefore, the tip portion 10 of the inserter 8 inserted into the retrieval member 1 fits into the fitting portion 11A at the tip of the retrieval member 1, and the suture 5 inside the retrieval member 1 can be clamped between the upper and lower surfaces of the fitting portion 11A and the inner surface of the tip wall 9, making it easy to pull out the suture 5 outside the body and easy to ligate the suture 5 outside the body. The tip 10 of the insertion body 8 and the abutment portion (fitting portion 11A) 11 of the retrieval member 1 are configured so that the outer surface of the tip 10 fits tightly against the inner surface of the abutment portion 11 to prevent the suture 5 located within the abutment portion (fitting portion 11A) 11 from falling out.Therefore, the tip 10 of the insertion body 8 inserted into the retrieval member 1 abuts (fits) against the abutment portion 11 of the retrieval member 1 to clamp the suture 5 within the retrieval member 1, making it easy to pull the suture 5 out of the body and easy to ligate the suture 5 outside the body.

[0045] The portion of the retrieval member 1 closer to the base than the opening 3 constitutes an insertion portion 15 for inserting the insert body 8, and the inner diameter of the insertion portion 15 is formed to be larger than the outer diameter of the insert body 8, thereby making it easy and smooth to insert the insert body 8 into the retrieval member 1, facilitating the engagement of the tip portion 10 of the insert body 8 with the tip portion 10 of the retrieval member 1, facilitating the operation of pulling the suture 5 out of the body, and facilitating the operation of tying the suture 5 outside the body. The opening 3 of the retrieval member 1 is formed to be at least large enough to pass the needle 16 and suture 5 through, but is configured to be large enough to allow the needle 16 equipped with the suture 5 that penetrates the meniscus H to pass through. Therefore, the suture 5 can be passed through the opening 3 of the retrieval member 1 together with the needle 16, making it easy to insert the suture 5 into the retrieval member 1.

[0046] The tip of the hollow, linear retrieval member 1 having a predetermined length and an insertion space 6 therein is closed by a tip wall 9, and an opening 3 having a predetermined length in the length direction of the retrieval member 1 is provided on the base side of the retrieval member 1 from the tip wall 9 so as to face the retrieval member 1 in a direction crossing the length direction, and the opening 3 is opened to a size that allows a suture 5 or a needle 16 to be inserted. A base side insertion port 7 for inserting an insert body 8 is formed on the base side of the retrieval member 1, and a contact portion 11 into which a tip portion 10 of the insert body 8 inserted into the insertion space 6 fits is formed on the side beyond the opening 3 of the retrieval member 1, so that the contact portion 11 of the retrieval member 1 is inserted from outside the body into an entrance path formed on the back side of the meniscus H, and the opening 3 of the retrieval member 1 is positioned on the back side of the torn and damaged portion D of the meniscus H. Meanwhile, an attachment tube 16A is placed against the joint capsule so as to penetrate the damaged area D of the meniscus H from the entry path on the front side of the meniscus H, a needle (needle 16B) 16 and suture 5 are advanced into the meniscus and joint, and either or both of the needle 16 and suture 5 are penetrated through the opening 3 of the retrieval member 1. Similarly, another suture 5 is penetrated through the opening 3. With the tips of the two sutures 5 left outside the retrieval member 1, an insert 8 is inserted into the insertion space 6 of the retrieval member 1, and the tip 10 of the insert 8 is tightly fitted into the abutment portion 11 of the retrieval member 1. The retrieval member 1 is then pulled out of the body together with the tips of the two sutures 5. The two removed sutures 5 are then connected, and the base of the looped suture 5 is pulled to suture the damaged area D of the meniscus H with the two sutures 5.

[0047] The retrieval member 1 is configured to be insertable into a straight, hollow, cylindrical casing 20 having a diameter larger than the outer diameter of the retrieval member 1 and inserted into the deep side of the meniscus H. The casing 20 is inserted parallel to the affected area (torn or damaged area D) of the meniscus H, the retrieval member 1 is inserted into this casing 20, the opening 3 of the retrieval member 1 is protruded beyond the tip of the casing 20, a suture 5 or needle 16 is inserted into the opening 3 of the retrieval member 1, and the tip of the suture 5 is engaged with the tip of the retrieval member 1. In this state, the retrieval member 1 is removed from the body while the casing 20 is left in place inside the body, and the suture 5 is pulled out of the body so that the ligation operation of the suture 5 can be performed outside the body. Then, by inserting the retrieval member 1 into the casing 20 again, the opening 3 of the retrieval member 1 is positioned near the meniscus H and the suture 5 is engaged with the retrieval member 1, allowing the suturing operation of the damaged area D of the meniscus H to be easily repeated.

