Suture device

Abstract

The present invention provides a suturing device that can more reliably and precisely oscillate the oscillating member to intersect the insertion member at the desired timing. [Solution] The suturing device 100 is a suturing device used for suturing biological tissue, and the suturing device 100 comprises a long insertion member 10 that is inserted into the lumen of a living body from outside the body, a swinging member 20 that is pivotally supported at a pivot point 14 on an intermediate portion 12 in the longitudinal direction of the insertion member 10, and an operating part 40 for operating the swinging member 20 to swing between a first state in which the swinging member 20 extends along the insertion member 10 and a second state in which the swinging member 20 intersects with the insertion member 10, and the swinging member 20 has a sliding surface 25 that slides against the insertion member 10 when swinging, and the sliding surface 25 has a fine uneven shape formed thereon.

Description

TECHNICAL FIELD

[0001] The present invention relates to a suturing device. BACKGROUND ART

[0002] Examples of suturing devices used for suturing living tissue include the one described in Patent Document 1. The suturing device of Patent Document 1 (referred to as a suture delivery device in the same document) includes an elongated insertion member (referred to as a delivery shaft in the same document) that is inserted from outside the body into a living lumen, a swinging member (referred to as a vascular wall positioning device in the same document) that is pivotally supported relative to the insertion member, and an operation unit (referred to as a handle in the same document) for performing an operation to swing the swinging member between a first state in which the swinging member extends along the insertion member and a second state in which the swinging member intersects the insertion member. PRIOR ART DOCUMENTS PATENT DOCUMENTS

[0003] PATENT DOCUMENT 1 Japanese Patent Publication No. 2018-508328 SUMMARY OF THE INVENTION PROBLEMS TO BE SOLVED BY THE INVENTION

[0004] According to studies by the inventors of the present application, the suturing device of Patent Document 1 still has room for improvement from the viewpoint of more reliably swinging the swinging member into a state intersecting the insertion member at a desired timing.

[0005] The present invention has been made in view of the above problems, and provides a suturing device capable of more reliably swinging the swinging member into a state intersecting the insertion member at a desired timing. MEANS FOR SOLVING THE PROBLEMS

[0006] According to the present invention, there is provided a suturing device used for suturing living tissue, A long insertion member that is inserted into the internal lumen of the body from outside, A swinging member is pivotally supported at the pivot point with respect to the middle portion of the insertion member in the longitudinal direction, An operating unit for performing an operation to swing the swinging member between a first state in which the swinging member extends along the insertion member and a second state in which the swinging member intersects with respect to the insertion member, Equipped with, The rocking member has a sliding surface that slides against the insertion member when it rocks, A suturing device is provided in which a fine uneven shape is formed on the sliding surface. [Effects of the Invention]

[0007] According to the present invention, it is possible to more reliably make the oscillating member oscillate in a state where it intersects with the inserting member at the desired timing. [Brief explanation of the drawing]

[0008] [Figure 1] This is a schematic overall view of a suturing device according to an embodiment. [Figure 2] Figures 2(a) and 2(b) are enlarged views of section A shown in Figure 1. Figure 2(a) shows the first state in which the oscillating member extends along the insertion member, and Figure 2(b) shows the second state in which the oscillating member intersects with the insertion member. [Figure 3] Figures 3(a) and 3(b) are enlarged sections of the cross-section of part A shown in Figure 1. Figure 3(a) shows the first state in which the oscillating member extends along the insertion member, and Figure 3(b) shows the second state in which the oscillating member intersects with the insertion member. [Figure 4] Figures 4(a) and 4(b) are enlarged sections of the cross-section of part A shown in Figure 1. Figure 4(a) shows the first state in which the oscillating member extends along the insertion member, and Figure 4(b) shows the second state in which the oscillating member intersects with the insertion member. [Figure 5] This is a magnified view of section A shown in Figure 1, and it shows the view in the direction of arrow A shown in Figure 2(a). [Figure 6]This figure illustrates an example of how to use the suturing device according to the embodiment, showing the state in which the oscillating member has been switched from the first state to the second state in a biological lumen. [Figure 7] This figure illustrates an example of how to use the suturing device according to the embodiment, showing the state in which the knot has been tightened and the suturing of the opening has been completed. [Figure 8] This is a photograph of the first flat plate member in the embodiment, showing the surface of the first flat plate member on which a textured, uneven surface is formed. [Figure 9] This is a photograph of the second flat plate member in the embodiment, showing the surface of the second flat plate member on which intersecting ridge-like protrusions are formed. [Figure 10] This is a photograph of the third flat plate member in the embodiment, showing the smoothly formed surface of the third flat plate member. [Modes for carrying out the invention]

