Suture Device

Abstract

To provide a suture device capable of speeding up a suturing procedure.SOLUTION: A suture device is attached to a distal end of an endoscope. The suture device comprises a curved needle formed in an arc shape as a whole and to which a suture thread is attached, a support body for slidably supporting the curved needle with a suture space S formed therebetween, and a drive part (a drive mechanism X) for advancing the curved needle. The drive mechanism X includes a rotary shaft 10b provided in the support body and being rotatable around an axis, and an operation wire directly or indirectly connected to the rotary shaft 10b and rotating the rotary shaft 10b by being pulled. The rotary shaft 10b advances the curved needle by rotating, with a side peripheral surface thereof coming into contact with a side portion of the curved needle.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to a suturing device with a curved needle. [Background technology]

[0002] Suturing devices attached to endoscopes are used in procedures such as resecting lesions and fixing stents to the digestive tract by suturing (closing) tissue. Compared to medical clips, which close by pulling the mucous membrane on the surface of the tissue, these suture devices can close the tissue deeply (for example, to the entire layer, or at least to the submucosal layer). For this reason, they are known to have extremely low retraction rates, are easy to close over a wide area, and have high hemostatic properties.

[0003] For example, Patent Document 1 describes that in a suturing device, the claws of the shuttle are engaged with the notch of a curved needle (arched needle), and the operating wire (cable) is pulled, causing the shuttle connected to the operating wire to oscillate back and forth, thereby advancing the curved needle. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Special Publication No. 2021-526948 Summary of the Invention [Problem to be solved by the invention]

[0005] The suturing device described in Patent Document 1 has a shuttle that swings back and forth at a predetermined angle, intermittently pushing out a curved needle (arched needle) that engages with the shuttle's claws, so the angle at which the curved needle advances each time is limited to the amount of movement of the shuttle, which is less than one revolution.

[0006] This meant that the shuttle had to be swung back and forth many times, making it difficult to operate the curved needle smoothly.Therefore, there was room for improvement in terms of speeding up the suturing procedure.

[0007] The present invention has been made in view of the above-mentioned problems, and aims to provide a suturing device that can speed up suturing procedures. [Means for solving the problem]

[0008] The present invention First The suturing device is attached to the distal end of an endoscope, and comprises a curved needle formed in an arc shape overall and to which a suture thread is attached, a support body that slidably supports the curved needle with a suturing space provided, and a drive unit that advances the curved needle, the drive unit having a rotating shaft that is provided on the support body and can rotate around its axis, and an operating wire that is directly or indirectly connected to the rotating shaft and is pulled to rotate the rotating shaft, and the rotating shaft advances the curved needle by rotating with its side peripheral surface in contact with the side of the curved needle. The operating wire rotates the curved needle continuously in the same direction over one revolution with one pulling operation. It is characterized by: [Effects of the Invention]

[0009] The suturing device of the present invention can speed up the suturing procedure. [Brief explanation of the drawings]

[0010] [Figure 1] FIG. 1 is a perspective view of a suturing device. [Figure 2] FIG. 1 shows a curved needle and a sewing thread. [Figure 3] FIG. 2 is an explanatory diagram schematically illustrating a drive mechanism of the suturing device. [Figure 4] FIG. 2 is a plan view showing a portion where a drive gear and a driven gear of a drive mechanism are arranged. [Figure 5] 4 is a diagram illustrating a ratchet mechanism, showing the area below the disk body as viewed from above in FIG. 3. FIG. [Figure 6] 10A and 10B are diagrams illustrating an attached state of the spiral spring. [Figure 7] 1A is an explanatory diagram showing a state in which the operating wire is being pulled, and FIG. 1B is an explanatory diagram showing a state in which the pulling of the operating wire has stopped. [Figure 8] (a) is a schematic diagram showing the state in which a suturing device is placed on top of the mucosa and submucosa to be closed. (b) is a schematic diagram showing the state in which a curved needle has been inserted into the mucosa and submucosa. (c) is a schematic diagram showing the state just before the suture thread sutures the mucosa and submucosa. (d) is a schematic diagram showing the state in which the suture thread has sutured the mucosa and submucosa. DETAILED DESCRIPTION OF THE INVENTION

