Suturing device

Abstract

Provided is a suturing device with which a suturing needle can penetrate even if the width of a sewing-target part is small and the thickness of an edge section of the sewing-target part is thick. A suturing device 10 includes: a needle support tool 20 having an insertion part 21 to be inserted into a sewing-target part 1; and a suturing needle 30 which is supported by the needle support tool 20 and to which one end of a suture thread 5 is connected. The suturing needle 30 extends linearly and has, at a distal end thereof, a puncturing part 32 that punctures the sewing-target part 1. The suturing needle 30 is supported by the needle support tool 20 such that a proximal-end part 31' of the suturing needle in the extension direction thereof is separated from a distal-end part 21' of the insertion part 21 in the extension direction thereof and such that the puncturing part 32 is oriented toward a proximal end 21b of the insertion part 21 in the extension direction thereof. The puncturing part 32 punctures an edge section 2 of the sewing-target part 1 from a rear side 4 toward a front side 3.

Description

suture device

[0001] The present invention relates to a suture instrument for suturing a part to be sutured, a needle support for supporting a suture needle for suturing a part to be sutured, and a suturing method using the suture instrument.

[0002] BACKGROUND ART Holes, openings, etc. (parts to be sutured) may occur in the skin, walls of organs, etc. Conventionally, such parts to be sutured have been sutured using an instrument having a suture needle or the like.

[0003] For example, Patent Document 1 below describes a medical device having an elongated side tube, a needle disposed at the tip of the side tube, and a suture attached to the needle tip. The needle has a shaft extending a predetermined length and a generally round needle tip that is curved and rounded from the tip of the shaft and points toward the base end of the shaft.

[0004] When using the medical device, for example, a generally round needle is inserted from the near side of the part to be sutured, and after passing through the part, the tip of the needle is punctured from the back side of the part to the near side, causing the suture needle to penetrate the edge of the part to be sutured.Then, by withdrawing the suture needle from the part to be sutured, it becomes possible to insert a suture thread into the edge of the part to be sutured.

[0005] By repeating the above steps, the suture thread is passed through two points on the edge of the part to be sutured, and the part to be sutured can then be sutured by tying off the suture thread.

[0006] Special Publication No. 2012-525228

[0007] In the case of the medical device of Patent Document 1, the needle is generally round, so the outer dimensions of the needle are relatively large, making it difficult to insert the needle when the width of the sutured part is small. Also, if the thickness of the edge of the sutured part is thick, when the needle tip is inserted from the back side to the front side of the sutured part, the needle tip may protrude from the middle part in the thickness direction of the sutured part, making it impossible to reliably penetrate the edge part of the sutured part from the back side to the front side.

[0008] Therefore, an object of the present invention is to provide a suture instrument, a needle support, and a suturing method using a suture instrument that allows the suture needle to be easily inserted even when the width of the sutured part is small, and that allows the suture needle to be reliably penetrated even when the edge of the sutured part is thick.

[0009] One aspect related to the present invention is a suture instrument for suturing a part to be sutured, comprising: a needle support having an insertion portion that is inserted into the part to be sutured and extends a predetermined length; and a suture needle that is supported by the needle support and to which at least one end of a suture thread is connected or through which at least one end of a suture thread is inserted, the suture needle extending in a straight line and having a puncturing portion at the tip in the direction of extension that punctures the part to be sutured, the suture needle being supported by the needle support with the puncturing portion facing the base end in the direction of extension of the insertion portion and aligned along the direction of extension of the insertion portion, and the puncturing portion punctures an edge portion of the part to be sutured from the back side to the front side of the part to be sutured.

[0010] The suture instrument of the present invention is used to suture a part to be sutured, and comprises a needle support having an insertion portion that is inserted into the part to be sutured and extends a predetermined length, and a suture needle that is supported by the needle support and to which at least one end of a suture thread is connected or through which at least one end of a suture thread is inserted, the suture needle extending in a straight line or extending while bending, and having a puncturing portion at its tip in the extension direction that punctures the part to be sutured, the suture needle being supported by the needle support so that its base end in the extension direction is separated from the tip end in the extension direction of the insertion portion, and with the puncturing portion facing the base end side in the extension direction of the insertion portion, and the puncturing portion punctures the edge portion of the part to be sutured from the back side to the front side of the part to be sutured.

[0011] With the suture instrument, when suturing the part to be sutured, the insertion portion of the needle support tool is inserted from the front side of the part to be sutured to the back side, and then the needle support tool is pulled back toward the base end of the suture instrument or needle support tool (which can also be said to be the operator's hand side) to puncture the edge of the part to be sutured from the back side to the front side with the suture needle. After that, the suture needle itself is held by the needle support tool of another suture instrument or a needle holder that holds the suture needle, or the suture thread inserted into the suture needle is held by a holder.

[0012] Next, the suture needle or suture thread is pulled back toward the proximal end, causing the suture thread to pass through the edge of the area to be sutured and be pulled out toward the proximal side of the area. After that, the suture needle with the other end of the suture thread connected thereto or the other end of the suture thread is passed through another part of the edge of the area to be sutured in the same manner as above, so that the suture thread is passed through two parts of the edge of the area to be sutured. Furthermore, by grasping both ends of the suture thread and appropriately tying the suture thread, the area to be sutured can be closed.

[0013] In the suture instrument of the above aspect, the suture needle is supported by the needle support with the puncture portion facing the base end in the extension direction of the insertion portion and aligned in the extension direction of the insertion portion. This allows the distance between the insertion portion and the suture needle to be narrowed, making it easier to insert the suture needle along with the insertion portion even if the width of the part to be sutured is small.

[0014] In the suturing instrument of the present invention, the suture needle is supported by the needle support device so that the base end in the extension direction is spaced from the tip end in the extension direction of the insertion portion, and so that the puncture portion faces the base end in the extension direction of the insertion portion. Therefore, when the base end of the suture needle in the extension direction is supported by the needle support device, the support position of the suture needle by the needle support device can be freely selected, and the support position can be easily adjusted to a width appropriate for suturing the part to be sutured. Therefore, even when the distance between the insertion portion and the suture needle is narrow, the suture needle can be supported by the needle support device, and the position of the suture needle relative to the insertion portion can be maintained. As a result, it is easy to insert the suture needle together with the insertion portion, even if the width of the part to be sutured is small.

[0015] Furthermore, since the suture needle extends in a straight line or extends while bending, and the puncture portion of the suture needle faces the base end side of the insertion portion, even if the edge portion of the sutured part is thick, the suture needle can be reliably penetrated into the edge portion of the sutured part, and the puncture portion of the suture needle can be inserted and removed from the near side of the edge portion of the sutured part.