[0009] Embodiments of the present invention will be described below with reference to Figures 1 to 10. In all drawings, the same reference numerals are used for similar components, and descriptions are omitted where appropriate. In Figures 3(a) and 3(b), the insertion member is selectively shown in a cross-section along the axial direction. Figures 2(a) to 3(b) show the view in the direction of arrow B shown in Figure 5. Figures 4(a) and 4(b) show the view in the direction of arrow C shown in Figure 5. Furthermore, the various components of the suture device 100 of the present invention do not need to be independent entities. It is permissible for multiple components to be formed as a single member, for one component to be formed from multiple members, for one component to be part of another component, for a part of one component to overlap with a part of another component, and so on. Furthermore, in the following, the distal end of the suture device 100 will be referred to as the proximal end, and its proximal end as the proximal end. The proximal end refers to a certain range including the distal end (frontmost point) and its surroundings, while the proximal end refers to a certain range including the proximal end (very proximal end) and its surroundings.

[0010] The suturing device 100 according to this embodiment is a suturing device used for suturing biological tissue. As shown in Figures 1 and 2, the suturing device 100 includes a long insertion member 10 that is inserted into the lumen of a living body from outside the body, a swinging member 20 that is pivotally supported at a pivot point 14 on the middle portion 12 in the longitudinal direction of the insertion member 10, and an operating unit 40 for operating the swinging member 20 to a first state in which the swinging member 20 extends along the insertion member 10 (see Figure 2(a)) and a second state in which the swinging member 20 intersects with the insertion member 10 (see Figure 2(b)). In Figure 1, the second state of the swinging member 20 is schematically illustrated. The oscillating member 20 has a sliding surface 25 that slides against the insertion member 10 when it oscillates, and the sliding surface 25 has a fine uneven shape (see, for example, Figures 8 to 10 described later).

[0011] The suturing device 100 is used for suturing biological tissue with a suture thread 62 (for example, suturing an opening 320 formed in biological tissue after percutaneous catheterization). More specifically, the suturing device 100 is configured to guide the suture thread 62 so that it forms a loop with the opening 320 in between. The oscillating member 20 detachably holds a connecting thread 66 (see Figure 1) which is connected to one end of the suture thread 62. When forming a loop of suture thread 62 using the suturing device 100, the intermediate portion 12 of the insertion member 10 is inserted into the biological lumen 300 through the opening 320, and an operation is performed on the operating unit 40 to switch the oscillating member 20 from the first state to the second state. As a result, the portion of the oscillating member 20 that holds the connecting thread 66 (in this embodiment, both ends in the longitudinal direction of the oscillating member 20) is exposed from the insertion member 10. As shown in Figure 6, with the portion of the oscillating member 20 exposed from the insertion member 10 in close contact with the biological tube wall, the operation to form a loop of suture thread 62 (details described later) is performed.

[0012] According to the present embodiment, the swinging member 20 has a sliding surface 25 that slides relative to the insertion member 10 when swinging, and a fine uneven shape is formed on the sliding surface 25. Thereby, the sliding resistance of the swinging member 20 relative to the insertion member 10 can be reduced, so that the swinging member 20 can slide smoothly relative to the insertion member 10. Therefore, the swinging member 20 can be more reliably switched from the first state to the second state (or from the second state to the first state). As described above, according to the present embodiment, the swinging member 20 can be swung to a state intersecting the insertion member 10 (the second state) at a desired timing more reliably.