[0011] Hereinafter, embodiments of the present invention will be described with reference to the drawings. Note that the embodiments described below are merely examples for facilitating understanding of the present invention and are not intended to limit the present invention. In other words, the shapes, dimensions, arrangements, etc. of the components described below may be changed or improved without departing from the spirit of the present invention, and the present invention naturally includes equivalents thereof. In addition, in all drawings, similar components are given similar reference numerals, and duplicate explanations are omitted as appropriate.

[0012] <Summary> First, an overview of a suturing device 1 according to this embodiment will be described mainly with reference to FIGS. 1 to 3. FIG. FIG. 1 is a perspective view showing a suturing device 1, FIG. 2 is a diagram showing a curved needle 2 and a suture 2a, and FIG. 3 is an explanatory diagram showing a schematic view of a drive mechanism X of the suturing device 1. As shown in FIG. 1 is a diagram showing the suturing device 1 in a state where the curved needle 2 is not attached. Furthermore, an operating wire 15 is wound around the center of the operating wire winding portion 8, but the operating wire 15 is not shown in FIG.

[0013] The suturing device 1 according to this embodiment is attached to the tip of an endoscope (not shown) by an attachment part 1a shown in FIG. The suturing device 1 comprises a curved needle 2 formed in an arc shape overall, to which a suture thread 2a shown in FIG. 2 is attached, a support body 6 that slidably supports the curved needle 2 across a suture space S, and a drive unit (drive mechanism X shown in FIG. 3) that advances the curved needle 2. The drive mechanism X comprises a rotating shaft 10b that is provided on the support body 6 and is rotatable about its axis, and an operating wire 15 (see FIG. 7) that is connected directly or indirectly to the rotating shaft 10b and rotates the rotating shaft 10b when pulled. The rotating shaft 10b advances the curved needle 2 by rotating with its side circumferential surface in contact with the side of the curved needle 2.

[0014] Specifically, as shown in Figure 1, the support body 6 has a pair of arms 6a formed in the shape of a wrench, and the space between the pair of arms 6a is open, and this open portion forms the suture space S where the tip of the curved needle 2 is exposed. The "suture space S" refers to a space through which the curved needle 2 passes and into which the body tissue (the mucosa 20 and the submucosa 20a) can be inserted. "Supporting the curved needle 2 so that it can slide while leaving the suture space S" specifically means that the curved needle 2 is not supported in the suture space S portion, but is supported so that it can slide in other portions.

[0015] Regarding the configuration of the "operating wire 15 that rotates the rotating shaft 10b by being pulled," specifically, in this embodiment, the operating wire 15 is wound around the operating wire winding section 8 and is indirectly connected to the rotating shaft 10b. Specifically, the operating wire 15 is connected to the rotating shaft 10b via the operating wire winding portion 8, the first central shaft 9a, the ratchet mechanism Y, the second central shaft 10a, and the gear portion 10. However, the present invention is not limited to this configuration, and the operating wire 15 may be wound directly around the rotating shaft 10b.

[0016] According to the above configuration, by pulling the operating wire 15 to rotate the rotary shaft 10b, the curved needle 2 can be smoothly advanced. In other words, as long as the rotating shaft 10b continues to rotate, the curved needle 2 in contact with the rotating shaft 10b can rotate in the same direction more than once (360 degrees) and can continuously perform suturing using the sewing thread 2a attached to the curved needle 2.

