Port wound closure guide

Abstract

To provide a port wound closure guide that can safely and easily close a port wound after removing a trocar or the like in a surgical operation. [Solution] A port wound closure guide (10) comprises a main body (11), a flange (12), a first insertion hole, and a second insertion hole; the main body extends from the base end to the tip; the base end of the main body is connected to the bottom surface of the flange; the first insertion hole penetrates the main body and the flange; one end (13_1) of the first insertion hole is located on the flange; the other end (13_2) of the first insertion hole is located on one side of the side of the main body; the second insertion hole penetrates the main body and the flange; one end (14_1) of the second insertion hole is located on the upper surface of the flange; and the other end (14_2) of the second insertion hole is located on one side of the side of the main body, closer to the tip of the main body than the other end of the first insertion hole.

Description

[Technical Field]

[0001] The present invention relates to a port wound closure guide used to close a port wound after removal of a trocar or other device during a surgical procedure. [Background technology]

[0002] Minimally invasive surgical procedures, such as laparoscopic surgery and thoracoscopic surgery, are performed. In these procedures, in addition to a laparoscope (rigid endoscope), trocars are used to insert surgical instruments such as forceps and electric scalpels into the body cavity. Trocars are also used in laparoscopy and surgical procedures.

[0003] When using a trocar, an incision (hereinafter referred to as a "port incision") is made by partially cutting the skin of the patient's abdomen or other area before inserting the trocar. A laparoscope or surgical instrument, for example, is inserted into the body cavity through the trocar inserted into this port incision, and surgery or the like is performed while observing the surgical site with the laparoscope. Here, multiple port incisions are made and multiple trocars are inserted to insert the laparoscope and various surgical instruments into the body cavity.

[0004] After laparoscopic surgery, laparoscopy, or other surgical procedures, the trocar is removed and the port wound is closed. If the port wound is not closed properly, abdominal contents may pass through the port wound and cause a hernia.

[0005] Patent Documents 1 to 4 disclose examples of the port wound closure guide used for closing the above-mentioned port wound.

[0006] The closure of a port wound using a general port wound closure guide and a suture grasper will be described below (for example, Non-Patent Document 1).

[0007] As shown in FIGS. 11A and 11B, the port wound closure guide 40 includes a cylindrical main body 41 and a flange 42 disposed at the base end of the main body 41.

[0008] The main body 41 has a first insertion hole 43 and a second insertion hole 44. The first insertion hole 43 and the second insertion hole 44 each have a predetermined angle with respect to the central axis and are arranged at positions that are line-symmetrical with respect to the central axis.

[0009] The first insertion hole 43 has one end 43_1 at the bottom of the flange 42 and the other end 43_2 at the side surface of the main body 41.

[0010] On the other hand, the second insertion hole 44 has one end 44_1 at the bottom of the flange 42 and the other end 44_2 at the side surface of the main body 41.

[0011] An example of a method for closing a port wound using a conventional port wound closure guide 40 will be described with reference to FIGS. 12A to 12H.

[0012] First, after the surgery is completed, the trocar is removed, and the port wound closure guide 40 is inserted into the port site (port wound) 6 in the abdominal wall 1 (FIG. 12A).

[0013] Next, the suture 7 is grasped with the tip of the suture grasping tool 8 and inserted from one end 43_1 of the first insertion hole 43 of the port wound closure guide 40 through the first insertion hole 43 into the abdominal cavity (body cavity) 5 (Figures 12B and 12C).

[0014] Here, the suture holder 8 is, for example, "Bear Passtle" (manufactured by Bear Medic Co., Ltd.).

[0015] As a result, the tip of the suture grasping tool 8 pierces a part of tissue (hereinafter referred to as "first tissue portion") 4_1 of the abdominal wall 1 and is ejected from the surface 3 of the abdominal wall on the abdominal cavity side.

[0016] Next, the suture 7 is released from the suture grasper 8 and the suture grasper 8 is pulled out (FIG. 12D). As a result, the suture 7 passes through the first tissue 4_1.

[0017] Next, the suture thread holder 8 is inserted from one end 44_1 of the second insertion hole 44 through the second insertion hole 44 into the body cavity 5. As a result, the tip of the suture thread holder 8 pierces a part of the tissue of the abdominal wall 1 (hereinafter referred to as the "second tissue portion") 4_2.

[0018] Next, forceps 9 are inserted through the trocar of the other port wound, and the suture 7 is grasped with the forceps 9. The suture grasped with the forceps 9 is passed through the open ring at the tip of the suture grasper 8, and then the ring is closed to grasp (fix) the suture at the tip of the suture grasper 8 (Fig. 12E).

[0019] Next, the port wound closure guide 40 is removed, and the suture 7 is released from the port wound closure guide 40 (FIGS. 12F and 12G). In this state, a trocar is inserted again into this port wound, and forceps are inserted to close the other port wounds (not shown).

[0020] Finally, both ends of the suture 7 are pulled to pull together the abdominal wall tissues on both sides of the tissue opening (the first tissue portion 4_1 and the second tissue portion 4_2), and the sutures are tied near the abdominal wall tissues to close the port wound (FIG. 12H). [Prior art documents] [Patent documents]

[0021] [Patent Document 1] U.S. Patent No. 6,183,485 [Patent Document 2] U.S. Patent No. 5,954,734 [Patent Document 3] U.S. Patent No. 5,827,299 [Patent Document 4] U.S. Patent No. 5,507,758 [Non-patent literature]

[0022] [Non-Patent Document 1] Yohei Owada et al., "A novel method for port site closure using the CloseSure system," Kitakanto Med.J.(2014)64,pp.343-346. Summary of the Invention [Problem to be solved by the invention]

[0023] Thus, when closing a port wound using a conventional port wound closure guide 40, the surgeon had to grasp the suture 7 using forceps 9 at the tip of the suture grasper 8 inside the body cavity 5 (Fig. 12E). This increases the number of steps in the port wound closure procedure, which takes time and places a greater burden on the surgeon. [Means for solving the problem]

[0024] In order to solve the above-mentioned problems, the port wound closure guide of the present invention comprises a main body, a flange, a first insertion hole, and a second insertion hole, the main body extending from a base end to a tip end, the base end of the main body connected to the bottom surface of the flange, the first insertion hole penetrating the main body and the flange, one end of the first insertion hole being located on the upper surface of the flange, the other end of the first insertion hole being located on one side of the side of the main body, the second insertion hole penetrating the main body and the flange, one end of the second insertion hole being located on the flange, and the other end of the second insertion hole being located on the one side of the side of the main body, closer to the tip end of the main body than the other end of the first insertion hole.