[0048] The insert 8 is made of a material having flexibility and rigidity such as vinyl silicone so that the tip of the insert 8 reaches the tip 10 of the retrieval member 1 when inserted into the insertion space 6 of the retrieval member 1, making it easy to insert the insert 8. The opening 3 of the retrieval member 1 is formed in the shape of a rectangular slit having a width of 1 to 2 mm and a length of 12 to 20 mm, making it easy to insert the suture 5 from the crossing direction. Handle 30 is formed by fixing, by fixture 27, one handle 24 having an attachment tube 23 for attaching retrieval member 1 which has an opening 3 at its tip and through which suture 5 is inserted, and the other handle 26 having an attachment tube attachment tube 25 for attaching needle tube 16A which guides suture 5 through insertion near damaged area D of meniscus H, so that handle 30 can be held to insert insertion body 8 into retrieval member 1, making the insertion of insertion body 8 easy.

[0049] Mounting tube 23 and mounting tube 25 are arranged relative to each other so that the tip of needle 16 is positioned to intersect with opening 3 of retrieval member 1 with opening 3 located at a predetermined position near meniscus H, so that retrieval member 1 and needle 16 attached to handle 30 are positioned to intersect with each other inside the body, facilitating the insertion of retrieval member 1 and needle 16. That is, handle 30 is composed of one-side handle 24 having mounting tube 23 and other-side handle 26 movably attached to one-side handle 24, and the base of one-side handle 24 and the base of other-side handle 26 are overlapped and fixed with fixing screw fastener 35, so that the length of handle 30 can be adjusted to be long or short, improving operability and workability.

[0050] The mounting tube 23 and mounting tube 25 of the handle 30 are positioned relative to each other so that the tip of the needle 16 is positioned to intersect with the opening 3 of the retrieval member 1, with the opening 3 being located at a predetermined position near the meniscus H. Therefore, the predicted position where the suture 5 will be inserted into the damaged portion D of the meniscus H is set in advance, and the orientation of the mounting tube 23 of the handle 30 is set so that the opening 3 of the retrieval member 1 is located at this set location. Next, the one side handle 24 and the other side handle 26 are combined and fixed so that the mounting tube 25 of the other side handle 26 is positioned at an angle where the tip of the needle 16 will be inserted into the position where the opening 3 of the retrieval member 1 will be located.

[0051] Therefore, it is possible to simulate in advance outside the body the positional relationship between the damaged area D of the meniscus H, the opening 3 of the retrieval member 1, and the tip position of the needle 16.Based on this simulation, the retrieval member 1 and tube 16 are brought into contact with the joint capsule and inserted into the needle 16, and the suture 5 is then inserted and secured into the opening 3 of the retrieval member 1 through the needle 16, allowing the suturing operation to be performed in an extremely short time. A system for repairing a meniscus tear, the meniscus repair device comprising a retrieval member 1, a barrel 16 and a handle 30, the retrieval member 1 having an insertion space 6 therein and an insert 8 inserted into the insertion space 6, the insert 8 being advanceable through the insertion space 6 of the retrieval member 1, the needle 16 including a length of suture 5 configured to be at least partially threaded through tissue, the suture 5 being loaded into the needle 16, the suture 5 advancing from within the needle 16 being retained by the insert 8 in a state where it protrudes out of the retrieval barrel 1 through an opening 3 of the retrieval barrel 1, the retained suture 5 being a retrieval member. The hand do 30 is configured to be removed from the body together with the collection tube 1, and is a system that includes an attachment tube 23 that moves the collection tube 1 in the length direction of the collection tube 1 and fixes it at the desired position, a one-side handle 24 to which the attachment tube 23 is attached, an attachment tube 25 that moves the needle 16 in the length direction of the needle 16 and fixes it at the desired position, and a positioning device K that changes the attachment positions of the one-side handle 24 and the other-side handle 26 so that the suture 5 advancing from the needle 16 is directed toward the opening 3 of the collection tube 1, making it easy to suture the meniscus H.