[0016] In one aspect of the suture instrument of the present invention, it is preferable that a suture thread is connected to the suture needle, and that a detachable portion that detachably grips the suture needle is provided adjacent to the tip side of the insertion portion in the extension direction.

[0017] According to the above aspect, the suturing needle can be gripped and detached by the detachable part, so that the edge of the part to be sutured can be sutured using a suturing instrument of the same structure, and there is no need to separately prepare different types of components (such as a suture needle holder.) As a result, component management is easier and the cost of the suturing system including the suturing instrument can be reduced.

[0018] In one aspect of the suture instrument of the present invention, the insertion portion and the suture needle are tubular in shape so that a suture thread can be inserted therethrough, and it is preferable that the tip end of the insertion portion in the extension direction and the base end of the suture needle in the extension direction are connected via a connecting portion, so that the insertion portion and the suture needle are integrated.

[0019] According to the above aspect, the insertion portion and the suture needle are integrated, which simplifies the structure of the suture instrument, makes the procedure easier, and eliminates the risk of the suture needle accidentally falling out of the insertion portion.

[0020] In one aspect of the suture instrument of the present invention, it is preferable that the suture instrument further comprises a capture tool that receives the puncture portion of the suture needle and is capable of capturing the suture thread that has been inserted through the tip opening of the puncture portion.

[0021] According to the above aspect, since the suture capture tool capable of capturing the suture thread is further provided, the suture thread can be captured reliably, and the part to be sutured can be securely sutured.

[0022] In one aspect of the suture instrument of the present invention, when the shortest distance between the base end of the suture needle in the extension direction and the point of the insertion portion that corresponds to the base end of the suture needle in the extension direction of the insertion portion in the extension direction of the insertion portion is defined as D1, and the shortest distance between the puncture portion and the point of the insertion portion that corresponds to the puncture portion in the extension direction of the insertion portion is defined as D2, it is preferable that the suture needle is supported by the needle support device so that D2 > D1.

[0023] According to the above aspect, the suture needle is supported by the needle support device in the above relationship, so that when the insertion portion is inserted into the back side of the sutured portion to suture the sutured portion, and then the needle support device is pulled back toward the base end, and the suture needle is punctured into the edge portion of the sutured portion from the back side to the front side, the suture needle can be punctured into a portion of the edge portion of the sutured portion that is away from the opening, rather than a portion close to the opening.

[0024] As a result, the suturing needle can be reliably inserted into the edge of the sutured part without damaging the area of ​​the edge of the sutured part that is close to the opening, and the suturing operation of the sutured part can be carried out stably.

[0025] In one aspect of the suture instrument of the present invention, it is preferable that the suture needle is supported by the needle support so that the angle of the extension direction L2 of the suture needle relative to the extension direction L1 of the insertion portion is inclined at an angle of 30° or less.

[0026] According to the above aspect, since the suturing needle is supported by the needle support tool in the above relationship, it is possible to more easily narrow the gap between the insertion portion and the suturing needle so as to be suitable for suturing the part to be sutured.

[0027] In one aspect of the suture instrument of the present invention, it is preferable that the suture needles are supported by the needle support tool in a state where they are aligned in a direction in which the insertion portion extends.

[0028] According to the above aspect, since the suturing needle is supported by the needle support tool in the above relationship, it is possible to more easily narrow the gap between the insertion portion and the suturing needle so as to be suitable for suturing the part to be sutured.

[0029] The needle support device of the present invention supports a suture needle that sutures a part to be sutured, and has an insertion part that is inserted into the part to be sutured and extends a predetermined length, and is characterized in that it supports the base end of the suture needle in the extension direction so as to be separated from the tip end of the insertion part in the extension direction, and supports the puncture part located at the tip of the suture needle in the extension direction toward the base end side in the extension direction of the insertion part.

[0030] According to the above-described needle support device, the base end of the suture needle in the extension direction is supported so as to be spaced apart from the tip end of the insertion section in the extension direction, and the puncture section located at the tip end of the suture needle in the extension direction is supported toward the base end of the insertion section in the extension direction. This makes it possible to freely select the support position of the suture needle when supporting the base end of the suture needle in the extension direction with the needle support device, and to easily adjust the support position to a width appropriate for suturing the part to be sutured. Therefore, even when the distance between the insertion section and the suture needle is narrow, the suture needle can be supported by the needle support device, and the position of the suture needle relative to the insertion section can be maintained. As a result, it is easy to insert the suture needle together with the insertion section even when the width of the part to be sutured is small.

[0031] The suturing method using the suture instrument of the present invention includes a first method in which the insertion portion of the needle support instrument is inserted from the front side of the part to be sutured using the suture instrument, and then the needle support instrument is pulled back toward the base end, causing the suture needle to puncture the edge portion of the part to be sutured from the back side to the front side of the part to be sutured; a second method in which the suture needle itself is held by the needle support instrument of another suture instrument or a holder that holds the suture needle, or the suture thread inserted into the suture needle is held by a capture tool that can capture the suture thread; and a third method in which the suture is pulled back toward the base end, and the suture is passed through the edge of the sutured part and pulled out to the near side of the sutured part; a fourth method in which the suture needle to which the other end of the suture is connected, or the other end of the suture is passed through another part of the edge of the sutured part by repeating the first, second and third methods, and the suture is inserted into two parts of the edge of the sutured part; and a fifth method in which both ends of the suture are grasped and the suture is tied off.

[0032] In one aspect of the suturing method using the suture instrument of the present invention, when the shortest distance between the base end of the suture needle in the extension direction and the corresponding point of the insertion portion in the extension direction of the insertion portion relative to the base end of the suture needle in the extension direction is D1, and the shortest distance between the puncture portion and the corresponding point of the insertion portion in the extension direction of the insertion portion relative to the puncture portion is D2, the suture needle is supported by the needle support device so that D2 > D1, and the third method preferably involves tilting the insertion portion obliquely with respect to the insertion direction of the insertion portion relative to the part to be sutured, and pressing the inner circumference of the edge portion of the part to be sutured, while pulling the suture needle back towards the base end, so that the suture thread passes through the edge portion of the part to be sutured and is pulled out to the front side of the part to be sutured.