[0013] Hereinafter, the suturing device 100 according to the present embodiment will be described in more detail. Note that, in the suturing device 100 according to the present embodiment, configurations of various suturing devices can be adopted for configurations other than the configuration related to the swinging member 20, so the following will only provide a brief description of an example, and a detailed description thereof will be omitted in the present specification. In addition, the structure of the suturing device 100 described below is an example, and as the structure of the suturing device 100, a known structure (for example, the structure described in Patent Document 1) may be applied without departing from the gist of the present invention.

[0014] The insertion member 10 is a tubular member having a lumen (not shown) through which a guide wire (not shown) is inserted. In the case of the present embodiment, the outer diameter of the insertion member 10 is constant regardless of the position in the axial direction. The insertion member 10 is configured to be bendable in a direction intersecting the axial direction of the insertion member 10. Thereby, when inserting the insertion member 10 into the living body lumen 300, the distal end portion of the insertion member 10 can be easily bent along the living body lumen 300.

[0015] More specifically, as shown in Figures 2(a) to 5, a storage section 16 is formed in the middle portion 12 of the insertion member 10, in which the oscillating member 20 is housed. The storage section 16 is an opening that penetrates the insertion member 10 radially. The storage section 16 is formed in a straight line along the axial direction. The pivot support 14 that pivotally supports the oscillating member 20 is formed inside the storage section 16. The axis of the pivot support 14 extends in a direction perpendicular to the extending direction of the storage section 16. When the oscillating member 20 switches from the first state to the second state, one end 20a of the oscillating member 20 is exposed to the outside of the insertion member 10 through one opening of the storage section 16, and the other end 20b of the oscillating member 20 is exposed to the outside of the insertion member 10 through the other opening of the storage section 16. Furthermore, a portion of the inner wall surface of the storage section 16 constitutes an insertion member side sliding surface 15 (in this embodiment, a first insertion member side sliding surface 15a and a second insertion member side sliding surface 15b) that slides against the rocking member 20 when the rocking member 20 rocks.

[0016] As shown in Figure 2(a), the rocking member 20 is formed, for example, as a long, flat plate in one direction. Both ends of the rocking member 20 are rounded. The width dimension of the oscillating member 20 is set to be smaller than the outer diameter dimension of the insertion member 10. The length dimension of the insertion member 10 is set to be smaller than the length dimension of the storage section 16. In the first state, the entire oscillating member 20 is housed within the storage section 16 of the oscillating member 20. In this embodiment, each plate surface of the oscillating member 20 constitutes a sliding surface 25 (hereinafter referred to as the first sliding surface 25a and the second sliding surface 25b) that slides against the insertion member 10. When the oscillating member 20 oscillates, the first sliding surface 25a slides against the second insertion member side sliding surface 15b, and the second sliding surface 25b slides against the first insertion member side sliding surface 15a. As shown in Figure 1, one end of the connecting thread 66 is held by one end 20a of the rocking member 20 by a holding structure (not shown), and the other end of the connecting thread 66 is held by the other end 20b of the rocking member 20 by a holding structure (not shown). In this way, the connecting thread 66 is held by the rocking member 20 in a substantially V-shape (or substantially U-shape). However, in the present invention, the shape of the oscillating member 20 and the configuration in which the oscillating member 20 holds the connecting thread 66 are not limited to this example and can be appropriately set without departing from the spirit of the present invention.

[0017] As shown in Figure 1, the operating unit 40 includes, for example, a main body 41 formed in the shape of a cylinder, a first swinging operating unit 42 for operating the swinging member 20 to a first state in which the swinging member 20 extends along the insertion member 10, a second swinging operating unit 44 for operating the swinging member 20 to a second state in which the swinging member 20 intersects with the insertion member 10, and a thread operating unit 46 for operating the suture thread 62 in a loop shape.

[0018] The main body portion 41 is a hollow member, and is formed, for example, in a cylindrical shape. The main body portion 41 is provided at the base end of the insertion member 10. The main body portion 41 has a slide hole 41a that extends in the axial direction, and the first oscillating operating portion 42 is guided by the slide hole 41a and is able to slide relative to the main body portion 41 in the axial direction. Similarly, the main body portion 41 has a slide hole 41b that extends in the axial direction, and the second oscillating operating portion 44 is guided by the slide hole 41b and is able to slide relative to the main body portion 41 in the axial direction.