[0025] In addition, the port wound closure guide of the present invention may be divided into two members by a plane perpendicular to the flange, one of the two members having a mating convex portion on a surface parallel to the dividing plane, and the other member having a mating concave portion on a surface parallel to the dividing plane.

[0026] In addition, the port wound closure guide of the present invention may have one side of the side of the main body curved or bent toward the inside of the main body, and the bottom surface of the flange may be inclined with respect to a plane perpendicular to the extension direction of the main body so that the distance between the top surface and the bottom surface narrows from one side to the opposite side of the one side.

[0027] In addition, the port wound closure guide of the present invention may have a curved or bent angle that is greater than 0° and less than 25°, a slope angle of the bottom surface of the flange that is greater than 0° and less than 15° relative to a plane perpendicular to the extension direction of the main body, and the first insertion hole arranged in a straight line at an angle of 5° to 15° relative to the one side surface.

[0028] In addition, the port wound closure guide of the present invention is a port wound closure guide that is inserted into a port wound in the abdominal wall to close the port wound, and that includes a suture holder having a gripping portion that opens and closes at the tip, and that passes a suture into the abdominal cavity, and may be configured so that the suture holder is inserted through the first insertion hole, the suture is inserted through the second insertion hole, and the suture that is inserted through the second insertion hole is grasped by the gripping portion of the suture holder.

[0029] In addition, in the port wound closure guide of the present invention, one end of the first insertion hole and one end of the second insertion hole may be arranged on the same straight line passing through the center of the upper surface of the flange.

[0030] Furthermore, the port wound closure guide according to the present invention is a port wound closure guide comprising a main body, a flange, a first insertion hole, and a second insertion hole, and comprises a first member and another member, the first member comprising a main body portion and a flange portion connected to the first main body portion, the other member comprising the first main body portion and another main body portion constituting the main body, and the first flange portion and another flange portion connected to the other main body portion and constituting the flange, a groove constituting the first insertion hole is provided on an inner surface of at least one of the first member and the other member, and the second insertion hole is provided on an inner surface of at least one of the first member and the other member. the first member and the second member are in contact with each other at an inner surface thereof, the main body extends from a base end to a tip end, the base end of the main body is connected to a bottom surface of the flange, the first insertion hole penetrates the main body and the flange, one end of the first insertion hole is located on an upper surface of the flange, and the other end of the first insertion hole is located on one side of a side surface of the main body, the second insertion hole penetrates the main body and the flange, one end of the second insertion hole is located on the upper surface of the flange, and the other end of the second insertion hole is located on the one side of the side surface of the main body, closer to the tip end of the main body than the other end of the first insertion hole. [Effects of the Invention]

[0031] According to the present invention, a port wound closure guide can be provided that can safely and easily close a port wound after removing a trocar or other device during a surgical operation. [Brief explanation of the drawings]

[0032] [Figure 1] FIG. 1 is a bird's-eye view showing the configuration of a port wound closure guide according to a first embodiment of the present invention. [Figure 2] FIG. 2 shows the configuration of the port wound closure guide according to the first embodiment of the present invention, with (a) a top view, (b) a side view, and (c) a cross-sectional view taken along the line IIC-IIC′. [Figure 3] FIG. 3 is a perspective view showing the configuration of a port wound closure guide according to a first embodiment of the present invention. [Figure 4] FIG. 4 shows the configuration of a port wound closure guide according to a first embodiment of the present invention, with (a) a top view, (b) a side view, and (c) a cross-sectional view taken along the line IVC-IVC'. [Figure 5] FIG. 5 is a diagram for explaining the configuration of the port wound closure guide according to the first embodiment of the present invention. [Figure 6] FIG. 6 is a diagram for explaining the configuration of the port wound closure guide according to the first embodiment of the present invention. [Figure 7] Figure 7 shows the configuration of one member of a port wound closure guide according to a second embodiment of the present invention, with (a) a top view, (b) an inner side view, and (c) an outer side (outer peripheral surface) view. [Figure 8] Figure 8 shows the configuration of the other member of the port wound closure guide according to the second embodiment of the present invention, with (a) a top view, (b) an inner side view, and (c) an outer side (outer peripheral surface) view. [Figure 9A] FIG. 9A is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9B] FIG. 9B is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9C] FIG. 9C is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9D] FIG. 9D is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9E] FIG. 9E is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9F] FIG. 9F is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9G] FIG. 9G is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9H] FIG. 9H is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9I]FIG. 9I is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9J] FIG. 9J is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9K] FIG. 9K is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 9L] FIG. 9L is a view for explaining the operation of the port wound closure guide according to the second embodiment of the present invention. [Figure 10] FIG. 10 is a diagram for explaining the effect of the port wound closure guide according to the present invention. [Figure 11A] FIG. 11A is a bird's-eye view showing the configuration of a conventional port wound closure guide. [Figure 11B] FIG. 11B is a cross-sectional view taken along the line XB-XB' showing the configuration of a conventional port wound closure guide. [Figure 12A] FIG. 12A is a diagram illustrating the operation of a conventional port wound closure guide. [Figure 12B] FIG. 12B is a diagram for explaining the operation of a conventional port wound closure guide. [Figure 12C] FIG. 12C is a view for explaining the operation of a conventional port wound closure guide. [Figure 12D] FIG. 12D is a view for explaining the operation of a conventional port wound closure guide. [Figure 12E] FIG. 12E is a view for explaining the operation of a conventional port wound closure guide. [Figure 12F] FIG. 12F is a view for explaining the operation of a conventional port wound closure guide. [Figure 12G] FIG. 12G is a diagram for explaining the operation of a conventional port wound closure guide. [Figure 12H] FIG. 12H is a view for explaining the operation of a conventional port wound closure guide. DETAILED DESCRIPTION OF THE INVENTION