[0017] Next, the configuration of each part of the suturing device 1 will be described with reference to FIGS. 4 to 8 in addition to FIGS. Fig. 4 is a plan view of a portion where the drive gear 11 and driven gears (first driven gear 12 and second driven gear 13) of the drive mechanism X are arranged. Fig. 5 is a view for explaining the ratchet mechanism Y, showing the portion below the disc body 9f as viewed from above in Fig. 3. FIG. 6 is a diagram showing the attached state of the spiral spring 7, FIG. 7(a) is an explanatory diagram showing the state in which the operating wire 15 is being pulled, and FIG. 7(b) is an explanatory diagram showing the state in which the pulling of the operating wire 15 has stopped. Figure 8(a) is a schematic diagram showing the state in which the suturing device 1 is placed on top of the mucosa 20 and submucosal layer 20a, which are the objects to be closed; Figure 8(b) is a schematic diagram showing the state in which the curved needle 2 has been inserted into the mucosa 20 and submucosal layer 20a; Figure 8(c) is a schematic diagram showing the state just before the suture 2a sutures the mucosa 20 and submucosal layer 20a; and Figure 8(d) is a schematic diagram showing the state in which the suture thread 2a has sutured the mucosa 20 and submucosal layer 20a.

[0018] As shown in Figure 1, the suturing device 1 mainly comprises an operating wire etc. accommodating section 3 that accommodates the distal end of the operating wire 15 and the spiral spring 7, a ratchet accommodating section 4 that accommodates the ratchet mechanism Y, a gear accommodating section 5 that accommodates the drive gear 11, the first driven gear 12, and the second driven gear 13, and a support main body section 6 that slidably supports the curved needle 2.

[0019] <Drive mechanism> The operating wire 15 can rotate the curved needle 2 continuously in the same direction for more than one revolution with one pulling operation. Specifically, the curved needle 2 rotates when the side of the curved needle 2 comes into contact with the circumferential side surface of the rotating shaft 10b shown in Figure 4. The gap in the sliding region R of the curved needle 2 in the support body 6 (the gap between the pair of arms 6a in the suture space S) is shorter than the length of the curved needle 2.

[0020] For this reason, the sliding region R of the curved needle 2 is formed in a circular shape, and there is nothing in the suturing device 1 that obstructs the rotation of the curved needle 2, so the curved needle 2 is configured to be able to rotate more than one revolution. "Continuous rotation" is not limited to a smooth, continuous movement, but also includes repeated intermittent advancement movements, and means that the curved needle 2 is rotated by an amount of rotation that corresponds to the amount of pulling of the operating wire 15.

[0021] The circumferential side surface of the rotary shaft 10b is preferably made of a material with high friction, for example, the circumferential side surface is preferably covered with silicone rubber.

[0022] According to the above configuration, by continuously rotating the curved needle 2, suturing can be performed continuously, and the treatment speed can be increased.

[0023] As shown in FIG. 4, a plurality of (two in this embodiment) rotary shafts 10b are arranged in the support body 6 along the sliding region R of the curved needle 2. The angular interval θ2 between adjacent rotating shafts 10b is smaller than the central angle θ1 of the curved needle 2 shown in Figure 2 on the side of the support body part 6 opposite the suture space S side, with the boundary connecting the adjacent rotating shafts 10b as the reference point.

[0024] Specifically, the "central angle θ1 of the curved needle 2" refers to the angle on the curved needle 2 side between the line segments connecting the center of curvature C and the tip and base ends of the curved needle 2, as shown in Figure 2, and the central angle θ1 in this embodiment is approximately 230 degrees. Specifically, the "angular interval θ2 of the rotating shaft 10b" refers to the angle between the line segments connecting the center of curvature C, which is the center of rotation of the curved needle 2, and the center of each rotating shaft 10b, as shown in Figure 4, and the angular interval θ2 in this embodiment is approximately 200 degrees. In particular, it is preferable that the angle interval θ2 is greater than the angle obtained by subtracting θ1 from 360 degrees (approximately 130 degrees in this embodiment).

[0025] The number of rotating shafts 10b that rotate the curved needle 2 may be one, and for example, the second central shaft 10a may have that function. However, if multiple rotating shafts 10b are provided, rotational power can be continuously applied to the curved needle 2 that slides relative to the support body 6.