[0019] The first swing operation unit 42 is connected to one end 20a of the swing member 20, for example, via a first operation wire (not shown). In the first state, when the first swing operation unit 42 is slid toward the base end, the first operation wire pulls the one end 20a toward the base end, and the swing member 20 swings in one direction in the swing direction (for example, clockwise in Figure 2(b), etc.) with the pivot 14 as the pivot axis. As a result, the swing member 20 switches from the first state to the second state. Similarly, the second swing operation unit 44 is connected to the other end 20b of the swinging member 20 via, for example, a second operation wire (not shown). In the second state, when the second swing operation unit 44 is slid toward the base end, the other end 20b is pulled toward the base end by the second operation wire, and the swinging member 20 swings toward the other side in the swing direction (for example, counterclockwise in Figure 2(b), etc.) with the pivot 14 as the pivot axis. As a result, the swinging member 20 switches from the second state to the first state. In this invention, the oscillating structure of the oscillating member 20 is not limited to this example, and known structures (for example, the structure described in Patent Document 1) may be applied without departing from the spirit of the present invention.

[0020] The thread manipulation section 46 is configured to allow a pair of wires (a first wire and a second wire (not shown)) that detachably hold the suture thread 62 to move in the axial direction. The thread handling section 46 is detachably attached to the main body 41 and is slidable in the axial direction relative to the main body 41. The thread handling section 46 is connected to the base ends of the first wire and the second wire, respectively. When the thread manipulation section 46 is slid toward the tip, the respective tips of the first wire and the second wire are exposed from the outlet holes (not shown) formed in the insertion member 10 and move toward the tip (towards the oscillating member 20). When the thread manipulation section 46 is slid toward the base end, the respective ends of the first wire and the second wire move toward the base end (away from the oscillating member 20). Furthermore, by removing the thread manipulation unit 46 from the main body 41, the first wire and the second wire can also be separated from the main body 41. Each of the first and second wires has sufficient rigidity to penetrate the wall of a biological tube, and its tip is sharply formed. The tip of the first wire detachably holds one end of the suture thread 62. The second wire is connected to the other end of the suture thread 62.

[0021] As described above, the sliding surface 25 has a fine uneven surface. The uneven surface includes, for example, a textured uneven surface (see, for example, Figure 8 described later). With this configuration, the sliding resistance of the oscillating member 20 relative to the insertion member 10 can be reduced in any of the multiple directions intersecting the insertion member 10 within the range where the textured uneven surface is formed. Therefore, the oscillating member 20 can be switched more smoothly from the first state to the second state (or from the second state to the first state).

[0022] Furthermore, the uneven shape includes a plurality of striated protrusions 28 (see, for example, Figure 9 described later) that extend in different directions from one another. With this configuration, the sliding resistance of the rocking member 20 to the insertion member 10 when the rocking member 20 slides in the direction of extension of the protrusion 28 can be reduced.

[0023] The multiple striated protrusions 28 include, for example, striated protrusions 28 that intersect with each other. In this context, "intersecting each other" includes not only cases where the protrusions 28 directly intersect each other, but also cases where the extension of one protrusion 28 intersects with the extension of another protrusion 28 that is spaced apart from that protrusion 28. With this configuration, the sliding resistance of the rocking member 20 relative to the insertion member 10 can be reduced in any of the multiple directions intersecting the insertion member 10. The width dimension of the multiple striated protrusions 28 is preferably, for example, 0.003 mm or more and 0.02 mm or less.