[0033] First Embodiment A port wound closure guide according to a first embodiment of the present invention will be described with reference to FIGS. 1 and 2. FIG.

[0034] <Configuration of the port wound closure guide> 1 and 2, the port wound closure guide 10 according to this embodiment includes a columnar main body 11 and a flange 12 disposed at the base end (one end) of the main body 11. The port wound closure guide 10 also includes a first insertion hole 13 and a second insertion hole 14 that pass through the main body 11 and the flange 12.

[0035] The main body 11 extends linearly from the base end (one end) to the tip end (the other end). A portion of the main body 11 may be curved or bent at a predetermined angle so as not to interfere with insertion into the port wound.

[0036] The tip of the main body 11 has a shape that tapers toward the tip so that the port wound closure guide 10 can be easily inserted through the port wound into the body cavity 5. The tip of the main body 11 has a rounded shape to avoid damaging organs in the abdominal cavity 5.

[0037] The flange 12 has a top surface 121, a bottom surface 122, and a side surface (outer surface) 123. The top surface 121 of the flange 12 is parallel to a plane (xy plane) perpendicular to the extension direction (z direction) of the main body. The top surface 121 may be inclined with respect to the xy plane.

[0038] A bottom surface 122 of the flange 12 connects to the base end of the main body 11. The bottom surface 122 is parallel to the xy plane. The bottom surface 122 may be inclined with respect to the xy plane.

[0039] The first insertion hole 13 penetrates the main body 11 and the flange 12. One end 13_1 of the first insertion hole 13 (hereinafter also referred to as the “first flange-side inlet / outlet”) is disposed on the upper surface 121 of the flange 12.

[0040] The other end 13_2 of the first insertion hole 13 (hereinafter also referred to as the "first main body side inlet / outlet") is disposed on the same side of the side surface of the main body 11.

[0041] The second insertion hole 14 penetrates the main body 11 and the flange 12. One end 14_1 of the second insertion hole 14 (hereinafter also referred to as the "second flange-side inlet / outlet") is disposed on the upper surface 121 of the flange 12 at a position a predetermined distance away from one end 13_1 of the first insertion hole 13. The second insertion hole 14 may be configured to widen toward the upper surface 121 of the flange 12 near the upper surface 121. For example, the second insertion hole 14 may have a truncated cone shape that widens toward the upper surface 121 of the flange 12 near the upper surface 121 of the flange 12. One end 14_1 of the second insertion hole 14 may be disposed on a side surface 123 of the flange 12.

[0042] The other end 14_2 of the second insertion hole 14 (hereinafter also referred to as the "second main body side inlet / outlet") is arranged on the same side of the side surface of the main body 11 as the other end 13_2 of the first insertion hole 13. The other end 14_2 of the second insertion hole 14 is arranged at a position farther from the flange 12 than the other end 13_2 of the first insertion hole 13. The distance between the other end 13_2 of the first insertion hole 13 and the other end 14_2 of the second insertion hole 14 may be about 40 to 50 mm, or may be about 15 to 60 mm.

[0043] The port wound closure guide 10 according to this embodiment may be produced by forming the first insertion hole 13 and the second insertion hole 14 after molding the outer shape (main body 11 and flange 12).

[0044] <First Example> A port wound closure guide 20 according to a first embodiment of the present invention will be described with reference to FIGS.

[0045] <Configuration of the port wound closure guide> The port wound closure guide 20 according to this embodiment includes a main body 21 and a flange 22 disposed at the base end of the main body 21. The port wound closure guide 20 also includes a first insertion hole 23 and a second insertion hole 24. The total length of the port wound closure guide 20 is approximately 80 to 110 mm.

[0046] The main body 21 extends from a base end (one end) to a tip end (the other end). The side surface (outer peripheral surface) of the main body 21 is curved. For example, the side surface (outer peripheral surface) of the main body 21 may be the curved surface of a cylinder or an elliptic cylinder.

[0047] The length of the main body 21 is, for example, about 60 to 90 mm, and the radial length (excluding the vicinity of the tip) is approximately the same as the size of the port wound (outer diameter of the trocar) (for example, about 5 to 15 mm).

[0048] The tip of the main body 21 has a shape that tapers toward the tip. The tip of the main body 21 has a rounded shape.

[0049] The flange 22 has a top surface 221, a bottom surface 222, and a side surface (outer surface) 223. The top surface 221 and the bottom surface 222 may be flat. The top surface 221 and the bottom surface 222 may have projections and recesses. The flange 22 may be circular, elliptical, or polygonal in top view. Alternatively, the flange 22 may have a shape with projections on the side surface 223, such as a star-shaped polygon in top view.

[0050] The length of the flange 22 is about 20 mm to 30 mm, and the length in the radial direction is about 20 to 40 mm.

[0051] The bottom surface 222 of the flange 22 is connected to the base end of the main body 21 .

[0052] The first insertion hole 23 and the second insertion hole 24 are disposed so as to penetrate the main body 21 and the flange 22, respectively. The cross-sectional shape of the first insertion hole 23 and the second insertion hole 24 may be circular or elliptical. The cross-sectional diameter of the first insertion hole 23 and the second insertion hole 24 may be approximately 1.5 to 2.5 mm.