[0052] That is, first, the location of the damaged portion D of the meniscus H in the knee is detected by an MRI examination. Based on the result of this, the insertion depth of one side handle 24 of the handle 30 of the recovery barrel 1 into the mounting barrel 23 is determined. Next, the insertion depth of the needle 16 into the mounting tube 25 of the other handle 26 of the handle 30 is determined so that the tip of the suture 5 is positioned in a straight line with respect to the opening 3 of the retrieval member 1 attached to the mounting tube 23 of the handle 30. In this state, the orientation of the mounting tube 23 of the one handle 24 of the handle 30 and the orientation of the mounting tube 25 of the other handle 26 are determined, and the retrieval member 1, handle 30, and needle 16 are positioned so that the needle 16 and the tip of the suture 5 will be inserted into the opening 3 of the retrieval member 1 if they are extended as they are. This allows easy simulation of the approach of the handle 30, retrieval member 1 and needle 16 of the suturing instrument to the site of the damaged portion D of the meniscus H within the joint capsule outside the body. [Explanation of symbols]

[0053] 1...retrieval member, 3...opening, 5...suture, 6...insertion space, 6A...engagement groove, 7...base side insertion port, 8...insertion body, 9...tip wall, 10...tip, 11...contact portion, 11A...engagement portion, 12...jig, 12A...protrusion, 13...jig, 13A...insertion groove, 13B...curved surface, 15...insertion portion, 16...needle, 16A...mounting tube, 16B...needle, 17...insertion space, 18...connecting portion, 20...casing, 23...mounting tube, 24...one side handle, 25...mounting tube, 26...other side handle, 27...fixing device, 30...handle, 33...fastener, 35...fastener, D...damaged portion, H...meniscus, S...joint capsule.

Claims

1. The suturing instrument has a straight or curved semi-cylindrical or spatula-shaped retrieval member (1) having a predetermined length and an opening (3) at the tip thereof, the opening (3) opening in a direction perpendicular to the longitudinal direction of the retrieval member (1).

2. 2. The suturing instrument according to claim 1, wherein a fitting groove is provided on the inner surface of the retrieval member, and an axial rod-shaped insert body is inserted into the fitting groove from the base side of the retrieval member.

3. 3. A suturing instrument according to claim 2, wherein the distal end of the retrieval member is provided with a distal wall, and the retrieval member is provided with an opening having a predetermined length in the longitudinal direction of the retrieval member on the base side of the distal wall.

4. 4. A suturing instrument according to claim 3, wherein the distal end wall of the retrieval member is formed at an abutting portion against which a distal end portion of an insert inserted into the fitting groove from the base side of the retrieval member abuts.

5. 5. The suturing instrument according to claim 4, wherein the tip portion 10 of the insertion body 8 and the abutment portion 11 of the recovery member 1 are configured such that the outer surface of the tip portion 10 abuts against the inner surface of the abutment portion 11 to prevent the suture thread 5 from falling out.

6. The suturing instrument according to claim 2, wherein at least the tip portion 10 of the insert 8 is formed to be flexible, and configured to prevent the suture 5 from being cut when the tip portion 10 of the insert 8 passes through the opening 3 of the recovery member 1.

7. 3. The suturing instrument according to claim 2, wherein the opening 3 of the recovery member 1 is formed to have a size for at least inserting the suture 5 and / or the needle 16 therethrough.

8. The suturing instrument comprises a hollow tubular retrieval member having a predetermined length and a straight or curved shape, and an opening portion at the tip of the retrieval member, the opening portion opening in a direction intersecting with the axial direction of the retrieval member.

9. 9. The suturing instrument according to claim 8, wherein an insertion space 6 is provided inside the retrieval member 1, and an axial rod-shaped insert body 8 is inserted from a base side insertion port 7 provided on the base side of the retrieval member 1.

10. In claim 8, the tip of the retrieval member 1 is closed by a tip wall 9, and an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 base side of the tip wall 9 so as to face each other in a direction perpendicular to the longitudinal direction of the retrieval member 1.

11. 11. A suturing instrument according to claim 10, wherein the distal end wall of the retrieval member is formed at an abutting portion against which the distal end of the insertion body inserted from the base side of the retrieval member into the insertion space comes into abutment.

12. A suturing instrument as claimed in claim 11, in which the tip portion 10 of the insertion body 8 and the abutment portion 11 of the recovery member 1 are configured such that the outer surface of the tip portion 10 abuts against the inner surface of the abutment portion 11 to prevent the suture thread 5 located within the abutment portion 11 from falling out.

13. A suturing instrument according to claim 12, wherein at least the tip portion 10 of the insert 8 is formed to be flexible, and configured to prevent the suture 5 from being cut when the tip portion 10 of the insert 8 passes through the opening 3 of the recovery member 1.

14. 14. The suturing instrument according to claim 13, wherein a portion of the retrieval member (1) on the base side from the opening (3) serves as an insertion portion (15) into which an insertion body (8) is inserted, and the inner diameter of the insertion portion (15) is formed to be larger than the outer diameter of the insertion body (8).