[0024] More specifically, the sliding surface 25 includes, for example, a constantly covered portion 32 that is always covered by the insertion member 10 during the oscillation process from the second state (Figure 3(b)) to the first state (Figure 3(a)), and a final covered portion 34 that is exposed from the insertion member 10 at an intermediate stage of the oscillation process (between Figure 3(a) and Figure 3(b)) and covered by the insertion member 10 at the final stage (see Figure 3(a)). The normally covered portion 32 has an uneven surface, while the final covered portion 34 is formed to be smoother than the normally covered portion 32. In this context, "covered by the insertion member 10" means that, when viewed in the direction normal to the sliding surface 25 (for example, the state shown in Figures 3(a) to 4(b)), it overlaps with the insertion member 10. Furthermore, the statement that "the final coating portion 34 is always formed to be smoother than the coating portion 32" means that the surface roughness of the final coating portion 34 is smaller than the surface roughness of the coating portion 32. As long as this condition is met, the final coating portion 34 may also have an uneven surface. With this configuration, the sliding resistance of the oscillating member 20 against the insertion member 10 is reduced during the oscillating process, while ensuring an appropriate amount of frictional resistance of the oscillating member 20 against the insertion member 10 when the oscillating is complete. Therefore, the state in which the oscillating member 20 is covered by the insertion member 10 can be stably maintained (unintended oscillating can be suppressed). Furthermore, in the final stage of the oscillating member 20's movement, the user can intuitively recognize that the oscillating member 20 is about to complete its switch from the second state to the first state by the frictional sensation (click sensation) that occurs between the insertion member 10 and the oscillating member 20. In this invention, the entire surface of the permanently covered portion 32 may have an uneven surface, or an uneven surface may be locally formed on a portion of the permanently covered portion 32. If an uneven surface is formed on a portion of the permanently covered portion 32, for example, the uneven surface may be formed in a predetermined circular area of ​​the permanently covered portion 32 centered on the pivot support portion 14, or in a portion of the circular area in the radial or circumferential direction, or in an oval-shaped area (for example, an oval shape) obtained by cutting out a portion of the circular area in the radial direction. Similarly, in the present invention, the entire final coating portion 34 may be formed to be smoother than the normally coated portion 32, or a portion of the final coating portion 34 may be locally formed to be smoother than the normally coated portion 32. Furthermore, on the sliding surface 25, the region where the uneven shape of the normally covered portion 32 is formed and the region of the final covered portion 34 that is formed more smoothly than the normally covered portion 32 may be formed continuously with respect to each other, or they may be spaced apart from each other.

[0025] Furthermore, as shown in Figures 4(a) and 4(b), the sliding surface 25 includes an exposed portion 36 that is exposed from the insertion member 10 during part of the oscillation process between the first state and the second state (at a specific timing during the oscillation process), and a constantly covered portion 32 that is always covered by the insertion member 10. The uneven shape of the exposed portion 36 includes linear, striated protrusions 28 that extend in a direction intersecting the oscillation direction of the rocking member 20. The uneven surface of the normally covered portion 32 is formed in a textured manner. In this context, "exposed from the insertion member 10" means that, when viewed in the direction normal to the sliding surface 25 (for example, as shown in Figures 3(a) to 4(b)), it is located outside the outline of the insertion member 10. With this configuration, the sliding resistance of the rocking member 20 against the insertion member 10 is reduced during the rocking process, while the groove-shaped protrusions 28 guide the movement of the rocking member 20 in the rocking direction. In this invention, the protrusions 28 may be formed on the entire exposed portion 36, or one or more protrusions 28 may be formed locally on a part of the exposed portion 36. Furthermore, on the sliding surface 25, the region where the protrusions 28 in the exposed portion 36 are formed and the region where the uneven shape in the normally covered portion 32 is formed may be formed continuously with respect to each other, or they may be spaced apart from each other.

