Surgical instrument for valve repair surgery in animals

Abstract

To provide a surgical instrument for valve repair surgery of an animal capable of determining the length of an artificial thread even when the length of a normal tendon is not used as a reference.SOLUTION: A surgical instrument 1 for valve repair surgery of an animal includes a support portion 20 which is rod-like and has an end portion on one side in a longitudinal direction capable of abutting on a ventricle 56 of a heart 50 of the animal, and a thread holding portion 30 which is provided on an end portion on the other side of the support portion 20, has three protrusions 32A, 32B, and 32C on an end surface, and is capable of abutting on a valve cusp 52 of the heart 50.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to surgical instruments for use in animal valve repair surgery. [Background technology]

[0002] Conventionally, a known method of valvuloplasty involves connecting the mitral valve cusps and papillary muscles with artificial threads for artificial chordae to treat conditions in which one or more of the chordae tendineae that connect the mitral valve cusps to the papillary muscles stretch or break.

[0003] For example, Patent Document 1 describes a surgical instrument for humans in which the length of an artificial thread is determined based on the length of normal chordae tendineae. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Publication No. 2022-165479 Summary of the Invention [Problem to be solved by the invention]

[0005] However, when applying valve repair surgery to animals other than humans, such as dogs and cats, it is often the case that multiple or all chordae tendineae are ruptured, making it difficult to determine the length of the artificial thread based on the length of normal chordae tendineae, as in the technique described in Patent Document 1.

[0006] In view of the above problems, the present invention aims to provide a surgical instrument for use in animal valve repair surgery that can determine the length of an artificial thread even when the length of the chordae tendineae is not used as a standard. [Means for solving the problem]

[0007] In order to solve the above problems, according to a first aspect of the present invention, there is provided the following surgical instrument for use in animal valve repair surgery: This surgical instrument for use in animal valve repair surgery is placed between the ventricle and valve cusp of the animal's heart, and is rod-shaped and long in one direction, and includes a support part whose end located on one longitudinal side is capable of contacting the ventricle of the animal's heart, and a suture holding part that is provided on an end located on the other longitudinal side of the support part, has three protrusions on the other side, and is capable of contacting the valve cusp of the heart.

[0008] In addition, in the surgical instrument for animal valve repair surgery according to the second aspect of the present invention, the three protrusions are each arranged at each vertex of an imaginary triangle when viewed from the suture holding portion side in the longitudinal direction.

[0009] In addition, in the surgical instrument for animal valve repair surgery according to the third aspect of the present invention, the length of one of the protrusions in the longitudinal direction is shorter than the length of the other of the protrusions in the longitudinal direction.

[0010] Furthermore, in the surgical instrument for animal valve repair surgery according to the fourth aspect of the present invention, when viewed from the thread holding portion side in the longitudinal direction, the imaginary triangle connecting the tips of the three protrusions is an approximately isosceles triangle.

[0011] In addition, in the surgical instrument for animal valve repair surgery according to the fifth aspect of the present invention, the longitudinal length of one of the protrusions having its tip at a vertex that is not adjacent to the base of the approximately isosceles triangle is shorter than the longitudinal lengths of the other protrusions.

[0012] In addition, in the surgical instrument for animal valve repair surgery according to a sixth aspect of the present invention, at least one of the protrusions is provided so as to protrude in the outer circumferential direction of the suture holding portion.

[0013] Moreover, in the surgical instrument for animal valve repair surgery according to the seventh aspect of the present invention, the support part is removable.

[0014] In addition, in the surgical instrument for animal valve repair surgery according to an eighth aspect of the present invention, one end of the support portion is rounded.

[0015] In addition, in the surgical instrument for animal valve repair surgery according to a ninth aspect of the present invention, the diameter of the suture holding portion is larger than the diameter of the support portion.