[0033] According to the above aspect, in order to suture the part to be sutured, the insertion part is inserted into the back side of the part to be sutured, and then the needle support is pulled back towards the base end, and when the suture needle is punctured into the edge part of the part to be sutured from the back side to the front side, the insertion part is tilted diagonally to press against the inner circumference of the edge part of the part to be sutured while the suture needle is pulled back, so that the suture needle can be efficiently punctured into a location on the edge part of the part to be sutured that is away from the opening.

[0034] In other words, because the insertion part is supported on the inner periphery of the edge part of the sutured part, the suture needle can be firmly supported in an oblique position, making it easier to puncture the targeted part of the edge part and improving the puncture performance of the puncture part against the edge part. Note that the soft edge part is pressed and compressed by the insertion part, and the edge part is elastic tissue, and is assumed to be compressed by the suture when ligated with the suture, so even if the edge part is compressed, there is no impairment to the puncture performance of the puncture part against the edge part.

[0035] According to the present invention, the suture needle is supported by the needle support device so that the base end in the extension direction is spaced apart from the tip end in the extension direction of the insertion part, and so that the puncture part is facing the base end side in the extension direction of the insertion part.This means that the support position of the suture needle by the needle support device can be freely selected, making it easy to adjust the support position to a width suitable for suturing the part to be sutured.Since the suture needle can be supported by the needle support device even when the distance between the insertion part and the suture needle is narrow, it is easy to insert the suture needle together with the insertion part, even if the width of the part to be sutured is small.

[0036] 1 shows a first embodiment of a suture instrument according to the present invention, with (a) being a side view and (b) being a front view. It is a bottom view of the suture instrument. It is an explanatory diagram of the suture instrument with the detachable portion of the needle support tool open. It shows a second embodiment of a suture instrument according to the present invention, with (a) being an enlarged perspective view of the main part and (b) being an enlarged perspective view of the main part including the grasping tool. It is an explanatory diagram of a third embodiment of a suture instrument according to the present invention. A suturing method using the suture instrument of the first embodiment is shown, with (a) to (g) being explanatory views of each method. The same suturing method is shown, with (h) to (n) being explanatory views of each method. Another suturing method using the suture instrument of the first embodiment is shown, with (a) to (f) being explanatory views of each method. The same suturing method is shown, with (g) to (m) being explanatory views of each method. In a suturing method using a suture instrument according to the present invention, a suturing method using a suture instrument of a second embodiment is shown, with (a) to (c) being explanatory views of a method of using a grasping tool. The same suturing method is shown, with (a) to (g) being explanatory views of each method. The same suturing method is shown, with (h) to (n) being explanatory views of each method. In a suturing method using a suture instrument according to the present invention, a suturing method using a suture instrument of a third embodiment is shown, with (a) to (d) being explanatory views of each method. The same suturing method is shown, with (a) to (c) being explanatory views of a method of using a grasping tool. In a suture instrument according to the present invention, a first modified example of the third embodiment is shown, with (a) to (c) being schematic explanatory views of a suturing method using the same suture instrument. In a suture instrument according to the present invention, a second modified example of the third embodiment is shown, with (a) to (c) being schematic explanatory views of a suturing method using the same suture instrument. In a suture instrument according to the present invention, a fourth embodiment is shown, with (a) being a side view and (b) being a front view. 10A to 10E show modified examples of the fourth embodiment, with (a) being an enlarged explanatory view of a main portion of a first modified example, (b) being an enlarged explanatory view of a main portion of a second modified example, and (c) being an enlarged explanatory view of a main portion of a third modified example. 10B to 10E are enlarged explanatory views of a main portion of a fourth modified example of the fourth embodiment. 10C shows modified examples of the fourth embodiment, with (a) to (e) being explanatory views of each method.

[0037] (First Embodiment of Suturing Instrument) Hereinafter, a first embodiment of a suture instrument according to the present invention will be described with reference to Figs.

[0038] The suture instrument 10 of this embodiment is used to suture a part to be sutured 1, for example, as shown in Figures 6 to 9, and is equipped with a needle support tool 20 having an insertion part 21 that is inserted into the part to be sutured 1 and extends a predetermined length, and a suture needle 30 that is supported by the needle support tool 20 and to which one end of a suture thread 5 is connected.

[0039] 6(g), another suture needle 30 is connected to the other end of the suture thread 5. The direction in which the insertion portion 21 extends is referred to as the "extension direction L1," and the distal end and proximal end of the insertion portion 21 in the extension direction L1 are referred to as the distal end 21a and proximal end 21b, respectively. In addition, in the extension direction L1 of the insertion portion 21, the distal portion of the insertion portion 21 in the extension direction L1, including the distal end 21a in the extension direction L1, is referred to as the distal end 21' in the extension direction L1 of the insertion portion 21.

[0040] In addition, the needle support device 20 of the present invention supports the suture needle 30 that sutures the sutured part 1, and has an insertion portion 21 that is inserted into the sutured part 1 and extends a predetermined length, and is configured to support the base end 31' of the suture needle 30 in the extension direction L2 so as to be separated from the tip end 21' of the insertion portion 21 in the extension direction L1, and to support the puncture portion 32 located at the tip of the suture needle 30 in the extension direction L1 toward the base end 21b of the insertion portion 21 in the extension direction L1.

[0041] The needle support tool 20 has a first opening / closing body 22 and a second opening / closing body 23 that can be opened and closed via a support shaft 24. The first opening / closing body 22 and the second opening / closing body 23 have an elongated shape that extends a predetermined length, and the base ends 22a, 23a in the extending direction are thicker than the tip ends 22b, 23b in the extending direction to make them easier for an operator (practitioner) to grasp. The tip ends 22b, 23b of the first opening / closing body 22 and the second opening / closing body 23 form the insertion section 21.

[0042] In addition, by bringing the base ends 22a, 23a of the two opening / closing bodies 22, 23 close to each other via the support shaft 24, the tip ends 22b, 23b close to each other, and by moving the base ends 22a, 23a away from each other via the support shaft 24, the tip ends 22b, 23b open to each other.

[0043] 2, an insertion hole 28 is formed in the base end portion 23a of the second opening / closing body 23. A plate-shaped locking portion 28a extends from the outer edge of the insertion hole 28.

[0044] On the other hand, a generally L-shaped locking member 27 made of a leaf spring or the like is provided on the base end 22a of the first opening / closing body 22. This locking member 27 has a base 27a fixed to the base end 22a of the first opening / closing body 22 and a bent portion 27b bent relative to the base 27a and inserted into the insertion hole 28 of the second opening / closing body 23.

[0045] The bent portion 27b is provided with a plurality of ratchet-tooth shaped protrusions 27c, which can be engaged with the engaging portion 28a of the second opening / closing body 23 in stages.