[0026] As shown in FIG. 4 and described above, the drive section (drive mechanism X) is provided with a plurality of rotating shafts 10b (two in this embodiment). The drive mechanism X further includes a main shaft (second central shaft 10a) that is indirectly connected to the plurality of rotary shafts 10b and transmits rotational power to each of the rotary shafts 10b. The operating wire 15 is indirectly connected to the second central shaft 10a via the operating wire winding portion 8, the first central shaft 9a, and the ratchet mechanism Y, which will be described later, and rotates the second central shaft 10a when pulled.

[0027] According to the above configuration, by pulling the operating wire 15, the plurality of rotary shafts 10b can be rotated, and the advancement of the curved needle 2 can be stabilized. Furthermore, the second central shaft 10a and one of the rotary shafts 10b may be directly connected by a belt or the like (not shown).

[0028] Furthermore, for example, if the configuration does not include the ratchet mechanism Y, the operating wire 15 may be wound directly around the second central shaft 10a. With such a configuration, the suturing device 1 can be made more compact since it does not include the ratchet mechanism Y or the operating wire winding section 8.

[0029] The multiple rotating shafts 10b and the main shaft (second central shaft 10a) are each provided with a gear portion 10 (second driven gear 13, drive gear 11). The gear portion (drive gear 11) of the second central shaft 10a is indirectly meshed with the gear portion (second driven gear 13) of the multiple rotating shafts 10b.

[0030] Specifically, the second central shaft 10a according to this embodiment is indirectly connected to the rotating shaft 10b via the drive gear 11, the first driven gear 12, and the second driven gear 13. The number of teeth of the drive gear 11 is 22, and the number of teeth of the first driven gear 12 and the second driven gear 13 is 8. The gear ratio between the drive gear 11 and the first driven gear 12 and the second driven gear 13 is 2.75. In this way, a configuration in which the second central shaft 10a and the rotating shaft 10b are indirectly connected is preferable compared to a configuration in which they are directly connected, because it allows the individual sizes of the first driven gear 12 and the second driven gear 13 to be kept small. Furthermore, it becomes possible to arrange the second driven gear 13, to which the rotating shaft 10b is fixed, in the vicinity of the suture space S, and the load for suturing can be suitably applied to the curved needle 2.

[0031] However, the present invention is not limited to this configuration, and the drive gear 11 may be configured to directly mesh with the second driven gear 13.

[0032] According to the above configuration, gear portions (second driven gear 13, driving gear 11) are provided on each of the rotating shaft 10b and the second central shaft 10a, so that the rotational power of the second central shaft 10a can be easily transmitted to the rotating shaft 10b.

[0033] The support body 6 is provided with a housing portion (housing groove 6b) that houses the curved needle 2 so that the curved needle 2 can slide therein. The accommodation groove 6b is provided with a slit 6c that communicates with the outside of the support body 6 and through which the sewing thread 2a attached to the curved needle 2 passes. The opening width of the slit 6c is narrower than the wire diameter of the curved needle 2. Specifically, the accommodation groove 6b is formed so as to straddle the gear accommodation portion 5 and the support main body portion 6, and is formed in an arc shape so as to form a sliding region R for the curved needle 2.

[0034] However, the present invention is not limited to this configuration, and the housing portion may be provided only in the support body portion 6. The slit 6c extends in an arc shape and is open toward the center of rotation of the curved needle 2. The opening width of the slit 6c is equal to or greater than the diameter of the sewing thread 2a. According to the above configuration, the suture thread 2a protrudes to the outside through the slit 6c, and thus the suture thread 2a can be prevented from becoming entangled with the curved needle 2 and the suturing device 1.

[0035] <Ratchet mechanism> The drive unit (drive mechanism X) includes a ratchet unit (ratchet mechanism Y). The ratchet mechanism Y transmits rotational power in the forward rotation direction to the main shaft (second center shaft 10a) so that the rotating shaft 10b rotates in the direction that advances the curved needle 2, but does not transmit rotational power to the second center shaft 10a in the direction opposite to the forward rotation direction.