[0053] One end (first flange-side inlet / outlet) 23_1 of the first insertion hole 23 is disposed on the upper surface 221 of the flange 22.

[0054] The other end 23_2 (first main body side inlet / outlet) of the first insertion hole 23 is disposed on the side surface of the main body 21, for example, at a position spaced apart from the bottom surface 222 of the flange 22 by about 5 to 10 mm.

[0055] One end 24_1 (second flange-side inlet / outlet) of the second insertion hole 24 is disposed on the upper surface 221 of the flange 22 at a position spaced a predetermined distance (for example, about 5 to 10 mm) from one end 23_1 of the first insertion hole 23. One end 24_1 (second flange-side inlet / outlet) of the second insertion hole 24 may be disposed on the same straight line passing through the center of the upper surface 221 of the flange 22 (for example, on the same diameter when the flange 22 is circular in top view) as one end 23_1 of the first insertion hole 23. One end 24_1 of the second insertion hole 24 may be disposed on a side surface 223 of the flange 22.

[0056] The second insertion hole 24 may be configured to widen toward the upper surface 221 of the flange 22 near the upper surface 221. For example, the second insertion hole 24 may be in the shape of a truncated cone whose diameter widens toward the upper surface 221 near the upper surface 221 of the flange 22. The diameter of the opening of the second insertion hole 24 on the upper surface 221 of the flange 22 is about 5 to 10 mm.

[0057] The other end (second main body side entrance / exit) 24_2 of the second insertion hole 24 is disposed on the side surface of the main body 21, on the same side as the other end 23_2 of the first insertion hole 23.

[0058] For example, the other end 24_2 of the second insertion hole 24 may be arranged on the same line (dotted line in FIG. 3) as the other end 23_2 of the first insertion hole 23, which is the shortest line connecting the base end to the tip on the side surface of the main body 21. In other words, the other end 23_2 of the first insertion hole 23 and the other end 24_2 of the second insertion hole 24 may be arranged on the outer edge of the same side in the cross section of the main body 21, as shown in FIG. 4(c).

[0059] 5, the other end 24_2 of the second insertion hole 24 may be disposed at a predetermined distance L1 from the shortest line (the dotted line in the figure) connecting the other end 23_2 of the first insertion hole 23 to the tip of the main body 21 on the side surface of the main body 21. The predetermined distance L1 may be equal to the width w of the gripping ring 81 at the tip of the suture gripper (needle) 8 in an open state, through which the suture to be inserted from the other end 24_2 of the second insertion hole 24 is passed, and may be within about 10 mm, for example.

[0060] Even when the tip of the suture holding device (needle) 8 has a different shape such as forceps, the tip of the holding device can be positioned near the other end 24_2 of the second insertion hole 24 in a side view, so that the suture can be easily held by the suture holding device (needle) 8.

[0061] The other end 24_2 of the second insertion hole 24 is disposed at a position approximately 40 to 60 mm away from the other end 23_2 of the first insertion hole 23 toward the tip of the main body 21. The other end 24_2 of the second insertion hole 24 may be disposed at a position approximately 15 to 60 mm away from the other end 23_2 of the first insertion hole 23 toward the tip of the main body 21.

[0062] On the side of the main body 21, a portion of the side where the other end 23_2 of the first insertion hole 23 and the other end 24_2 of the second insertion hole 24 are located is bent or curved at an angle θm so as to be concave toward the inside of the main body 21 in the extension direction (z direction) of the main body, as shown in Figure 6 (details will be described later).

[0063] Specifically, the extending direction (z direction) of the main body is defined as a direction parallel to the surface opposite to the side where the other end 23_2 of the first insertion hole 23 and the other end 24_2 of the second insertion hole 24 are arranged. Also, a straight line in the extending direction that passes through the center of the upper surface of the flange 22 is defined as a central axis.

[0064] In the flange 22, the upper surface 221 may be parallel to a plane perpendicular to the central axis (xy plane), or may be inclined with respect to the xy plane.

[0065] In the flange 22, the bottom surface 222 may be inclined at a predetermined angle θf with respect to a plane (xy plane) perpendicular to the central axis (described in detail later). For example, the bottom surface 222 of the flange 22 may be inclined with respect to the vertical plane (xy plane) so that the distance between the top surface 221 and the bottom surface 222 narrows from the side where the other end 23_2 of the first insertion hole 23 and the other end 24_2 of the second insertion hole 24 are located toward the opposite side. The inclination angle θf of the bottom surface 222 with respect to the vertical plane (xy plane) may be greater than 0° and equal to or less than 15°. The bottom surface 222 may be parallel to the xy plane (θf=0°).

[0066] In the cross section of the port wound closure guide, the outer edge where the first insertion hole 23 is located may be inclined at an angle θ1 relative to the extension direction (z direction) of the main body so that the radial length (x direction) of the main body 21 decreases toward the tip.

[0067] In the cross section of the port wound closure guide, the outer edge where the first insertion hole 23 is arranged may be arranged perpendicular to the bottom surface 222. Here, "perpendicular" includes the angle θ0 between the outer edge and the bottom surface 222 being a right angle, and includes the range of processing error. In this case, the inclination angle θf of the bottom surface 222 with respect to the vertical plane (xy plane) and the angle θ1 of the outer edge of the first insertion hole 23 with respect to the z direction are equal. Therefore, the angle θ1 may be greater than 0° and not more than 15°. When the bottom surface 222 is parallel to the xy plane (θf = 0°), the angle θ1 is 0°.