[0046] 2, so that the protrusion 27c can be locked to the locking portion 28a. The operator can also grasp the distal end of the bent portion 27b and bend the bent portion 27b of the locking member 27 toward the base end of the second opening / closing body 23 as shown by the dashed line in FIG. 2, thereby releasing the locked state between the locking portion 28a and the protrusion 27c.

[0047] When the operator removes his / her finger from the bent portion 27b that has been bent and deformed toward the base end of the second opening / closing body 23, the bent portion 27b is biased to return to its initial state (elastic return).

[0048] The needle support tool 20 also has a spacing support portion that can support the base end portion 31' of the suture needle 30 in the extending direction L2 so as to be spaced apart from the tip end portion 21' of the insertion portion 21 in the extending direction L1.

[0049] 1, detachable portions 25, 26 for detachably gripping the suture needle 30 are provided adjacent to the tip side in the extending direction L1 of the insertion portion 21 of the needle support tool 20. In this embodiment, as shown in FIGS. 1(a) and 1(b), the detachable portions 25, 26 protrude from the most distal ends of the tip portions 22b, 23b of the opening / closing bodies 22, 23, respectively, so as to be perpendicular to the extending direction L1 of the insertion portion 21.

[0050] The detachable portions 25 and 26 constitute the "separate support portion" of the needle support device. Note that the detachable portions 25 and 26 are also included in the "insertion portion" of the present invention, and constitute a part of the insertion portion 21.

[0051] When the tip ends 22b, 23b of both opening / closing bodies 22, 23 are closed, the detachable portions 25, 26 approach each other and grip the base end 31' of the suture needle 30 in the extension direction L2, thereby supporting the suture needle 30 on the needle support device 20 (see FIG. 2). When the tip ends 22b, 23b of both opening / closing bodies 22, 23 are opened, the detachable portions 25, 26 move away from each other, and the base end 31' of the suture needle 30 in the extension direction L2 is released (see FIG. 3). As a result, the suture needle 30 can be attached to and detached from the needle support device 20 (it can be supported and removed).

[0052] As described above, when the locking member 27 is bent and deformed, the bent portion 27b elastically returns to its original state, and the protrusion 27c is always biased against the engaging portion 28a, so that the state in which the detachable portions 25, 26 are close to each other and grip the suture needle 30 as shown in FIG. 2, or the state in which the detachable portions 25, 26 are separated from each other and release the suture needle 30 as shown in FIG. 3, is maintained.

[0053] Furthermore, suture needle 30 has a so-called straight needle shape, which has a constant diameter and extends linearly for a predetermined length, and has a puncturing portion 32 at the tip in the extension direction, which is pointed and punctures the sutured part 1. Furthermore, suture needle 30 has a substantially square cross section (see FIG. 1(b)). Note that the length of the suture needle is not particularly limited, but when the suture needle has a straight needle shape, its overall length (which can also be called the "axial length" and means the length from the base end to the tip end in the extension direction L2 of the suture needle) is preferably 3 to 15 mm, and more preferably 7 to 12 mm.

[0054] The suture needle 30 may be a straight needle with a circular or elliptical cross section. Furthermore, the suture needle may be a so-called curved needle that extends while bending (this will be described in detail in the fourth embodiment below).

[0055] As shown in the partially enlarged view of Figure 1, the suture needle 30 is supported by the needle support device 20 with the puncture portion 32 facing toward the base end 21b of the insertion portion 21 of the needle support device 20 in the extension direction L1, and aligned in parallel along the extension direction L1 of the insertion portion 21.

[0056] Furthermore, as shown in Figures 6(b), (c) and 7(i), (j), for example, the puncturing portion 32 is configured to puncture the edge portion 2 of the sutured portion 1 from the back side 4 to the front side 3 of the sutured portion.

[0057] The near side of the part to be sutured means the side on which the suture needle is placed (located) before it is inserted into the part to be sutured (before the suture needle is inserted into the part to be sutured), and can also be said to be the side of the part to be sutured that the operator of the suture instrument faces (faces).

[0058] On the other hand, the back side of the sutured part means the side opposite the front side across the sutured part, i.e., the side on which the suture needle is placed (located) after the suture needle has been inserted into the sutured part (after the suture needle has been inserted into the sutured part), and can also be said to be the side opposite the side of the sutured part that the operator of the suture instrument faces (faces).

[0059] In this embodiment, the tip ends 22b, 23b of the two opening and closing bodies 22, 23 of the needle support device 20 are closed, and the base end 31' of the suture needle 30 in the extension direction L2 is clamped between a pair of detachable parts 25, 26 of the needle support device 20, thereby supporting the suture needle 30 on the needle support device 20.

[0060] Furthermore, when the extension direction of the suture needle 30 is L2, the suture needle 30 is supported on the needle support device 20 in a parallel position with the puncture portion 32 facing the base end 21b of the insertion portion 21 of the needle support device 20 so that the extension direction L2 of the suture needle 30 is parallel to the extension direction L1 of the insertion portion 21.

[0061] It is preferable that the extension direction L2 of the suture needle 30 is parallel to the extension direction L1 of the insertion portion 21. However, the suture needle 30 may be supported by the needle support device 20 so that the angles θ1 and θ2 of the extension direction L2 of the suture needle 30 with respect to the extension direction L1 of the insertion portion 21 (the angles θ1 and θ2 of the line segment L2' along L2 with respect to the line segment L1' along L1) are inclined at 30° or less, as long as the suture needle 30 is supported by the needle support device 20 with the puncture portion 32 facing the base end 21b of the insertion portion 21 and aligned along the extension direction L1 of the insertion portion 21.

[0062] In addition, in the extension direction L2 of the suture needle 30, a base end portion of the suture needle 30 in the extension direction L2, including the base end 31 in the extension direction L2, is referred to as a base end portion 31' of the suture needle 30 in the extension direction L2.

[0063] This suture needle 30 is supported by the needle support device 20 so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion portion 21, and so that the puncture portion 32 faces toward the base end 21b in the extension direction L1 of the insertion portion 21.

[0064] In addition, it can also be said that the suture needle 30 is supported by the spacing support portion of the needle support device 20 so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion portion 21, and the puncture portion 32 is supported toward the base end 21b in the extension direction L1 of the insertion portion 21.