[0016] In addition, in the surgical instrument for animal valve repair surgery according to a tenth aspect of the present invention, the protrusion is made of an elastic material. [Effects of the Invention]

[0017] According to the surgical instrument for animal valve repair surgery of the present invention, by having three protrusions, even if the length of the chordae tendineae of normal tendines is not used as the standard, the length of the artificial threads attached to one protrusion can be used as the standard to determine the lengths of the other artificial threads. [Brief explanation of the drawings]

[0018] [Figure 1] 1 is a perspective view showing a surgical instrument according to an embodiment of the present invention. [Figure 2] 2 is a plan view of the suture holding section shown in FIG. 1 as viewed from direction A. FIG. [Figure 3] 1 is a schematic diagram showing an example of a heart to which a surgical instrument is applied. [Figure 4] 1 is a schematic diagram of surgical instruments positioned within the heart. [Figure 5] FIG. 10 is a schematic diagram of a state in which an artificial thread is hung on a first protrusion of a surgical instrument. [Figure 6] FIG. 10 is a schematic diagram showing a state in which a second artificial thread is hung on the second protrusion of a surgical instrument and a third artificial thread is hung on the third protrusion. [Figure 7] This is a schematic diagram of the surgical instruments removed from the heart and the excess portions of each artificial thread cut off. DETAILED DESCRIPTION OF THE INVENTION

[0019] Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. To facilitate understanding of the description, the same components in the drawings will be denoted by the same reference numerals as much as possible, and duplicated descriptions will be omitted.

[0020] ---Embodiment --- First, a surgical instrument 1 according to an embodiment of the present invention will be described.

[0021] <Overall structure> FIG. 1 is a perspective view showing a surgical instrument 1 according to an embodiment of the present invention.

[0022] As shown in Figure 1, a surgical instrument 1 according to an embodiment of the present invention includes a rod-shaped support part 20 that is long in one direction, and a thread holding part 30 provided at the end of the support part 20. The surgical instrument 1 is a surgical instrument for animal valve repair surgery that is capable of determining the chordae tendineae length of artificial chordae. The surgical instrument 1 has a substantially cylindrical shape that extends along the axial direction (hereinafter referred to as the longitudinal direction).

[0023] The support portion 20 has a tip portion 22, a rod portion 24, and a protrusion 26. The tip portion 22 is one end of the rod portion 24. The protrusion 26 is the end of the rod portion 24 opposite the tip portion 22. The tip portion 22 has a rounded conical shape, which prevents damage to the heart if the end of the surgical instrument 1 hits the heart when placed inside the heart during valve repair surgery. The protrusion 26 fits into the recess 34 of the suture holding portion 30, connecting the support portion 20 to the suture holding portion 30. The support portion 20 can be removed by pulling it out of the suture holding portion 30. The longitudinal length of the rod portion 24 can be adjusted, for example, by cutting a portion of the rod portion 24. This allows the surgical instrument 1 to be adjusted to a length that matches the size of the animal's heart. For example, when applying the surgical instrument 1 to a Chihuahua, the longitudinal length of the surgical instrument 1 can be adjusted to be shorter than when applying the surgical instrument 1 to a Great Dane, which has a larger heart than a Chihuahua.

[0024] The suture holding portion 30 has a protrusion 32 and a recess 34. The suture holding portion 30 is provided at the end of the surgical instrument 1 located on the other longitudinal side of the support portion 20. In other words, the suture holding portion 30 is provided on the opposite side of the distal end 22 of the support portion 20. The protrusion 32 includes a first protrusion 32A, a second protrusion 32B, and a third protrusion 32C. The longitudinal length of the first protrusion 32A is shorter than the longitudinal lengths of the other second protrusions 32B and third protrusions 32C. The protrusion 32 is provided on the other longitudinal side of the suture holding portion 30. In other words, the protrusion 32 is provided on the opposite side of the suture holding portion 30n. During valve repair surgery, the lengths of the artificial sutures can be aligned by threading the artificial sutures on each protrusion 32. The protrusions 32 are made of an elastic material. For example, the protrusions 32 are made of a material such as silicone rubber, natural rubber, or polyurethane. This makes it easy to attach and detach sutures to and from each protrusion 32 during valve repair surgery. The recess 35 fits into the protrusion 26 of the support part 20. The suture holding part 30 is cylindrical on the support part 20 side and has a triangular prism shape with rounded corners as it approaches the end face where the protrusions 32 are provided.