[0068] The outer edge where the second insertion holes 24 are arranged may be inclined at an angle θm relative to the outer edge where the first insertion holes 23 are arranged so that the length in the radial direction (x direction) of the main body 21 increases toward the tip. The angle θm may be greater than 0 and not greater than 25°. The outer edge where the second insertion holes 24 are arranged may not be inclined (θm=0°) relative to the outer edge where the first insertion holes 23 are arranged.

[0069] The first insertion hole 23 is formed at an angle θ' with respect to the outer edge where the first insertion hole 23 is disposed. The angle θ' may be 5° to 15°.

[0070] In this embodiment, the cross-sectional shapes of the first insertion hole 23 and the second insertion hole 24 are circular or elliptical, but are not limited thereto. The cross-sectional shapes of the first insertion hole 23 and the second insertion hole 24 may be polygonal.

[0071] The port wound closure guide according to this embodiment may be produced by forming the first insertion hole 23 and the second insertion hole 24 after molding the outer shape.

[0072] <Second Example> A port wound closure guide according to a second embodiment of the present invention will be described with reference to FIGS.

[0073] The port wound closure guide 30 according to this embodiment is configured by dividing the configuration of the first embodiment into two members along a plane parallel to the extending direction of the main body. For example, it is divided into two members along a plane along the central axis passing through the center of the upper surface 221 of the flange 22.

[0074] 7(a), (b), and (c) respectively show a top view of one member 30a of the two members of the port wound closure guide 30, a view from the inner surface 302a of the side (inner side view), and a view from the outer peripheral surface (outer surface) 301a of the side (outer side view). Figures 8(a), (b), and (c) respectively show a top view of the other member 30b of the two members of the port wound closure guide 30, a view from the inner surface 302b of the side (inner side view), and a view from the outer peripheral surface 301b of the side (outer side view).

[0075] 7, one of the two members, member 30a, includes a main body portion 31a, a flange portion 32a, a first insertion groove 33a, a second insertion groove 34a, a first fitting protrusion 35a, and a second fitting protrusion 36a. For example, in each of main body portion 31a and flange portion 32a, outer peripheral surface 301a is curved, and inner surface 302a is flat.

[0076] 8, the other member 30b includes a main body portion 31b, a flange portion 32b, a first insertion groove 33b, a second insertion groove 34b, a first fitting recess 35b, and a second fitting recess 36b. For example, in each of the main body portion 31b and the flange portion 32b, an outer circumferential surface 301b is curved, and an inner circumferential surface 302b is flat.

[0077] The port wound closure guide 30 is formed by abutting (combining) the inner surface 302a (inner surface of the main body portion 31a and flange portion 32a) of one member 30a and the inner surface 302b (inner surface of the main body portion 31b and flange portion 32b) of the other member 30b.

[0078] The configuration of the other member 30b is symmetrical to that of the one member 30a with respect to the contact surface (the abutting surface), except for the first fitting recess 35b and the second fitting recess 36b.

[0079] The first insertion groove 33a and the second insertion groove 34a are respectively arranged in one member 30a so as to be continuous with the inner surface of the main body portion 31a and the inner surface of the flange portion 32a.

[0080] The first insertion groove 33b and the second insertion groove 34b are respectively arranged so as to be continuous with the inner surface of the main body portion 31b and the inner surface of the flange portion 32b in the other member 30b.

[0081] In one member 30a, the first fitting protrusion 35a is disposed on the inner surface of the main body 31a, and the second fitting protrusion 36a is disposed on the inner surface of the flange 32a.

[0082] In the other member 30b, the first fitting recess 35b is disposed on the inner surface of the main body 31b, and the second fitting recess 36b is disposed on the inner surface of the flange 32b.

[0083] The first mating recess 35b and the second mating recess 36b of the other member 30b are respectively disposed at positions symmetrical to the first mating protrusion 35a and the second mating protrusion 36a of the one member 30a.

[0084] When the inner surface 302a of one member 30a and the inner surface 302b of the other member 30b are brought into contact with each other and combined, the first mating protrusion 35a and the second mating protrusion 36a are mated with each other.

[0085] At this time, the main body portion 31a and the main body portion 31b constitute the main body 31 of the port wound closure guide 30. The flange portion 32a and the flange portion 32b constitute the flange 32 of the port wound closure guide 30.

[0086] The first insertion groove 33a and the first insertion groove 33b form a first insertion hole 33, and the second insertion groove 34a and the second insertion groove 34b form a second insertion hole 34.

[0087] As in the first embodiment, one end (first flange-side inlet / outlet) 33_1 of the first insertion hole 33 is disposed on the upper surface of the flange 32.

[0088] The other end (first main body side inlet / outlet) 33_2 of the first insertion hole 33 is disposed on the side surface of the main body 31.

[0089] One end 34_1 (second flange-side inlet / outlet) of the second insertion hole 34 is disposed on the upper surface of the flange 32 at a predetermined distance from one end 33_1 of the first insertion hole 33. One end 34_1 of the second insertion hole 34 may be disposed on a side surface of the flange 32.

[0090] The other end (second main body side entrance / exit) 34_2 of the second insertion hole 34 is disposed on the side surface of the main body 31, on the same side as the other end 33_2 of the first insertion hole 33.

[0091] The port wound closure guide according to this embodiment may be manufactured by forming the first insertion grooves 33a, 33b and the second insertion grooves 34a, 34b after molding the outer shapes of the main bodies 31a, 31b. In this embodiment, the first and second insertion grooves can be formed more easily and accurately than the first and second insertion holes in the first embodiment and first example. Therefore, according to this embodiment, the port wound closure guide can be easily manufactured.

[0092] <Port wound closure method> A port incision closure method using the port incision closure guide 30 according to this embodiment will be described with reference to Figures 9A to 9H, taking as an example the closure of a port incision in an abdominal wall 1. Figures 9A to 9H show a cross section of the port incision closure guide 30 and a cross section around the port incision.