[0026] In this embodiment, as an example, the surrounding portion of the pivot support 14 on each of the first sliding surface 25a and the second sliding surface 25b is a normally covered portion 32. As described above, an uneven shape may be formed on the entire surrounding portion (normally covered portion 32) of the pivot support 14 on each of the first sliding surface 25a and the second sliding surface 25b, or an uneven shape may be formed locally on a part of the surrounding portion. Furthermore, for example, the portion of the first sliding surface 25a corresponding to one end 20a and the other end 20b is formed as a final covering portion 34 which is smoother than the normally covering portion 32. As described above, the entire portion of the first sliding surface 25a corresponding to one end 20a and the other end 20b (final covering portion 34) may be formed smoother than the normally covering portion 32, or a portion of the corresponding portion may be formed smoother than the normally covering portion 32. Furthermore, for example, the portion of the second sliding surface 25b corresponding to one end 20a and the other end 20b is an exposed portion 36 on which a striated protrusion 28 is formed. As described above, the protrusion 28 may be formed on the entire portion (exposed portion 36) of the second sliding surface 25b corresponding to one end 20a and the other end 20b, or the protrusion 28 may be formed on only a portion of the corresponding portion. With this configuration, the final covering portion 34 of the first sliding surface 25a ensures adequate frictional resistance of the oscillating member 20 against the insertion member 10 in the first state, while the exposed portion 36 of the second sliding surface 25b allows the oscillating member 20 to move smoothly in the oscillating direction. However, in the present invention, the configurations of the normally covered portion 32, the final covered portion 34, and the exposed portion 36 are not limited to this example and can be appropriately set according to the shape and dimensions of the oscillating member 20.

[0027] The oscillating member 20 is made of, for example, a resin material or a metal material. The method for forming the uneven shape on the sliding surface 25 is not particularly limited. For example, it may be formed by transferring the uneven shape formed on the mold when molding the oscillating member 20, or by machining, or by roughening the surface using sandblasting or a file. Alternatively, the striated protrusions 28 may be formed by constructing the oscillating member 20 from a resin material containing fillers such as carbon fibers.

[0028] Furthermore, in this embodiment, as shown in Figure 5, the insertion member 10 has an insertion member side sliding surface 15 (in this embodiment, a first insertion member side sliding surface 15a and a second insertion member side sliding surface 15b) that slides against the rocking member 20 when the rocking member 20 rocks. A fine uneven surface (see, for example, Figures 8 and 9) is formed on the sliding surface 15 on the insertion member side (same as above). With this configuration, the uneven shape formed on the sliding surface 25 and the uneven shape formed on the insertion member side sliding surface 15 can further reduce the sliding resistance of the oscillating member 20 relative to the insertion member 10. More specifically, the uneven shape formed on the insertion member side sliding surface 15 (first insertion member side sliding surface 15a and second insertion member side sliding surface 15b) includes, for example, a textured uneven shape. Furthermore, the uneven shape formed on the sliding surface 15 on the insertion member side includes, for example, intersecting ridge-like protrusions. The method for forming the uneven shape on the sliding surface 15 on the insertion member side is not particularly limited. For example, it may be formed by transferring the uneven shape formed on the mold when molding the insertion member 10, or by machining, or by roughening the surface using sandblasting or a file. Alternatively, the above-mentioned ridge-like protrusions 28 may be formed by constructing the insertion member 10 from a resin material containing fillers such as carbon fibers.

[0029] Here, a first flat plate member and a second flat plate member having the aforementioned uneven shape, and a third flat plate member formed more smoothly than the first and second flat plate members were prepared as test specimens. The first flat plate member has a surface with a textured uneven shape (see Figure 8), the second flat plate member has a surface with intersecting ridge-like protrusions 28 (see Figure 9), and the third flat plate member has a surface formed more smoothly than the respective plate surfaces of the first and second flat plate members (see Figure 10). When a first flat plate member having a textured, uneven surface is slid against a third flat plate member that is smoothly formed, the sliding resistance is reduced compared to when the third flat plate member is slid against another third flat plate member. Furthermore, when a first flat plate member having a textured, uneven surface is slid against another first flat plate member, the sliding resistance is reduced compared to when the first flat plate member is slid against a third flat plate member. In other words, when a third flat plate member having a smooth surface is slid against a first flat plate member, the sliding resistance is increased compared to when the first flat plate member is slid against another first flat plate member. Furthermore, when the second flat plate member having the striated protrusions 28 is slid in multiple directions relative to a smooth third flat plate member, the sliding resistance is reduced in each of the multiple directions compared to when the third flat plate member is slid relative to another third flat plate member. Furthermore, when the second flat plate member having the striated protrusions 28 is slid in multiple directions relative to another second flat plate member, the sliding resistance is reduced in each of the multiple directions compared to when the second flat plate member is slid relative to another third flat plate member. In this way, by forming an uneven shape (a textured uneven shape or a streaky protrusion 28) on the sliding surface 25 and the sliding surface 15 on the insertion member side, the sliding resistance generated between the surfaces can be reduced.