[0065] In other words, when the base end 31' of the suture needle 30 in the extension direction L2 is clamped by the detachable parts 25, 26, which are part of the insertion part 21 and form the above-mentioned ``separation support part,'' the base end 31' of the suture needle 30 in the extension direction L2 and the tip end 21' of the insertion part 21 in the extension direction L1 are separated from each other, and the puncture part 32 is supported toward the base end 21b of the insertion part 21 in the extension direction L1.

[0066] 1 etc., that the base end 31' in the extension direction L2 of the suture needle 30 is spaced apart from the tip end 21' in the extension direction L1 of the insertion section 21. Also, in other embodiments described later, it is shown in Figures 4, 13 etc. that the base end in the extension direction of the suture needle is spaced apart from the tip end in the extension direction L1 of the insertion section.

[0067] (Second embodiment of suturing instrument) A second embodiment of the suturing instrument according to the present invention is shown in Figure 4. Note that parts that are essentially the same as those in the previous embodiment are given the same reference numerals and their description will be omitted.

[0068] In the suture instrument 10A of this embodiment, the insertion section 21A and the suture needle 30A that constitute the needle support tool 20 are tubular in shape and capable of inserting a suture 5. Furthermore, the tip 21a side of the insertion section 21A in the extension direction L1 and the base end 31 side of the suture needle 30A in the extension direction L2 are connected via a connecting section 33, and the insertion section 21A and the suture needle 30A are integrated together.

[0069] 4(a), the insertion section 21A is generally cylindrical and has an internal space through which the suture 5 can be inserted. The distal end of the insertion section 21A in the extension direction is open, and the suture 5 inserted into the internal space can be extracted from the distal end opening 21c.

[0070] Similarly to the insertion section 21A, the suture needle 30A is generally cylindrical with an internal space through which the suture thread 5 can be inserted, and has a puncture section 32 in which the tip portion in the extension direction L2 is cut obliquely to form a sharp tip.

[0071] The base end 31 of the suture needle 30A in the extension direction L2 is aligned with the tip 21a of the insertion portion 21A in the extension direction L1, and the base end 31 of the suture needle 30A and the tip 21a of the insertion portion 21A are connected to each other by the connecting portion 33 to form an integrated unit (it can also be said that the base end 31' of the suture needle 30A in the extension direction L2 and the tip 21' of the insertion portion 21A in the extension direction L1 are connected to each other by the connecting portion 33 to form an integrated unit), so that the insertion portion 21A and the suture needle 30A as a whole form an approximately U-shaped hook shape.

[0072] In addition, this suture needle 30A is supported by the needle support device 20A so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion portion 21A, and so that the puncture portion 32 faces toward the base end 21b in the extension direction L1 of the insertion portion 21A.

[0073] In this embodiment, the connecting portion 33 serves as a spacing support portion that can support the base end portion 31' of the suture needle 30A in the extension direction L2 so as to be spaced apart from the tip end portion 21' in the extension direction L1 of the insertion portion 21A. In other words, it can be said that the suture needle 30A is supported by the spacing support portion of the needle support device 20 so that the base end portion 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion portion 21A, and so that the puncture portion 32 is supported toward the base end 21b of the insertion portion 21A in the extension direction L1.

[0074] The suture thread 5 is inserted into the internal space of the insertion portion 21A and ejected from the tip opening 21c of the insertion portion 21A, passes outside the connecting portion 33, is inserted into the internal space from the base end opening 31a of the suture needle 30A, and is further ejected from the tip opening 32a of the puncture portion 32 (see Figures 11 and 12).

[0075] The suture instrument 10A further includes a capture tool 50 that receives the puncture portion 32 of the suture needle 30A and is capable of capturing the suture thread 5 that has been inserted through the distal end opening 32a of the puncture portion 32.

[0076] 4(b) and 10, the grasping device 50 in this embodiment has a substantially cylindrical main body 51 and a grasping portion 52 that is provided inside the tip of the main body 51 in the extension direction and grasps the suture 5. The grasping portion 52 has a plurality of elongated plate-like pieces 53 that extend from the inner periphery of the tip of the main body 51 toward the base end and from the inner periphery of the main body 51 toward the center of the grasping portion 52 (see the axial view in FIG. 10(a)), and these plate-like pieces 53 are arranged in a substantially spiral shape.

[0077] Furthermore, the tip 53a of the plate-like piece 53 is positioned closer to the center than the outer diameter of the suture needle 30A. Furthermore, it is desirable to have three or more plate-like pieces 53 so that when the suture needle 30A is received in the capture portion 52, the center of the suture needle 30A coincides with the center of the capture portion 52. The plate-like piece 53 as described above can be formed, for example, by making a cut of a predetermined shape in part of a metallic cylindrical member and bending the part inside the cut inward of the cylindrical member.

[0078] 10(a) to 10(c), with the suture thread 5 received in the capturing portion 52 of the capturing device 50, by appropriately rotating the capturing device 50, the suture thread 5 inserted from the tip opening 32a of the suture needle 30A becomes caught on a predetermined plate-like piece 53 of the capturing portion 52, making it possible to capture the suture thread 5. In other words, by rotating the capturing device 50, the tips 53a of the multiple plate-like pieces 53 are pushed apart, and the suture needle 30 is inserted into the radial center of the multiple plate-like pieces 53, making it possible to firmly capture the suture thread 5. (Details of the capturing mode will be described later.)

[0079] Furthermore, the shape and structure of the grasping tool for grasping the suture thread 5 are not limited to those described above, and may be the forms shown in Figures 15 and 16 (which will be described later).

[0080] (Third embodiment of suturing instrument) A third embodiment of the suturing instrument according to the present invention is shown in Figure 5. Note that parts that are essentially the same as those in the previous embodiment are given the same reference numerals and their description will be omitted.

[0081] The suture instrument 10B of this embodiment basically has a structure in which the insertion portion 21A and the suture needle 30A are integrated, similar to the second embodiment shown in Figure 4, and further includes a cover portion 35 that covers the insertion portion 21A and the suture needle 30A. This cover portion 35 is shaped so that it can cover the tip portion of the insertion portion 21A and the suture needle 30A, and is provided with an opening 35a on its base end side, through which the puncture portion 32 of the suture needle 30A can appear and disappear.

[0082] Furthermore, in this third embodiment, unlike the second embodiment, there is a continuous connection from the insertion portion 21A to the suture needle 30A, and the internal spaces thereof are connected, allowing the suture thread 5 to be inserted into this internal space.

[0083] Furthermore, the base end of insertion section 21A of needle support device 20A is supported by support section 36 (see FIG. 13). This support section 36 serves as a portion that slidably supports main body 51 of capturing device 50. Furthermore, a predetermined portion of main body 51 of capturing device 50 is rotatably supported by slide member 37, and slide member 37 is slidably disposed on the outer periphery of insertion section 21A.