[0025] The diameter of the suture holding portion 30 is larger than the diameter of the support portion 20. Here, the diameter of the support portion 20 refers to the average of the maximum and minimum outer diameters measured at any cross section of the support portion 20. Furthermore, the diameter of the suture holding portion 30 refers to the average of the maximum and minimum outer diameters of the end face of the suture holding portion 30 where the protrusions 32 are provided. If the diameter of the support portion 20 is too large, it is difficult to handle, for example, it may get caught inside the heart during valve repair surgery. On the other hand, if the diameter of the support portion 20 is too small, it is difficult to stably position the surgical instrument 1 during valve repair surgery. Therefore, the diameter of the support portion 20 may preferably be approximately 1 mm to approximately 5 mm, and more preferably approximately 3 mm. Furthermore, if the diameter of the suture holding portion 30 is too large, it is difficult to handle, for example, it may get caught inside the heart during valve repair surgery, just like the support portion 20. On the other hand, if the diameter of the suture holding portion 30 is too small, it is difficult to secure space when threading the artificial suture onto each protrusion 32. Therefore, the diameter of the thread-holding part 30 may preferably be about 2 mm to about 6 mm, and more preferably about 4 mm. The diameters of the thread-holding part 30 and the support part 20 may be designed to any size depending on the size of the heart of the animal to which they are applied, the surgical field, etc., but from the viewpoint of ensuring space when the artificial thread is hung on each protrusion 32, it is more desirable that the diameter of the thread-holding part 30 be larger than the diameter of the support part 20.

[0026] FIG. 2 is a plan view of the suture holding part 30 shown in FIG. 1 as seen from the direction A. FIG.

[0027] As shown in FIG. 2 , the first protrusion 32A, the second protrusion 32B, and the third protrusion 32C are provided at the vertices of an imaginary, approximately isosceles triangle T1 of the thread holding portion 30 when viewed from the thread holding portion 30 in the longitudinal direction. That is, the imaginary, approximately isosceles triangle T1 represents a triangle connecting the joints of each protrusion 32 with the thread holding portion 30. The base of the approximately isosceles triangle T1 is defined as L12, the sides of approximately equal length are defined as L14 and L16, and the height of the approximately isosceles triangle T1 is defined as L18. Furthermore, the approximately isosceles triangle T2 is defined as an imaginary triangle connecting the tips of the three protrusions 32 when viewed from the thread holding portion 30 in the longitudinal direction. The base of the approximately isosceles triangle T2 is defined as L22, the sides of approximately equal length are defined as L24 and L26, and the height of the approximately isosceles triangle T2 is defined as L28. Here, the second protrusion 32B and the third protrusion 32C have their tips at vertices that contact the base L22 of the approximately isosceles triangle T2. Furthermore, the first protrusion 32A has its tip at a vertex that does not contact the base L22 of the approximately isosceles triangle T2. The size of the approximately isosceles triangle T1 is smaller than the size of the approximately isosceles triangle T2. In other words, each protrusion 32 is provided to protrude in the outer circumferential direction of the suture holding portion 30. This makes it easier to attach and detach the artificial suture to each protrusion 32 during valve repair surgery, compared to when each protrusion 32 is provided to protrude in the central axis direction of the surgical instrument 1.

[0028] The length L22, which is the base of the approximately isosceles triangle T2, may be preferably about 3 mm to about 7 mm, more preferably about 5 mm, depending on the distance between the valve cusps of the animal's heart. Furthermore, the length L28, which is the height of the approximately isosceles triangle T2, may be preferably about 2 mm to about 6 mm, more preferably about 4 mm, depending on the distance between the valve cusps of the animal's heart. If the length of L22 or L28 is too long, it may get caught on the valve cusps during valve repair surgery, interfering with the surgery. On the other hand, if the length of L22 or L28 is too short, the threading operation becomes difficult, interfering with the surgery. The isosceles triangle T1 may be a triangle that is not an isosceles triangle. Furthermore, the isosceles triangle T2 may also be a triangle that is not an isosceles triangle.

[0029] <Heart structure where surgical instruments are applied> FIG. 3 is a schematic diagram showing an example of a heart 5 to which the surgical instrument 1 is applied.