[0030] The following describes an example of how to use the suturing device 100 of this embodiment. In the following section, as an example, we will describe an example in which the suturing device 100 is used in a procedure to suture an opening 320 formed in the blood vessel wall 310 after percutaneous catheterization. The explanation begins with the intermediate portion 12 of the insertion member 10 positioned within the biological lumen 300 via an opening 320 along a guide wire (not shown), and the guide wire being removed from the biological lumen 300. First, the first oscillating operation unit 42 is slid toward the proximal end to switch the oscillating member 20 from the first state to the second state. At this time, the insertion member 10 is positioned at an angle of approximately 45 degrees to the blood vessel wall 310. While maintaining the posture of the insertion member 10, the insertion member 10 is pulled back toward the proximal end, and the oscillating member 20 in the second state is brought into close contact with the inner surface of the blood vessel wall 310 (see Figure 6). Next, the thread manipulation section 46 is slid toward the tip, exposing the respective tips of the first wire and the second wire toward the tip from the insertion member 10. Subsequently, the thread manipulation section 46 is slid further toward the tip until the respective tips of the first wire and the second wire penetrate the blood vessel wall 310 and reach the oscillating member 20. As a result, one end of the suture thread 62 is guided by the first wire to one end of the connecting thread 66 and connected to one end of the connecting thread 66. Once the suture thread 62 is connected to one end of the connecting thread 66, the suture thread 62 detaches from the tip of the first wire. The tip of the second wire is connected to the other end of the connecting thread 66. Next, the thread manipulation section 46 is slid towards the proximal end, pulling the first wire and the second wire back towards the proximal end. As a result, the connecting thread 66 is pulled out of the biological lumen 300 by the second wire. Subsequently, when the thread manipulation section 46 is slid further towards the proximal end, one end of the suture thread 62 is pulled out of the biological lumen 300 by the connecting thread 66 and is inserted into the winding portion of the knot 64 to become the axial thread. Next, the thread manipulation unit 46 is detached from the main body 41 and pulled towards the proximal end, thereby removing the first and second wires from the blood vessel wall 310 and separating them from the main body 41. Subsequently, the suture thread 62 is cut to the desired length. In this way, the suture thread 62 can be guided so that it forms a loop with the opening 320 in between. After forming the loop of the suture 62, the second oscillating operating part 44 is slid toward the proximal end, switching the oscillating member 20 from the second state to the first state and storing it again inside the insertion member 10, and the insertion member 10 is withdrawn from the biological lumen 300. Subsequently, while holding the axis thread (one end of the suture 62), the knot 64 can be tightened by using a plunger member (not shown) to bring the knot 64 close to the blood vessel wall (see Figure 7).

[0031] In this embodiment, as described above, the sliding surface 25 of the oscillating member 20 has an uneven shape. This reduces the frictional resistance between the insertion member 10 and the oscillating member 20, allowing the oscillating member 20 to smoothly switch from the first state to the second state (or from the second state to the first state) in the biological lumen 300.

[0032] The present invention is not limited to the embodiments described above, and includes various modifications, improvements, and other forms as long as the objectives of the present invention are achieved.