[0084] The insertion portion 21A and the capturing tool 50 are arranged in parallel, and are integrally connected to each other via the support portion 36 and the sliding member 37. Furthermore, the capturing tool 50 is slidable relative to the insertion portion 21A via the support portion 36 and the sliding member 37 along the extension direction L1 of the insertion portion 21A, and the capturing tool 50 and the puncture portion 32 of the suture needle 30A can move closer to or farther away from each other.

[0085] Furthermore, a coil spring 38 is provided at the rear side of the cover portion 35 and on the outside of the insertion portion 21A, and biases the puncture portion 32 of the suture needle 30A so that it does not protrude from the opening 35a of the cover portion 35. This prevents the puncture portion 32 from accidentally damaging the sutured portion 1.

[0086] (Suturing Method with Suturing Instrument) Next, a suturing method with the suture instrument according to the present invention, using the suture instruments 10, 10A, 10B configured as described above, will be described.

[0087] This suturing method has two methods: (1) a first method in which the insertion portion of the needle support tool is inserted from the front side 3 of the part to be sutured 1, and then the needle support tool is pulled back toward the base end, causing the suture needle to puncture the edge portion 2 of the part to be sutured 1 from the back side 4 to the front side 3; and (2) a second method in which the suture needle 30 itself is held by a needle support tool of another suturing instrument or a holder that holds a suture needle, or the suture thread 5 inserted into the suture needle is held by a grasping tool.

[0088] Furthermore, the above suturing method includes (3) a third method in which the suture needle or suture thread is pulled back toward the base end, and the suture thread is passed through the edge portion of the sutured part and pulled out to the front side of the sutured part; (4) a fourth method in which the suture needle to which the other end of the suture thread is connected or the other end of the suture thread is passed through other parts of the edge portion of the sutured part by repeating the first, second and third methods, and the suture thread is inserted into two parts of the edge portion of the sutured part; and (5) a fifth method in which both ends of the suture thread are grasped and the suture thread is tied off.

[0089] The suturing method in each embodiment will be described below.

[0090] (One suturing method using the suture instrument of the first embodiment) First, one suturing method using the suture instrument 10 of the first embodiment will be described with reference to Figures 6 and 7. This suturing method utilizes two suture instruments (first and second suture instruments).

[0091] First, the insertion portion 21 of the needle support tool 20 is inserted from the tip 21a side into the near side 3 of the sutured part 1 (see FIG. 6(a)), and the puncture portion 32 of the suture needle 30 is aligned with a predetermined location on the edge portion 2 on the far side 4 of the sutured part 1 (see FIG. 6(b)). Thereafter, the needle support tool 20 is pulled back toward the base end (the base end side of the suture instrument 10, needle support tool 20, etc.), and the puncture portion 32 of the suture needle 30 punctures the edge portion 2 of the sutured part 1 from the far side 4 of the sutured part 1 to the near side 3 (see FIG. 6(c)).

[0092] Next, the puncture portion 32 side of the suture needle 30 is supported by the needle support tool 20 of the second suture instrument 10 (see FIG. 6(d)). Meanwhile, support of the suture needle 30 by the first suture instrument 10 is released (see FIG. 6(e)).

[0093] Thereafter, the suture needle 30 is pulled back toward the proximal end by the second suture instrument 10, and the suture thread 5 is passed through the edge portion 2 of the sutured portion 1 and pulled out to the proximal side 3 (see FIG. 6(f)). As a result, the suture thread 5 is inserted into a predetermined location in the edge portion 2 of the sutured portion 1. Furthermore, support of the suture needle 30 by the second suture instrument 10 is released (see FIG. 6(g)).

[0094] Next, the base end 31' in the extending direction L2 of the suture needle 30, to which the other end of the suture thread 5 is connected, is again supported by the needle support tool 20 of the first suture instrument 10 (see FIG. 7(h)). After that, the insertion part 21 of the needle support tool 20 is inserted from the tip 21a side from the front side 3 of the part to be sutured 1, and the puncture part 32 of the suture needle 30 is aligned with a position on the edge part 2 at the back side 4 of the part to be sutured 1 that is different from the position through which the suture thread 5 has already been inserted (here, a position opposite the position through which the suture thread 5 has already been inserted) (see FIG. 7(i)).

[0095] Thereafter, the needle support tool 20 is pulled back to the base end side, and the puncture part 32 of the suture needle 30 punctures the edge part 2 of the sutured part 1 from the rear side 4 to the front side 3 of the sutured part 1 (see FIG. 7(j)).

[0096] Next, the puncture portion 32 side of the suture needle 30 is again supported by the needle support tool 20 of the second suture instrument 10 (see FIG. 7(k)). Also, support of the base end portion 31' of the suture needle 30 in the extension direction L2 by the first suture instrument 10 is released.

[0097] Thereafter, the second suture instrument 10 is used to pull the suture needle 30 back toward the proximal end, causing the suture thread 5 to pass through the edge portion 2 of the part to be sutured 1 and be pulled out to the proximal side 3 (see FIG. 7(l)). As a result, the suture thread 5 is passed through the edge portion 2 of the part to be sutured 1 at a different location from where the suture thread 5 has already been passed.

[0098] Next, the support of the base end 31' of the suture needle 30 in the extension direction L2 by the second suture instrument 10 is released, and the suture needles 30, 30 are removed from both ends of the suture thread 5 (see FIG. 7(m)). Next, by grasping both ends of the suture thread 5 and appropriately tying them, the part to be sutured 1 can be sutured with the suture thread 5.

[0099] (Another suturing method using the suture instrument of the first embodiment) Next, with reference to Figures 8 and 9, another suturing method using the suture instrument 10, different from that shown in Figures 6 and 7, will be described. This suturing method utilizes one suture instrument 10 and a holder 40 capable of holding a suture needle 30.

[0100] In this embodiment, the holder 40 is formed of an elastomer such as rubber or porous resin. When the suture needle 30 is inserted into the holder 40, the holder 40 grips the suture needle 30 with a predetermined elastic force and holds it so that it cannot be pulled out of the holder 40. As a result, the holder 40 can pull the suture needle 30 back toward the proximal end of the operator while holding the suture needle 30.

[0101] The holder may be a well-known fastener (such as a structure used for pin badges, industrial fasteners, etc.) that can hold the suture needle and retract it toward the base end.