[0036] In other words, the ratchet mechanism Y, as will be described in detail later, transmits the rotational power of the operating wire 15 to the second center shaft 10a when pulling the operating wire 15, and does not transmit the rotational power to the second center shaft 10a when returning the operating wire 15. According to the above configuration, it is possible to prevent the curved needle 2 from unintentionally moving in the retracting direction.

[0037] The drive section (drive mechanism X) further includes a drive shaft (operation wire winding section 8) around which an operation wire 15 is wound, and a table 9 fixed to the operation wire winding section 8. The ratchet portion (ratchet mechanism Y) is composed of a disk body 9f fixed to the main shaft (second central axis 10a), a plurality of uneven portions 9e shown in Figure 5 formed on the side wall 9c of the disk body 9f in the circumferential direction, and a locking claw 9d attached to the table 9 so as to be swingable, positioned opposite the plurality of uneven portions 9e, and capable of being locked onto the uneven portions 9e. When the operating wire 15 is pulled, the drive shaft (operating wire winding section 8), table 9 and locking claw 9d rotate, and the locking claw 9d abuts against and presses against the uneven section 9e (the protruding portion), thereby rotating the main shaft (second center axis 10a) in the direction of advancing the curved needle 2.

[0038] Specifically, as shown in FIG. 5, two support pins 9b that protrude upward are provided on the top surface of the table 9, and locking claws 9d are rotatably attached to the support pins 9b. The concave-convex portion 9e is composed of a slope formed obliquely so as to connect the radially inner side and the radially outer side with respect to a virtual concentric circle that is centered on the first central axis 9a and passes through the center of the concave-convex portion 9e, and a protrusion extending in the radial direction. These slopes and protrusions are provided repeatedly in the circumferential direction.

[0039] As shown in Fig. 7(a), when the operating wire 15 is pulled by the operating ring 14, the table 9 rotates counterclockwise in the direction shown in Fig. 5. The counterclockwise rotation of the table 9 causes the locking claw 9d to come into contact with and press against the slope of the uneven portion 9e, and the locking claw 9d is locked to the uneven portion 9e (the locking claw 9d does not rotate around the support pin 9b). In this state, the locking claw 9d rotates the side wall 9c counterclockwise. In this way, the rotation of the locking claw 9d is locked by the concave-convex portion 9e because the reaction force from the concave-convex portion 9e to the locking claw 9d has a load component directed toward the support pin 9b, which is the center of rotation.

[0040] According to the above configuration, the traction force of the operating wire 15 is converted into a rotational force of the main shaft (second center shaft 10a), and the curved needle 2 can be advanced by rotating the rotating shaft 10b indirectly connected to the second center shaft 10a.

[0041] <Power spring> The drive unit (drive mechanism X) further includes an elastic member (power spring 7). Power spring 7 biases table 9 to rotate in the direction opposite to the direction of rotation of table 9 when operating wire 15 is pulled (clockwise in the orientation shown in FIG. 5). When rotating in the reverse direction, the locking claw 9d of the ratchet portion (ratchet mechanism Y) does not lock onto the uneven portion 9e, causing the table 9 to spin freely and preventing the main shaft (second central shaft 10a) from rotating.

[0042] Specifically, after the operating wire 15 is pulled, when the pulling force weakens as shown in Fig. 7(b), the elastic restoring force of the spiral spring 7 causes the table 9 to rotate clockwise in the direction shown in Fig. 5. As the table 9 rotates clockwise, the locking claw 9d also rotates and comes into contact with the protruding portion of the uneven portion 9e.

[0043] At this time, a rotational torque about the support pin 9b is applied to the locking pawl 9d from the protruding portion of the uneven portion 9e, causing it to rotate counterclockwise around the support pin 9b. In this state, only a very small load is applied from the locking pawl 9d to the side wall 9c, so the locking pawl 9d cannot rotate the side wall 9c or the disk body 9f, and cannot transmit rotational power to the second center shaft 10a. In other words, the ratchet mechanism Y prevents the curved needle 2 from rotating in the reverse direction.