15. 15. The suturing instrument according to claim 14, wherein the opening 3 of the recovery member 1 is formed to have a size for at least inserting the suture 5 and / or the needle 16 therethrough.

16. 16. The suturing instrument according to claim 15, wherein the opening 3 of the recovery member 1 is sized to allow a needle 16 having a suture 5 attached thereto that penetrates the meniscus H to pass therethrough.

17. 17. The suturing instrument according to claim 16, wherein the distal end wall 9 of the recovery member 1 is formed in an arc shape in a side view.

18. 8. A suturing instrument according to claim 8, in which the tip of a hollow, straight or curved retrieval member 1 having a predetermined length and an insertion space 6 therein is closed by a tip wall 9, an opening 3 having a predetermined length in the longitudinal direction of the retrieval member 1 is provided on the retrieval member 1 on the base side of the tip wall 9 so as to face each other in the crossing direction of the retrieval member 1, the opening 3 being opened to a size allowing a suture 5 and / or a needle 16 to be inserted, a base side insertion port 7 for inserting an insert body 8 is formed on the base side of the retrieval member 1, and an abutment portion 11 is formed on the tip side of the retrieval member 1 against which the tip portion 10 of the insert body 8 inserted into the insertion space 6 abuts to abut and engage the inserted suture 5.

19. 9. The suturing instrument according to claim 8, wherein the retrieval member is insertable into a linear hollow cylindrical casing having a diameter larger than the outer diameter of the retrieval member, the casing being inserted into the back side of the meniscus.

20. In claim 8, the insert 8 is a suturing instrument formed from a material having flexibility and rigidity, such as vinyl silicone, so that the tip 10 of the insert 8 reaches the tip of the recovery member 1 when inserted into the insertion space 6 of the recovery member 1.

21. 9. The suturing instrument according to claim 8, wherein the opening 3 of the recovery member 1 is formed in a slit shape having a width of 1 to 2 mm and a length of 12 to 20 mm.

22. In claim 8, a positioning device for suturing in which a handle 30 is formed by overlapping and fixing with a fixing device 27 a handle on one side 24 having an attachment tube 23 to which a retrieval member 1 having an opening 3 at its tip is attached, and a handle on the other side 26 having an attachment tube 25 to which a needle 16 for inserting and guiding a suture 5 near a damaged portion D of the meniscus H is attached, the handles overlapping and being fixed with a fixing device 27 so that the overlap length can be adjusted.

23. In claim 22, the one side handle 24 and the other side handle 26 are configured to fix the recovery member 1 and the needle 16 in an intersecting state at any angle by adjusting the overlap length between the one side handle 24 and the other side handle 26.

24. In claim 22, the mounting tube 23 and the mounting tube 25 are arranged relative to each other so that the tip of the needle 16X (needle 16?) is positioned so as to intersect with the opening 3 of the retrieval member 1, with the opening 3 being positioned at a predetermined position near the meniscus H.

25. In claim 22, the mounting tube 23 and the mounting tube 25 of the handle 30 are arranged relative to each other so that the tip of the needle 16 is positioned so as to intersect with the opening 3 of the retrieval member 1 with the opening 3 positioned at a predetermined position near the meniscus H.

26. A system for repairing a meniscus tear, the meniscus repair device including a retrieval member 1, a needle 16, and a handle 30, the retrieval member 1 having an insertion space 6 therein and an insert 8 disposed within the insertion space 6, the insert 8 being advanceable through the insertion space 6 of the retrieval member 1, the needle 16 having an insertion space 17 therein and a suture 5 disposed within the insertion space 17, the suture 5 being advanceable through the insertion space 17 of the needle 16, the needle 16 including a length of suture 5 configured to be threaded at least partially through tissue, the suture 5 being loaded into the needle 16, and the suture 5 emerging from within the needle 16 being circumferentially retracted. The system is configured such that the suture 5 is held by the insert 8 in a state where it protrudes outside the retrieval member 1 through the opening 3 of the retrieval member 1, and the held suture 5 is removed from the body together with the retrieval member 1, and the hand 30 has an attachment tube 23 that moves the retrieval member 1 in the length direction of the retrieval member 1 and fixes it at a desired position, a one-side handle 24 to which the attachment tube 23 is attached, an attachment tube 25 that moves the needle 16 in the length direction of the needle 16 and fixes it at a desired position, and a other-side handle 26 to which the attachment tube 25 is attached, and includes a positioning device K that changes the attachment positions of the one-side handle 24 and the other-side handle 26 so that the suture 5 advancing from the needle 16 is directed toward the opening 3 of the retrieval member 1.

Citation Information

Patent Citations

  • JP2010-440418A