[0093] The port wound closure guide 30 uses a combination of one member 30a and the other member 30b. When the one member 30a and the other member 30b are combined, the first insertion groove 33a and the first insertion groove 33b form the first insertion hole 33, and the second insertion groove 34a and the second insertion groove 34b form the second insertion hole 34.

[0094] At this time, the one member 30a and the other member 30b may be joined by being pressed by the surgeon's hand, or may be joined by a fixing device such as a fixing band, or may be joined by being fixed with an adhesive or the like.

[0095] First, after the surgery is completed, the trocar is removed, and the port wound closure guide 30 is inserted into the port site (port wound) 6 in the abdominal wall 1 on the body surface 2 (FIGS. 9A and 9B).

[0096] Next, the suture thread holder (needle) 8 is inserted into the first insertion hole 33. After being inserted from the other end 33_2 of the first insertion hole 33, the suture thread holder 8 is inserted into the abdominal wall 1, and the tip of the suture thread holder 8 is protruded into the abdominal cavity 5. Subsequently, the holding ring 81 at the tip of the suture thread holder (needle) 8 is opened.

[0097] As a result, the tip of the suture holding device 8 pierces a portion of the tissue (hereinafter referred to as the "first tissue portion") 4_1 of the abdominal wall 1 and is inserted from the abdominal cavity side surface 3 of the abdominal wall, and the holding ring 81 at the tip of the suture holding device (needle) 8 is positioned near the other end 34_2 of the second insertion hole 34.

[0098] Furthermore, the suture 7 is inserted into the second insertion hole 34. Subsequently, the suture 7 that is inserted from the other end 34_2 of the second insertion hole 34 is inserted into the gripping ring 81 at the tip of the suture gripping tool (needle) 8 (FIG. 9C).

[0099] At this time, the holding ring 81 at the tip of the suture holding device (needle) 8 is positioned near the other end 34_2 of the second insertion hole 34, so that the suture 7 is inserted from the other end 34_2 of the second insertion hole 34 and then inserted directly into the holding ring 81 at the tip of the suture holding device (needle) 8.

[0100] In this way, with the port wound closure guide 30, the suture 7 can be inserted into the holding ring 81 at the tip of the suture holding device (needle) 8 simply by inserting it through the second insertion hole 34, without using forceps 9 that are inserted through a trocar for another port wound as with conventional port wound closure guides.

[0101] Next, the gripping ring 81 at the tip of the suture gripping device (needle) 8 is closed to allow the suture gripping device (needle) 8 to grip the suture 7. Subsequently, the suture gripping device 8 gripping the suture 7 is pulled out from the first insertion hole 33 (FIG. 9D).

[0102] As a result, the suture 7, together with the suture grasper 8, is inserted (pierced) through the first tissue portion 4_1, and captures the first tissue portion 4_1.

[0103] Next, the suture 7 is released from the suture holder 8, and the suture holder 8 is rotated horizontally by 180° (FIGS. 9E and 9F). As a result, the suture inserted through the first insertion hole 33 is passed between the outer periphery of the main body 31 and the abdominal wall 1 (indicated by the dashed line in the drawings), and is inserted (pierced) through the first tissue portion 4_1.

[0104] Next, the suture holder (needle) 8 is inserted into the first insertion hole 33. At this time, the suture holder 8 is inserted into the first insertion hole 33 together with the suture 7 that was inserted in the above process. After being inserted from the other end 33_2 of the first insertion hole 33, the suture holder (needle) 8 is inserted into the abdominal wall 1, and the tip of the suture holder 8 is protruded into the abdominal cavity 5. Subsequently, the holding ring 81 at the tip of the suture holder (needle) 8 is opened.

[0105] As a result, the tip of the suture holding device 8 pierces a portion of the tissue (hereinafter referred to as the "second tissue portion") 4_2 of the abdominal wall 1 and is inserted from the abdominal cavity side surface 3 of the abdominal wall, and the holding ring 81 at the tip of the suture holding device (needle) 8 is positioned near the other end 34_2 of the second insertion hole 34.

[0106] Next, the other end of the suture 7 is inserted into the second insertion hole 34. At this time, the suture 7 that was inserted in the above process and the suture 7 that is to be inserted this time are both inserted into the second insertion hole 34, and the suture 7 is inserted back and forth within the second insertion hole 34.

[0107] Subsequently, the suture 7 inserted from the other end 34_2 of the second insertion hole 34 is inserted through the gripping ring 81 at the tip of the suture gripping tool (needle) 8 in the same manner as above (FIG. 9G).

[0108] In this way, in the port wound closure guide 30, as described above, the suture 7 can be inserted into the gripping ring 81 at the tip of the suture gripping device (needle) 8 simply by inserting it through the second insertion hole 34 without grasping the suture with forceps 9.

[0109] Next, the gripping ring 81 at the tip of the suture gripping device (needle) 8 is closed, causing the suture gripping device (needle) 8 to grip the suture 7. Subsequently, the suture gripping device 8 gripping the suture 7 is pulled out from the first insertion hole 33 (FIG. 9H). Furthermore, the suture gripping device 8 is pulled, and the suture 7 is pulled out from the first insertion hole 33 (FIG. 9I).

[0110] As a result, the suture 7 in the first insertion hole 33 is pulled out from the other end 33_2 of the first insertion hole 33, and is inserted (pierced) through the second tissue portion 4_2 together with the suture grasping tool 8, thereby capturing the second tissue portion 4_2.

[0111] Next, the port wound closure guide 30 is removed, and the suture 7 is released from the port wound closure guide 10 (Figs. 9J and 9K).

[0112] Finally, both ends of the suture 7 are pulled to pull together the abdominal wall tissues on both sides of the tissue opening (the first tissue portion 4_1 and the second tissue portion 4_2), and the sutures are tied near the abdominal wall tissues to close the port wound (FIG. 9L).