[0102] First, insert the insertion portion 21 of the needle support device 20 from the tip 21a side first, from the near side 3 of the sutured part 1 (see FIG. 8(a)), and align the puncture portion 32 of the suture needle 30 with a predetermined location on the edge portion 2 on the far side 4 of the sutured part 1 (see FIG. 8(b)). Also, place the holder 40 against the edge portion 2 on the near side 3 of the sutured part 1, at a location that aligns with the suture needle 30 (see FIG. 8(b)).

[0103] Thereafter, the needle support tool 20 is pulled back toward the proximal end of the operator, and the puncture portion 32 of the suture needle 30 punctures the edge portion 2 of the sutured part 1 from the rear side 4 to the front side 3 of the sutured part 1, and the portion of the suture needle 30 including the puncture portion 32 that has been inserted from the front side 3 is held by the holder 40 (see FIG. 8(c)). Also, support of the suture needle 30 by the suture instrument 10 is released (see FIG. 8(d)).

[0104] Next, the suture needle 30 is pulled back toward the base end by the holder 40, and the suture thread 5 is passed through the edge portion 2 of the sutured portion 1 and pulled out to the proximal side 3 (see FIG. 8(e)). As a result, the suture thread 5 is inserted into a predetermined location in the edge portion 2 of the sutured portion 1. The suture needle 30 is then removed from the holder 40 (see FIG. 8(f)).

[0105] Next, the base end 31' in the extending direction L2 of the suture needle 30, to which the other end of the suture thread 5 is connected, is again supported by the needle support device 20 of the suture instrument 10 (see FIG. 9(g)). After that, the insertion portion 21 of the needle support device 20 is inserted from the tip 21a side from the near side 3 of the part to be sutured 1, and the puncture portion 32 of the suture needle 30 is aligned with a position on the edge portion 2 on the far side 4 of the part to be sutured 1 that is different from the position through which the suture thread 5 has already been inserted (see FIG. 9(h)). In addition, the holder 40 is placed against a position on the edge portion 2 on the near side 3 of the part to be sutured 1 that is aligned with the suture needle 30 (see FIG. 9(h)).

[0106] Thereafter, the needle support device 20 is pulled back toward the base end, and the puncture portion 32 of the suture needle 30 punctures the edge portion 2 of the sutured portion 1 from the rear side 4 of the sutured portion 1 to the front side 3, and the portion of the suture needle 30 including the puncture portion 32 inserted from the front side 3 is held by the holder 40 (see Figure 9(i)).

[0107] Next, the holder 40 pulls the suture needle 30 back toward the base end, causing the suture thread 5 to pass through the edge portion 2 of the part to be sutured 1 and be pulled out to the proximal side 3 (see FIG. 9(k)). As a result, the suture thread 5 is passed through the edge portion 2 of the part to be sutured 1 at a different location from where the suture thread 5 has already been passed.

[0108] Thereafter, the suture needle 30 is removed from the holder 40 (see Figure 9(l)), and both ends of the suture thread 5 are grasped and appropriately tied, thereby allowing the sutured part 1 to be sutured with the suture thread 5 (see Figure 9(m)).

[0109] (Suturing method using the suture instrument of the second embodiment) Next, a suturing method using the suture instrument 10A will be described with reference to Figures 10 to 12. This suturing method utilizes a grasping tool 50. Note that for the sake of convenience in the drawings, the shape of the grasping tool 50 that grasps the suture thread 5 has been simplified in Figures 11 and 12.

[0110] First, inserting portion 21A of needle support tool 20A is inserted from the tip 21a side into the near side 3 of the sutured part 1 (see FIG. 11(a)), and puncturing portion 32 of suture needle 30A is aligned with a predetermined location on edge portion 2 on the far side 4 of the sutured part 1 (see FIG. 11(b)). Thereafter, needle support tool 20A is pulled back toward the base end, and puncturing portion 32 of suture needle 30A punctures edge portion 2 of the sutured part 1 from the far side 4 of the sutured part 1 to the near side 3 (see FIG. 11(c)).

[0111] 11(c), the suture 5 together with the suture needle 30A is received in the capturing portion 52 of the capturing device 50 (see FIG. 10(a)). Then, the suture 5 inserted from the tip opening 32a of the puncture portion 32 of the suture needle 30A is positioned around the multiple plate-like pieces 53 of the capturing portion 52 of the capturing device 50.

[0112] 10(b), the grasping device 50 is rotated in a predetermined direction by a predetermined angle, whereby the suture thread 5 inserted from the distal end opening 32a of the suture needle 30A is caught on a predetermined plate-like piece 53 of the grasping portion 52, and the suture thread 5 is grasped (see FIG. 10(b)).

[0113] In this state, as shown in Figures 10(c) and 11(d), by pulling back the grasping tool 50 toward the base end, the amount of suture 5 pulled out from the distal end opening 32a of the suture needle 30A increases. Thereafter, one end of the suture 5 is released from the grasping portion 52 of the grasping tool 50 (see Figure 11(e)).

[0114] Next, the puncture portion 32 of the suture needle 30A is pulled out from the edge portion 2 on the rear side 4 of the sutured part 1 (see FIG. 11(f)). After that, the needle support device 20A is rotated together with the suture needle 30A, and the puncture portion 32 of the suture needle 30A is aligned with a position on the edge portion 2 on the rear side 4 of the sutured part 1 that is different from the position through which the suture thread 5 has already been inserted (see FIG. 11(g)).

[0115] Thereafter, needle support tool 20A is pulled back toward the proximal end, and puncture portion 32 of suture needle 30A punctures edge portion 2 of sutured portion 1 from rear side 4 to front side 3 of sutured portion 1 (see FIG. 12(h)). At this time, part 5a of suture thread 5, which has been inserted through tip opening 32a of suture needle 30A and is located on the outside of suture needle 30A, is inserted through edge portion 2 of sutured portion 1 from rear side 4 to front side 3 as suture needle 30A punctures edge portion 2 of sutured portion 1 (see FIG. 12(h)).

[0116] Next, as shown in Figure 12(i), the suture 5 together with the suture needle 30A is received in the capturing portion 52 of the capturing tool 50, and then the capturing tool 50 is rotated appropriately to capture the loop portion 5b of the suture 5 inserted from the distal opening 32a of the suture needle 30A. Thereafter, by pulling the capturing tool 50 back toward the base end (see Figure 12(j)), the amount of suture 5 pulled out from the near side 3 of the part to be sutured 1 increases.