[0044] According to the above configuration, the elastic material (spiral spring 7) and ratchet mechanism Y allow the operating wire 15 to return to the state it was in before being pulled without rotating the second central shaft 10a, and by repeatedly pulling the operating wire 15, a load in the direction of advancement can be repeatedly applied to the curved needle 2. Therefore, as shown in Figures 8(a) to (d), the curved needle 2 can be repeatedly passed through the mucosa 20 and submucosal layer 20a and sutured with the sewing thread 2a.

[0045] In addition, the above-mentioned ratchet mechanism Y can function without a spring or the like, but a tension spring may be attached to the locking claw 9d so that the locking claw 9d is biased in the direction of contact with the side wall 9c by this tension spring.

[0046] As described above, the elastic member according to this embodiment is the spiral spring 7 attached to the drive shaft (first central shaft 9a fixed to the operating wire winding portion 8). 6, the inner end 7a of the power spring 7 is engaged with an engaging groove 8b formed in a boss 8a that protrudes downward in the operating wire winding portion 8. The U-shaped outer end 7b of the power spring 7 is engaged with the edge of a slit 3a formed in the side wall of the operating wire accommodating portion 3 shown in FIG. In FIG. 1, the outer end portion 7b of the spiral spring 7 is omitted.

[0047] In this way, in the power spring 7, the inner end 7a engages with the operating wire winding portion 8 and the outer end 7b engages with the operating wire etc. accommodating portion 3 (the edge of the slit 3a), thereby allowing an elastic restoring force to be suitably applied to the operating wire winding portion 8. That is, the spiral spring 7 configured in this manner can impart an elastic restoring force to the operating wire winding portion 8 so that the pulled operating wire 15 unwinds. The engagement point of the spiral spring 7 is not limited to the edge of the slit 3a, but may be a protrusion or the like provided on the operating wire accommodating section 3, or may be a portion formed on the ratchet accommodating section 4, the gear accommodating section 5, etc.

[0048] A power spring 7 is preferable as the "elastic member" because it is easy to apply a restoring torque via the first central shaft 9a and can bias the first central shaft 9a toward the state before the operating wire 15 was pulled. However, the present invention is not limited to this configuration, and the "elastic member" may be, for example, a tension spring or a compression spring that applies an elastic restoring force to the operation ring 14.

[0049] <Operating wire winding section> The drive unit (drive mechanism X) includes a drive shaft (operation wire winding unit 8) around which an operation wire 15 is wound. The operation wire 15 is wound around the operation wire winding unit 8 to a length sufficient to make multiple turns around the curved needle 2.

[0050] In this embodiment, the distal end of the operating wire 15 is welded to the operating wire winding portion 8, and the operating wire 15 is pulled out to the proximal side through a through hole or the like (not shown) formed in the operating wire winding portion 8, and the proximal end is fixed to the operating ring 14 shown in Figure 7.

[0051] The operating wire winding portion 8 is formed in a bobbin shape, and is fitted at its radial center onto a first central shaft 9a. A central portion of a spiral spring 7 (described later) is fixed to one end (lower end) of the first central shaft 9a, and a central portion of a table 9 is fixed to the other concentric end (upper end). According to the above configuration, when the curved needle 2 is rotated continuously, the operating wire 15 can be stably supplied from the drive shaft (operating wire winding portion 8) to the operating ring 14 side.

[0052] It should be noted that the various components according to the present invention do not necessarily have to exist independently of one another. It is acceptable for multiple components to be formed as a single member, for one component to be formed from multiple members, for one component to be a part of another component, or for part of one component to overlap with part of another component.