[0030] As shown in FIG. 3 , the heart 50 includes valve leaflets 52, papillary muscles 54, and a ventricle 56. The valve leaflets 52 are part of the valves of the heart 50 and control the opening and closing of the valve. The valve leaflets 52 consist of a posterior leaflet 52A and an anterior leaflet 52B. The papillary muscles 54 are muscles that maintain the proper position of the valve leaflets 52 and assist in accurate valve closure. The papillary muscles 54 are connected to the valve leaflets 52 by normal chordae tendineae or artificial sutures. The ventricle 56 is made up of muscle and serves to pump blood throughout the body. The ventricle 56 has a ventricular base 57 located in the direction of the papillary muscles 54 from the valve leaflets 52.

[0031] <Usage Instructions> Next, an example of a procedure for using the surgical instrument 1 will be described with reference to Figures 3 to 7. In the example shown in Figure 3, all of the chordae tendineae between the valve cusp 52 and the papillary muscle 54 have been lost, causing prolapse, and new artificial chordae tendineae are to be formed between the valve cusp 52 and the papillary muscle 54.

[0032] First, before the valve repair surgery, the distance between the valve cusp 52 and the ventricular bottom 57 is measured ultrasonically, and the length of the surgical instrument 1 is adjusted so that it is approximately the same as the length from the valve cusp 52 to the ventricular bottom 57.

[0033] FIG. 4 is a schematic diagram of the surgical instrument 1 placed inside the heart 50. As shown in FIG.

[0034] As shown in FIG. 4 , the support unit 20 has a tip 22, which is one longitudinal end, that can abut against a ventricle 56 of an animal's heart 50. Specifically, the tip 22 of the support unit 20 is positioned near the bottom 57 of the ventricle. The suture holder 30 can also abut against a valve cusp 52 of the heart 50. Specifically, the suture holder 30 is positioned between the posterior cusp 52A and the anterior cusp 52B. The suture holder 30 is positioned such that the first protrusion 32A is positioned toward the posterior cusp 52A and the second protrusion 32B and the third protrusion 32C are positioned toward the anterior cusp 52B. The chest of the animal to be operated on is located to the left of FIG. 4 , and the back of the animal is located to the right. Valve repair is often performed by thoracotomy, so the surgeon performs the procedure while viewing the heart 50 from direction B.

[0035] FIG. 5 is a schematic diagram of the surgical instrument 1 with the artificial thread Y1 hung on the first protrusion 32A.

[0036] As shown in FIG. 5, the papillary muscle 54 is pierced with an artificial thread Y1 for forming artificial chordae tendineae. The artificial thread Y1 is then pierced through the posterior cusp 52A and hooked around the first protrusion 32A. The artificial thread Y1 hooked around the first protrusion 32A is then tied so that no excess thread remains. The artificial thread Y1 is pierced through the papillary muscle 54 and the posterior cusp 52A using, for example, a puncture needle, although the puncture needle is not shown. As an example, the artificial thread Y1 can be a thread made of a synthetic resin material, such as Gore-Tex (registered trademark). However, various threads suitable for forming artificial chordae tendineae may be used as the artificial thread Y1.

[0037] FIG. 6 is a schematic diagram of the surgical instrument 1 with the second artificial thread Y2 hooked around the second protrusion 32B and the third artificial thread Y3 hooked around the third protrusion 32C.

[0038] As shown in Figure 6, the papillary muscle 54 is pierced with the artificial thread Y2. The artificial thread Y2 is then pierced through the anterior cusp 52B and hooked around the second protrusion 32B. The artificial thread Y2 hooked around the second protrusion 32B is then tied so that no excess thread remains. Similarly, the artificial thread Y3 is pierced through the papillary muscle 54, pierced through the anterior cusp 52B, and hooked around the third protrusion 32C, and then tied so that no excess thread remains. By manipulating the artificial threads Y2 and Y3 as described above, the lengths of the artificial threads Y2 and Y3 can be made approximately the same as the length of the artificial thread Y1.

[0039] Here, the first protrusion 32A is located in front as seen from the surgeon performing the procedure from direction B. The second protrusion 32B and the third protrusion 32C are located on the far side as seen from the surgeon. Therefore, the longitudinal length of the first protrusion 32A is shorter than the longitudinal lengths of the other second protrusions 32B and third protrusions 32C, making the second protrusions 32B and third protrusions 32C easier to see and facilitate threading during the procedure. The longitudinal length of the first protrusion 32A may be preferably about 1 mm to about 5 mm, and more preferably about 3 mm. The longitudinal length of the second protrusion 32B or the third protrusion 32C may be preferably about 2 mm to about 6 mm, and more preferably about 4 mm.