[0113] Thus, according to the port wound closure method of this embodiment, the suture 7 can be inserted into the gripping ring at the tip of the suture gripping device (needle) simply by inserting it through the second insertion hole without grasping the suture with forceps. This reduces the number of steps in the port wound closure procedure, shortens the procedure time, and reduces the burden on the surgeon.

[0114] In the port wound closure method of this embodiment, the port wound closure guide 10 according to the first embodiment or the port wound closure guide 20 according to the first embodiment may be used.

[0115] In this embodiment, an example in which one member and the other member are symmetrical with respect to the surface where they abut against each other has been shown, but this is not limiting and one member and the other member may be asymmetrical with respect to the surface where they abut against each other.

[0116] For example, in this embodiment, two members are used that are divided by a plane along a central axis that passes through the center of the upper surface of the flange of the port wound closure guide, and insertion grooves that form insertion holes are arranged in both of the two members, but this is not limited to this. An insertion groove may be arranged in only one member, and no insertion groove may be arranged in the other member. Alternatively, a first insertion groove may be arranged in one member, and a second insertion groove may be arranged in the other member.

[0117] In these configurations, the insertion hole formed by the insertion groove is offset from the center (the center in the extension direction of the main body 31 in a side view), but it is sufficient that the suture inserted from the other end 34_2 of the second insertion hole 34 is passed through the gripping ring at the tip of the suture gripping device (needle) 8 inserted from the other end 33_2 of the first insertion hole 33.

[0118] In this embodiment, the suture thread gripper (needle) 8 has an openable and closable ring as a gripping part at its tip, but this is not limiting. The suture thread gripper (needle) 8 may have another gripping part, such as forceps, at its tip.

[0119] <Effects> The effects of the port wound closure guide according to the embodiment and examples of the present invention will be described using the port wound closure guide 30 according to the second example as an example. The port wound closure guide according to the first embodiment and first example also achieves the same effects.

[0120] When a port wound is closed using the port wound closure guide 30, as shown in Figure 10(a), the side where the other end 33_2 of the first insertion hole 33 is located is brought into close contact with the side wall of the port wound 6 in the abdominal wall 1. This causes the suture grasper (needle) 8 inserted through the first insertion hole 33 to be inserted at an angle θ' with respect to the side wall of the port wound 6. In this way, by setting the angle θ' of the first insertion hole 33 with respect to the side surface of the main body, the insertion angle of the suture grasper (needle) 8 with respect to the side wall of the port wound 6 can be adjusted.

[0121] The outer edge where the second insertion hole 24 is arranged may be inclined at an angle θm toward the outer edge where the first insertion hole 23 is arranged. This reduces the distance between the gripping portion (e.g., gripping ring 81) at the tip of the suture gripping device (needle) 8 inserted into the first insertion hole 33 and the other end 34_2 of the second insertion hole 34. This allows the suture gripping device (needle) 8 to easily grip the suture inserted from the other end 34_2.

[0122] Furthermore, by bending (or curving) the side where the other end 33_2 of the first insertion hole 33 and the other end 34_2 of the second insertion hole 34 are located so that it is concave at a predetermined angle, the opening surface of the holding ring 81 at the tip of the suture holding device (needle) 8 inserted into the first insertion hole 33 can be easily positioned in a position facing the opening surface of the other end 34_2 of the second insertion hole 34.

[0123] For example, if the surface on which the other end 33_2 of the first insertion hole 33 and the other end 34_2 of the second insertion hole 34 are disposed is flat, then as shown in Figure 10(b), the opening surface of the gripping ring 81 and the opening surface of the other end 34_2 of the second insertion hole 34 are not parallel to each other. Assuming that the suture 7 is inserted perpendicularly from the other end 34_2 of the second insertion hole 34, the insertion direction of the suture 7 is not perpendicular to the opening surface of the gripping ring 81, and therefore the area of ​​the gripping ring 81 through which the suture 7 can be inserted is actually small.

[0124] On the other hand, in the port wound closure guide 30, as shown in Figure 10(a), the side where the other end 33_2 of the first insertion hole 33 and the other end 34_2 of the second insertion hole 34 are arranged is curved (or bent), so the insertion direction of the suture 7 is perpendicular or nearly perpendicular to the opening surface of the holding ring 81, and therefore the area of ​​the holding ring 81 through which the suture 7 can be inserted is actually large.

[0125] This allows the suture 7 inserted from the other end 34_2 of the second insertion hole 34 to be easily inserted through the gripping ring 81 at the tip of the suture gripping tool (needle) 8.

[0126] Next, in the port wound closure guide, the bottom surface of the flange is inclined relative to the top surface, so that the suture holder 8 can be inserted into the first tissue portion 4_1 and the second tissue portion 4_2 at a large insertion angle. Here, the insertion angle is the angle between the insertion direction of the suture holder 8 and the inner wall of the port wound (the first tissue portion 4_1 and the second tissue portion 4_2).

[0127] As a result, the first tissue portion 4_1 and the second tissue portion 4_2 can be firmly captured by the suture, thereby enabling the port wound to be firmly sutured and closed.

[0128] With conventional port wound closure guides, the doctor may be able to manually tilt the guide by applying force to ensure the insertion angle. With the port wound closure guide 30, the insertion angle θ' is set by its own weight, allowing the suture holder 8 to be easily inserted into the inner wall of the port wound at the appropriate insertion angle.

[0129] In the embodiment and present example of the present invention, the position of the gripping portion at the tip of the suture gripping device (needle) can be moved depending on the degree of insertion of the suture gripping device (needle) into the first insertion hole, and the gripping portion at the tip can grip the suture. Therefore, since the area in which the suture can be gripped is wide, the suture can be gripped by the suture gripping device (needle) 8 outside the port wound closure guide (outside the other end of the second insertion hole).