[0053] The above embodiment encompasses the following technical ideas. (1) A suturing device attached to a distal end of an endoscope, a curved needle formed into an arc shape as a whole and to which a sewing thread is attached; a support body portion that slidably supports the curved needle with a suture space provided; a drive unit that advances the curved needle, the drive unit includes a rotation shaft that is provided on the support main body and is rotatable around an axis, and an operating wire that is directly or indirectly connected to the rotation shaft and is pulled to rotate the rotation shaft, The suturing device is characterized in that the rotating shaft advances the curved needle by rotating with its side surface in contact with the side of the curved needle. (2) The suturing device according to (1), wherein the operating wire continuously rotates the curved needle in the same direction more than once with one traction operation. (3) the drive unit includes a drive shaft around which the operating wire is wound, The suturing device according to (2), wherein the operating wire is wound around the drive shaft to a length sufficient to make multiple turns of the curved needle. (4) a plurality of the rotary shafts are arranged in the support body along a sliding area of ​​the curved needle; A suturing device according to any one of (1) to (3), wherein the angular interval between adjacent rotating shafts is smaller than the central angle of the curved needle on the support body portion side opposite the suturing space side. (5) The drive unit is provided with a plurality of the rotary shafts, the drive unit further includes a main shaft that is directly or indirectly connected to the plurality of rotary shafts and transmits rotational power to each of the rotary shafts; A suturing device described in any one of (1) to (4), wherein the operating wire is directly or indirectly connected to the main shaft and rotates the main shaft by being pulled. (6) a gear portion is provided on each of the plurality of rotary shafts and the main shaft, The suturing device according to (5), wherein the gear portion of the main shaft is directly or indirectly engaged with the gear portions of the plurality of rotating shafts. (7) the drive portion includes a ratchet portion; The suturing device according to (5) or (6), wherein the ratchet portion transmits rotational power in a forward rotation direction to the main shaft so that the rotating shaft rotates in a direction that advances the curved needle, and does not transmit rotational power to the main shaft in a direction opposite to the forward rotation direction. (8) The drive unit is a drive shaft around which the operating wire is wound; a table fixed to the drive shaft, The ratchet portion is a disk body fixed to the main shaft; a plurality of concave and convex portions formed on a side wall of the disc body in a circumferential direction; a locking claw attached to the table so as to be swingable, disposed at a position facing the plurality of concave-convex portions, and capable of being locked to the concave-convex portions, The suturing device described in (7) above, wherein when the operating wire is pulled, the drive shaft, the table, and the locking claw rotate, and the locking claw abuts and presses against the uneven portion, thereby rotating the main shaft in the direction of advancing the curved needle. (9) The drive unit further includes an elastic member, the elastic member biases the table to rotate in a direction opposite to the direction of rotation of the table when the operating wire is pulled, The suturing device according to (8), wherein the locking claw of the ratchet portion does not lock onto the uneven portion when rotating in the reverse direction, causing the table to spin freely and preventing the main shaft from rotating. (10) The suturing device according to (9), wherein the elastic member is a spiral spring attached to the drive shaft. (11) the support body portion includes a housing portion that slidably houses the curved needle, The storage section is provided with a slit that communicates with the outside of the support body section and through which the sewing thread attached to the curved needle passes, The suturing device according to any one of (1) to (10), wherein the opening width of the slit is narrower than the wire diameter of the curved needle. [Explanation of symbols]

[0054] C center of curvature R sliding area S suture space X drive mechanism Y Ratchet mechanism (ratchet part) 1. Suture device 1a Mounting part 2 curved needles 2a sewing thread 3. Control line housing 3a Slit 4 Ratchet housing 5 Gear housing 6 Support body 6a Arm section 6b Receiving groove 6c slit 7 Mainspring 7a Inner end 7b Outer end 8 Operating wire winding section (drive shaft) 8a Boss 8b Engagement groove 9 tables 9a First central shaft (drive shaft) 9b Support pin 9c side wall 9d Locking claw 9e Uneven part 9f board 10 Gear section (drive section) 10a Second central shaft (main shaft) 10b Rotating shaft 11 Drive gear (gear part) 12 First driven gear 13 Second driven gear (gear part) 14 Operation ring 15 Operating Line 20 Mucosa 20a Submucosal layer

Claims

1. A suturing device attached to a distal end of an endoscope, a curved needle formed into an arc shape as a whole and to which a sewing thread is attached; a support body portion that slidably supports the curved needle with a suture space provided; a drive unit that advances the curved needle, the drive unit includes a rotation shaft that is provided on the support main body and is rotatable around an axis, and an operating wire that is directly or indirectly connected to the rotation shaft and is pulled to rotate the rotation shaft, the rotating shaft rotates with its side circumferential surface in contact with the side of the curved needle to advance the curved needle; A suturing device in which the operating wire continuously rotates the curved needle in the same direction more than one full turn with a single pulling motion.