[0040] By arranging each protrusion 32 at each vertex of an imaginary triangle on the end face of the thread holding part 30, it is possible to arrange the first protrusion 32A to be located on the posterior apex 52A side, and the second protrusion 32B and the third protrusion 32C to be located on the anterior apex 52B side. This makes it easy to make the lengths of the artificial threads Y1 to Y3 approximately the same.

[0041] Since the imaginary triangle connecting the connecting portions of each protrusion 32 with the thread holding part 30 is a substantially isosceles triangle, the second protrusion 32B and the third protrusion 32C located on the far side when viewed from direction B are arranged at substantially equal intervals as seen by the surgeon. This makes threading easier and also makes it easier to make the lengths of the artificial thread Y2 and the artificial thread Y3 substantially the same.

[0042] FIG. 7 is a schematic diagram showing the state in which the surgical instrument 1 has been removed from the heart 50 and the excess portions of the artificial threads Y1 to Y3 have been cut off.

[0043] As shown in FIG. 7, the lengths of the artificial yarns Y1 to Y3 are made approximately the same.

[0044] In the usage procedure described in this embodiment, the artificial thread Y1 is first threaded around the first protrusion 32A, and then the artificial threads Y2 to Y3 are threaded around the second protrusion 32B and the third protrusion 32C. However, the order in which the artificial threads Y1 to Y3 are threaded is not limited to this. For example, an artificial thread may be threaded around the second protrusion 32B or the third protrusion 32C first, and then an artificial thread may be threaded around the first protrusion 32A. Furthermore, in the embodiment, the usage method is described in which an artificial thread threaded through the posterior leaflet 52A is threaded around the first protrusion 32A, and an artificial thread threaded through the anterior leaflet 52B is threaded around the second protrusion 32B or the third protrusion 32C. However, the correspondence between each protrusion 32 and the valve leaflets 52 is not limited to this. For example, an artificial thread threaded through the anterior leaflet 52B may be threaded around the first protrusion 32A, and an artificial thread threaded through the posterior leaflet 52A may be threaded around the second protrusion 32B or the third protrusion 32C. The procedure and method of use may be changed as appropriate depending on the conditions of the surgical field, the positions and sizes of the valve cusps 52, papillary muscles 54, and ventricular bottom 57, etc.

[0045] <Action and effect> As described above, the surgical instrument 1 for animal valve repair surgery according to this embodiment is a surgical instrument 1 for animal valve repair surgery that is placed between the ventricle 56 and the valve cusp 52 of the animal's heart 50, and is rod-shaped and long in one direction, and comprises a support part 20 whose end located on one side in the longitudinal direction is able to abut against the ventricle 56, and a suture holding part 30 that is provided at the end located on the other side in the longitudinal direction of the support part 20, has three protrusions 32 on the other side, and is able to abut against the valve cusp 52 of the heart 50.

[0046] According to this configuration, by having three protrusions 32, even if the length of the normal tendineal cord is not used as the standard, the length of the other artificial cords Y2 to Y3 can be determined based on the length of the artificial cord Y1 hung on one protrusion 32.

[0047] Furthermore, in the surgical instrument 1 for animal valve repair surgery, the three protrusions 32 are arranged at the vertices of an imaginary triangle when viewed from the suture holding portion 30 side in the longitudinal direction.

[0048] Generally, the valve cusps have an anterior cusp and a posterior cusp, and the artificial thread connects the papillary muscle to the anterior cusp or the posterior cusp. Therefore, with this configuration, by arranging one corner of an imaginary triangle near either the anterior cusp 52B or the posterior cusp 52A, and arranging two corners of the imaginary triangle near the other of the anterior cusp 52B or the posterior cusp 52A, it becomes easy to make the lengths of the artificial threads Y1 to Y3 approximately the same.

[0049] Furthermore, in the surgical instrument 1 for animal valve repair surgery, the length of one of the protrusions 32A in the longitudinal direction is shorter than the length of the other protrusions 32 in the longitudinal direction.