[0130] In this configuration, for example, the distance between the holding portion and the other end of the second insertion hole is approximately 5 to 10 mm, so even if the suture bends or warps after being inserted from the other end of the second insertion hole, the suture can be easily inserted into the holding ring.

[0131] In this way, the first insertion hole and the second insertion hole may be configured so that the distance between the position of the gripping portion and the other end of the second insertion hole when the suture gripping device (needle) 8 is inserted is approximately 5 to 10 mm.

[0132] For example, the gripping ring at the tip of the suture gripper (needle) 8 can be opened and closed, and after the suture is passed through the gripping ring with the gripping ring open, the gripping ring can be closed to grip the suture.

[0133] Therefore, since the area (holding ring) through which the suture is inserted is wide, the suture can be held by the suture holder (needle) 8 outside the port wound closure guide (outside the other end of the second insertion hole).

[0134] In this configuration, for example, the distance between the placed gripping ring and the other end of the second insertion hole is approximately 5 to 10 mm, and the diameter of the opening of the gripping ring is approximately 10 to 20 mm, so even if the suture bends or warps after being inserted from the other end of the second insertion hole, the suture can be easily inserted into the gripping ring.

[0135] In this way, the first insertion hole and the second insertion hole may be configured so that the distance between the position of the gripping ring and the other end of the second insertion hole when the suture gripping device (needle) 8 is inserted is approximately 5 to 10 mm.

[0136] The port wound closure guide according to the embodiment and examples of the present invention is made of stainless steel, but may also be made of other materials such as metals such as titanium, or resins such as polycarbonate and polyamide.

[0137] In the embodiments and examples of the present invention, the cross-sectional shapes of the first and second insertion holes are shown as being circular or elliptical, but are not limited thereto and may be polygonal. Also, the cross-sectional shapes of the first and second insertion grooves may be rectangular or semi-polygonal.

[0138] In the embodiments and examples of the present invention, examples of the structure, dimensions, materials, etc. of each component of the port wound closure guide are shown, but the present invention is not limited to these examples. Any component may be used as long as it can function and produce the desired effect. [Industrial Applicability]

[0139] The present invention can be applied to a port wound closure guide as a medical device used to close a port wound after removing a trocar or other device during surgical procedures. [Explanation of symbols]

[0140] 10 Port Wound Closure Guide 11 Main unit 12 flange 13 First insertion hole 13_1 One end of the first insertion hole (first flange side inlet / outlet) 13_2 The other end of the first insertion hole (the first main body side inlet / outlet) 14 Second insertion hole 14_1 One end of the second insertion hole (second flange side inlet / outlet) 14_2 Other end of the second insertion hole (second main body side inlet / outlet)

Claims

1. The main body and A flange and a first insertion hole; A second insertion hole; Equipped with The body extends from a proximal end to a distal end, The base end of the body is connected to the bottom surface of the flange; the first insertion hole passes through the main body and the flange; one end of the first insertion hole is disposed on an upper surface of the flange, the other end of the first insertion hole is disposed on one side of the side surface of the main body, the second insertion hole passes through the main body and the flange; One end of the second insertion hole is disposed in the flange, A port wound closure guide, wherein the other end of the second insertion hole is positioned on the one side of the side surface of the main body, closer to the tip of the main body than the other end of the first insertion hole.

2. The port wound closure guide according to claim 1 is composed of two members divided by a plane perpendicular to the flange, one of the two members has a fitting protrusion on a surface parallel to the plane to be divided; The other member has a fitting recess on a surface parallel to the divided surface.

3. The one side of the side surface of the main body is curved or bent toward the inside of the main body, A port wound closure guide as described in claim 1 or claim 2, wherein the bottom surface of the flange is inclined with respect to a plane perpendicular to the extension direction of the main body so that the distance between the top surface and the bottom surface narrows from the one side toward the opposite side of the one side.

4. The curved or bent angle is greater than 0° and not more than 25°, The angle at which the bottom surface of the flange is inclined is greater than 0° and not more than 15° with respect to a plane perpendicular to the extension direction of the main body, The port wound closure guide according to claim 3 , wherein the first insertion hole is arranged linearly at an angle of 5° to 15° relative to the one side surface.

5. A port wound closure guide is inserted into the port wound in order to close the port wound in the abdominal wall by suturing, and includes a suture grasper having a grasper at its tip and a suture thread that are passed through the abdominal cavity, The suture grasping tool is inserted through the first insertion hole, The suture is inserted through the second insertion hole, 3. The port wound closure guide according to claim 1, wherein the suture thread inserted through the second insertion hole is grasped by the grasping portion of the suture thread grasping device.

6. 3. The port wound closure guide according to claim 1, wherein one end of the first insertion hole and one end of the second insertion hole are arranged on the same straight line passing through the center of the upper surface of the flange.

7. A port wound closure guide including a main body, a flange, a first insertion hole, and a second insertion hole, One component and With other materials Equipped with The one member is One main body portion; a flange portion connected to the one main body portion; Equipped with The other member is the one main body portion and another main body portion constituting the main body; Another flange portion connected to the other main body portion and constituting the one flange portion and the flange; Equipped with a groove that forms the first insertion hole is provided on an inner surface of at least one of the first member and the second member, a groove that forms the second insertion hole is provided on an inner surface of at least one of the first member and the second member; an inner surface of the one member and an inner surface of the other member are in contact with each other; The body extends from a proximal end to a distal end, The base end of the body is connected to the bottom surface of the flange; the first insertion hole passes through the main body and the flange; one end of the first insertion hole is disposed on an upper surface of the flange, the other end of the first insertion hole is disposed on one side of the side surface of the main body, the second insertion hole passes through the main body and the flange; one end of the second insertion hole is disposed on an upper surface of the flange, A port wound closure guide, wherein the other end of the second insertion hole is positioned on the one side of the side surface of the main body, closer to the tip of the main body than the other end of the first insertion hole.

Images