2. the drive unit includes a drive shaft around which the operating wire is wound, The suturing device according to claim 1 , wherein the operating wire is wound around the drive shaft to a length sufficient to make a plurality of turns of the curved needle.

3. a plurality of the rotary shafts are arranged in the support body along a sliding area of ​​the curved needle; The suturing device according to claim 1 or 2, wherein the angular interval between adjacent rotating shafts is smaller than the central angle of the curved needle on the support body portion side opposite the suture space side.

4. The drive unit is provided with a plurality of the rotary shafts, the drive unit further includes a main shaft that is directly or indirectly connected to the plurality of rotary shafts and transmits rotational power to each of the rotary shafts; The suturing device according to any one of claims 1 to 3, wherein the operating wire is directly or indirectly connected to the main shaft and rotates the main shaft when pulled.

5. a gear portion is provided on each of the plurality of rotary shafts and the main shaft, The suturing device according to claim 4 , wherein the gear portion of the main shaft directly or indirectly meshes with the gear portions of the plurality of rotating shafts.

6. A suturing device attached to the tip of an endoscope, comprising: a curved needle formed into an arc shape as a whole and to which a sewing thread is attached; a support body portion that slidably supports the curved needle with a suture space provided; a drive unit that advances the curved needle, the drive unit includes a rotary shaft that is provided on the support main body and is rotatable around an axis, an operating wire that is directly or indirectly connected to the rotary shaft and that rotates the rotary shaft by being pulled, and a ratchet unit; the rotating shaft rotates with its side circumferential surface in contact with the side of the curved needle to advance the curved needle; The drive unit is provided with a plurality of the rotary shafts, the drive unit further includes a main shaft that is directly or indirectly connected to the plurality of rotary shafts and transmits rotational power to each of the rotary shafts; The operating wire is directly or indirectly connected to the main shaft and rotates the main shaft by being pulled; A suturing device in which the ratchet portion transmits rotational power in a forward rotation direction to the main shaft so that the rotating shaft rotates in a direction that advances the curved needle, and does not transmit rotational power to the main shaft in the direction opposite to the forward rotation direction.

7. The drive unit is a drive shaft around which the operating wire is wound; a table fixed to the drive shaft, The ratchet portion is a disk body fixed to the main shaft; a plurality of concave and convex portions formed on a side wall of the disc body in a circumferential direction; a locking claw attached to the table so as to be swingable, disposed at a position facing the plurality of concave-convex portions, and capable of being locked to the concave-convex portions, The suturing device according to claim 6, wherein when the operating wire is pulled, the drive shaft, the table, and the locking claw rotate, and the locking claw abuts and presses against the uneven portion, thereby rotating the main shaft in a direction to advance the curved needle.

8. The drive unit further includes an elastic member, the elastic member biases the table to rotate in a direction opposite to the direction of rotation of the table when the operating wire is pulled, The suturing device according to claim 7, wherein the locking claw of the ratchet portion does not lock onto the uneven portion when rotating in the reverse direction, causing the table to spin freely and preventing the main shaft from rotating.

9. The suturing device according to claim 8, wherein the elastic member is a power spring attached to the drive shaft.

10. the support body portion includes a housing portion that slidably houses the curved needle, The storage section is provided with a slit that communicates with the outside of the support body section and through which the sewing thread attached to the curved needle is passed, The suturing device according to claim 1 , wherein the opening width of the slit is narrower than the wire diameter of the curved needle.

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