[0033] This embodiment encompasses the following technical concepts. (1) A suturing device used for suturing biological tissue, A long insertion member that is inserted into the internal lumen of the body from outside, A swinging member is pivotally supported at the pivot point with respect to the middle portion of the insertion member in the longitudinal direction, An operating unit for performing an operation to swing the swinging member between a first state in which the swinging member extends along the insertion member and a second state in which the swinging member intersects with respect to the insertion member, Equipped with, The rocking member has a sliding surface that slides against the insertion member when it rocks, A suturing device having a fine, uneven surface formed on the sliding surface. (2) The suture device according to (1), wherein the uneven shape includes a textured uneven shape. (3) The sliding surface includes a constantly covered portion that is always covered by the insertion member during the oscillation process from the second state to the first state, and a final covered portion that is exposed from the insertion member at an intermediate stage during the oscillation process and is covered by the insertion member at the final stage, The aforementioned normally covered portion has the aforementioned uneven shape formed therein. The suture device according to (1) or (2), wherein the final covering portion is formed more smoothly than the normally covering portion. (4) The suture device according to (1) or (2), wherein the uneven shape includes a plurality of striated protrusions extending in different directions from each other. (5) The suture device according to (4), wherein the plurality of striated protrusions include striated protrusions that intersect with each other. (6) The suture device according to (4) or (5), wherein the width dimension of the plurality of striated protrusions is 0.003 mm or more and 0.02 mm or less. (7) The sliding surface includes an exposed portion that is exposed from the inserting member during part of the oscillation process between the first state and the second state, and a constantly covered portion that is always covered by the inserting member. The uneven shape of the exposed portion includes linear, striated protrusions that extend in a direction intersecting the oscillation direction of the rocking member. The suture device according to any one of (1) to (6), wherein the uneven shape of the normally covered portion is formed in a textured manner. (8) The insertion member has an insertion member side sliding surface that slides against the rocking member when the rocking member rocks, The suturing device according to any one of (1) to (7), wherein a fine uneven shape is formed on the sliding surface on the insertion member side. [Explanation of Symbols]

[0034] 10 Insertion member 12 Middle part 14 axis branches 15 Insertion member side sliding surface 15a Sliding surface on the side of the first insertion member 15b Sliding surface on the second insertion member side 16 Storage compartment 20. Oscillating member 20a One end 20b Base end 25 Sliding surface 25a 1st sliding surface 25b 2nd sliding surface 28 Convex part 32 Permanently covered part 34 Final coating section 36 Exposed part 40 Control section 41 Main body 41a Slide hole 41b Slide hole 42 First rocking operation unit 44 Second oscillation control unit 46 Thread manipulation section 62 Sutures 64 knots 66 Connecting threads 100 suturing devices 300 In vivo lumen 310 Blood vessel wall 320 opening

Claims

1. A suturing device used for suturing biological tissue, A long insertion member that is inserted into the internal lumen of the body from outside, A swinging member is pivotally supported at the pivot point with respect to the middle portion of the insertion member in the longitudinal direction, An operating unit for performing an operation to swing the swinging member between a first state in which the swinging member extends along the insertion member and a second state in which the swinging member intersects with respect to the insertion member, Equipped with, The rocking member has a sliding surface that slides against the insertion member when it rocks, A suturing device having a fine, uneven surface formed on the sliding surface.

2. The suture device according to claim 1, wherein the aforementioned uneven shape includes a textured uneven shape.

3. The sliding surface includes a constantly covered portion that is always covered by the insertion member during the oscillation process from the second state to the first state, and a final covered portion that is exposed from the insertion member at an intermediate stage during the oscillation process and is covered by the insertion member at the final stage. The aforementioned normally covered portion has the aforementioned uneven shape formed therein. The suture device according to claim 1 or 2, wherein the final covering portion is formed more smoothly than the normally covering portion.

4. The suture device according to claim 1 or 2, wherein the uneven shape includes a plurality of striated protrusions extending in different directions from each other.

5. The suture device according to claim 4, wherein the plurality of striate protrusions include striate protrusions that intersect with each other.

6. The suture device according to claim 4, wherein the width dimension of the plurality of striated protrusions is 0.003 mm or more and 0.02 mm or less.

7. The sliding surface includes an exposed portion that is exposed from the insertion member during part of the oscillation process between the first state and the second state, and a constantly covered portion that is always covered by the insertion member. The uneven shape of the exposed portion includes linear, striated protrusions that extend in a direction intersecting the oscillation direction of the rocking member. The suture device according to claim 1 or 2, wherein the uneven shape of the constantly covered portion is formed in a textured manner.

8. The insertion member has an insertion member side sliding surface that slides against the rocking member when the rocking member rocks, The suture device according to claim 1 or 2, wherein a fine uneven shape is formed on the sliding surface on the insertion member side.

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