[0050] According to this configuration, during valve repair surgery, the protrusion 32, which is often located at the back, is higher than the protrusion 32 at the front, making the protrusion 32 at the back easier to see and facilitating the operation of attaching or removing the artificial thread.

[0051] Furthermore, in the surgical instrument 1 for animal valve repair surgery, when viewed from the suture holding portion 30 side in the longitudinal direction, an imaginary triangle connecting the tips of the three protrusions 32 is a substantially isosceles triangle T2.

[0052] According to this configuration, during valve repair surgery, the protrusions 32, which are often located at the back, are positioned at approximately equal intervals with the protrusions 32 on the front side as seen from the surgeon, making it easy to make the lengths of the artificial threads Y1 to Y3 approximately the same.

[0053] In addition, in the surgical instrument 1 for animal valve repair surgery, the longitudinal length of one protrusion 32A having its tip at a vertex that does not contact the base L28 of the approximately isosceles triangle T2 is shorter than the longitudinal length of the other protrusions 32.

[0054] According to this configuration, the protrusions 32, which are often located at the back during valve repair surgery, are arranged at approximately equal intervals from the surgeon's perspective and are set higher than the protrusions 32 at the front, making the protrusions 32 at the back easier to see and making it easier to make the lengths of the artificial threads Y1 to Y3 approximately the same.

[0055] Furthermore, in the surgical instrument 1 for use in animal valve repair surgery, at least one of the projections 32 is provided so as to protrude in the outer circumferential direction of the suture holding portion 30.

[0056] With this configuration, compared to when each protrusion 32 is provided protruding in the direction of the central axis of the surgical instrument 1, it becomes easier to attach and detach the artificial thread to each protrusion 32 during valve repair surgery.

[0057] Furthermore, in the surgical instrument 1 for animal valve repair surgery, the support portion 20 is removable.

[0058] According to this configuration, the length of the surgical instrument 1 can be adjusted to match the size of the heart 50.

[0059] Furthermore, in the surgical instrument 1 for animal valve repair surgery, one end of the support portion 20 is rounded.

[0060] This configuration can prevent the heart 50 from being damaged.

[0061] Furthermore, in the surgical instrument 1 for animal valve repair surgery, the diameter of the suture holding portion 30 is larger than the diameter of the support portion 20 .

[0062] According to this configuration, it is possible to ensure space when the artificial threads Y1 to Y3 are hung on the protrusions 32, and the operation of hanging or removing the artificial threads becomes easy.

[0063] In addition, in the surgical instrument 1 for animal valve repair surgery, the protrusions 32 are made of an elastic material.

[0064] According to this configuration, the operation of attaching or detaching the artificial thread becomes easier compared to when the protrusions 32 are not made of an elastic material.

[0065] ---Variations--- The present invention is not limited to the above-described embodiments. In other words, designs that are produced by those skilled in the art with appropriate design modifications to the above-described specific examples are also included within the scope of the present invention as long as they include the features of the present invention. Furthermore, the elements of the above-described embodiments and the following modifications can be combined to the extent technically possible, and such combinations are also included within the scope of the present invention as long as they include the features of the present invention.

[0066] For example, although the tip portion 22 has been exemplified as having a rounded conical shape, the shape of the tip portion 22 is not limited to this. For example, the support portion 20 may have a uniform cylindrical shape. Furthermore, at least a portion of the tip portion 22 may be made of an elastic material. For example, the tip portion 22 may be covered with a hollow, hemispherical piece of rubber.

[0067] In the above embodiment, the longitudinal length of the surgical instrument 1 is adjustable by cutting a portion of the rod portion 24 and the protrusion portion 26, but the method for adjusting the length of the surgical instrument 1 is not limited to this. For example, support portions 20 of different lengths may be combined with the same suture holding portion 30 to suit the size of the animal's heart.

[0068] Furthermore, in the above-described embodiment, a configuration in which three protrusions 32 are provided is exemplified, but the number of protrusions 32 may be two, four, or more. However, in valve repair surgery, three chordae tendineae, including artificial chordae and normal chordae tendineae, are often used, and it is preferable to provide three or more protrusions 32. For example, when four protrusions 32 are provided, the protrusions 32 may be provided at each vertex of an imaginary triangle on the suture holding unit 30 and at the center of the triangle, or at each vertex of an imaginary square on the suture holding unit 30. By providing four or more protrusions 32, it is possible to use the three necessary protrusions 32 in the valve repair surgery depending on the positions of the valve cusps 52 in the heart 50, etc.

[0069] The protrusions 32 may also be made of materials other than elastic materials. For example, the protrusions 32 may be made of materials such as hard plastic, metal, or ceramic.

[0070] In addition, the thread holding part 30 has been shown as having a cylindrical shape on the support part 20 side and a triangular prism shape with rounded corners toward the end face where the protrusions 32 are provided, but the shape of the thread holding part 30 is not limited to this. For example, the thread holding part 30 may be spherical, uniformly triangular prism-shaped, or uniformly cylindrical. Furthermore, the outer diameter of the end face of the thread holding part 30 on the support part 20 side may be approximately the same as the outer diameter of the support part 20, so that the joint between the support part 20 and the thread holding part 30 is smoothly joined.

[0071] Furthermore, in the above-described embodiment, a configuration in which each protrusion 32 is provided so as to protrude in the outer circumferential direction of the surgical instrument 1 is given as an example, but the protrusion direction of the protrusions 32 is not limited to this. For example, each protrusion 32 may be provided so as to protrude parallel to the longitudinal direction, or each protrusion 32 may be provided so as to protrude in the central axis direction of the surgical instrument 1. However, in order to make it easier to thread the artificial thread onto each protrusion 32, a configuration in which each protrusion 32 is provided so as to protrude in the outer circumferential direction of the surgical instrument 1 is more desirable.

[0072] Furthermore, in the above-described embodiment, the longitudinal length of the first protrusion 32A is shorter than the longitudinal lengths of the other second protrusions 32B or third protrusions 32C, but the longitudinal lengths of each protrusion 32 are not limited to this. For example, the longitudinal length of the first protrusion 32A may be the same as or longer than the longitudinal lengths of the other second protrusions 32B or third protrusions 32C. However, from the viewpoints of visibility during treatment and ease of threading, it is preferable that the longitudinal length of the first protrusion 32A be shorter than the longitudinal lengths of the other second protrusions 32B or third protrusions 32C. [Explanation of symbols]

[0073] 1: surgical instrument, 5: heart, 20: support part, 30: thread holding part, 32: protrusion, 50: heart, 52: valve cusp, 56: ventricle

Claims

1. A surgical instrument for use in an animal valve repair surgery, which is placed between a ventricle and a valve leaflet of the animal's heart, comprising: a support part having a rod shape that is long in one direction and an end part located on one side in the longitudinal direction that can abut against the ventricle; a suture holding part that is provided at an end part located on the other side in the longitudinal direction of the support part, has three protrusions on the other side, and is capable of contacting the valve cusp; A surgical instrument comprising:

2. The three protrusions are provided at the vertices of an imaginary triangle when viewed from the suture holding portion side in the longitudinal direction. The surgical instrument of claim 1 .

3. The length of one of the protrusions in the longitudinal direction is shorter than the length of the other of the protrusions in the longitudinal direction. The surgical instrument of claim 2.

4. When viewed from the suture holding portion side in the longitudinal direction, an imaginary triangle connecting the tips of the three protrusions is a substantially isosceles triangle. The surgical instrument of claim 2.

5. the length in the longitudinal direction of one of the protrusions having a tip at a vertex that is not in contact with the base of the approximately isosceles triangle is shorter than the length in the longitudinal direction of the other of the protrusions; 5. The surgical instrument of claim 4.

6. At least one of the protrusions is provided so as to protrude in an outer circumferential direction of the thread holding portion. The surgical instrument of claim 2.

7. The support is removable. A surgical instrument according to any one of claims 1 to 6.

8. One end of the support is rounded. A surgical instrument according to any one of claims 1 to 6.

9. The diameter of the suture holding portion is larger than the diameter of the support portion. A surgical instrument according to any one of claims 1 to 6.

10. The protrusion is made of an elastic material. A surgical instrument according to any one of claims 1 to 6.

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