[0117] Next, the puncture portion 32 of the suture needle 30A is pulled out from the edge portion 2 at the rear side 4 of the sutured portion 1 and removed from the front side 3 of the sutured portion 1, leaving only the suture thread 5 in two places at the edge portion 2 of the sutured portion 1 (see Figure 12 (k)).

[0118] Thereafter, as shown in Figures 12(l) and (m), by grasping both ends of the suture thread 5 and tying them appropriately, the part to be sutured 1 can be sutured with the suture thread 5 (see Figure 12(n)).

[0119] In the above suturing method, the suture thread 5 is captured by the capturing device 50, but the suture thread 5 may also be captured and pulled toward the base end using an instrument capable of capturing the suture thread 5, such as tweezers or forceps.

[0120] (Suturing Method Using the Suturing Instrument of the Third Embodiment) Next, a suturing method using the suture instrument 10B will be described with reference to Figs. 13 and 14 .

[0121] First, insert the insertion portion 21A of the needle support device 20A together with the cover portion 35 into the near side 3 of the sutured part 1, starting from the tip 21a side (see FIG. 13(a)), and align the puncture portion 32 of the suture needle 30A with the edge portion 2 on the far side 4 of the sutured part 1 (see FIG. 13(b)). At this time, the capture device 50 is positioned so as to be aligned with the puncture portion 32 on the near side 3 of the sutured part 1.

[0122] Thereafter, while grasping and fixing the needle support tool 20A, the capture tool 50 is slid toward the tip 21a of the insertion part 21A, and the tip is brought into contact with the front side 3 of the sutured part 1 (see FIG. 13(c)).

[0123] Next, while holding and fixing the capturing device 50 and maintaining the tip end in contact with the proximal side 3 of the sutured part 1, the needle support device 20A is slid toward the base end against the biasing force of the coil spring 38, thereby receiving the suture 5 together with the suture needle 30A into the capturing portion 52 of the capturing device 50 (see Figure 13 (d)).

[0124] 14(a) and 14(b), by appropriately rotating the capturing device 50, the suture 5 inserted from the distal opening 32a of the suture needle 30A is caught on a predetermined plate-like piece 53 of the capturing portion 52, and the suture 5 is captured (see FIG. 14(b)). Furthermore, by pulling the capturing device 50 back toward the base end as shown in FIG. 14(c), the amount of suture 5 pulled out from the distal opening 32a of the suture needle 30A increases.

[0125] The other steps are basically the same as the suturing method using the suturing instrument of the second embodiment shown in Figures 10 to 12, so a description thereof will be omitted.

[0126] (Operation and Effect) Next, the operation and effect of the suture instrument configured as described above will be described.

[0127] In the suture instruments 10, 10A, 10B described above, the suture needles 30, 30A are supported by the needle support devices 20, 20A with the puncture portions 32 facing the base ends 21b of the insertion portions 21, 21A in the extension direction L1, and aligned in parallel along the extension direction L1 of the insertion portions 21, 21A.

[0128] Therefore, the distance between the insertion portions 21, 21A and the suture needles 30, 30A can be narrowed, so that even if the width of the sutured part 1 is small, it is possible to easily insert the suture needles 30, 30A together with the insertion portions 21, 21A.

[0129] Furthermore, in the suture instruments 10, 10A, 10B described above, the suture needles 30, 30A are supported by the needle supports 20, 20A so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion section 21, 21A, and so that the puncture section 32 faces the base end 21b of the insertion section 21 in the extension direction.

[0130] Therefore, when the needle support device 20, 20A supports the base end 31' of the suture needle 30, 30A in the extension direction L2, the support position of the suture needle 30, 30A by the needle support device 20, 20A can be freely selected, making it easier to adjust the support position to a width suitable for suturing the sutured part 1.

[0131] Therefore, even when the distance between the insertion section 21, 21A and the suture needle 30, 30A is narrowed, the suture needle 30, 30A can be supported by the needle support device 20, 20A, and the posture of the suture needle 30, 30A relative to the insertion section 21, 21A can be maintained. As a result, even if the width of the sutured area 1 is small, it is possible to easily insert the suture needle 30, 30A together with the insertion section 21, 21A.

[0132] Furthermore, the needle support device 20, 20A of the present invention is configured to support the base end 31' of the suture needle 30, 30A in the extension direction L2 so as to be separated from the tip end 21' of the insertion portion 21, 21A in the extension direction L1, and to support the puncture portion 32 located at the tip of the suture needle 30, 30A in the extension direction L2 toward the base end 21b of the insertion portion 21, 21A in the extension direction L1, thereby achieving the same effect as described above.

[0133] Furthermore, since the suture needles 30, 30A extend in a straight line and the puncture portion 32 of the suture needles 30, 30A faces the base end 21b of the insertion portion 21, 21A, even if the edge portion 2 of the sutured portion 1 is thick, the suture needles 30, 30A can be reliably penetrated into the edge portion 2 of the sutured portion 1, and the puncture portion 32 of the suture needles 30, 30A can be inserted and removed from the front side 3 of the edge portion 2 of the sutured portion 1.

[0134] In addition, in the suture instrument 10 of the first embodiment shown in Figures 1 to 3, a suture thread 5 is connected to the suture needle 30, and detachable portions 25, 26 that detachably grip the suture needle 30 are provided adjacent to the tip 21a side of the insertion portion 21 in the extension direction L1.

[0135] According to the above aspect, the suture needle can be gripped and detached by the detachable portions 25, 26, so the edge portion 2 of the sutured portion 1 can be sutured using the suture instrument 10 of the same structure, and there is no need to separately prepare different types of components (such as suture needle holders). As a result, component management becomes easier, and the cost of the suture system including the suture instrument 10 can be reduced.

[0136] Furthermore, in the second and third embodiments of the suture instruments 10A and 10B shown in Figures 4 and 5, the insertion portion 21A and the suture needle 30A are tubular in shape so that the suture thread 5 can be inserted therethrough, and the tip 21a side of the insertion portion 21A in the extension direction L1 and the base end 31 side of the suture needle 30A in the extension direction L2 are connected via a connecting portion 33, thereby integrating the insertion portion 21A and the suture needle 30A.

[0137] According to the above aspect, in suture instruments 10A, 10B, the insertion portion 21A and the suture needle 30A are integrated, which simplifies the structure of suture instruments 10A, 10B, facilitating the procedure, and also eliminating the risk of the suture needle 30A suddenly falling out of the insertion portion 21A.

[0138] Furthermore, the suture instruments 10A and 10B of the second and third embodiments shown in FIGS. 4 and 5 further include a capturing tool 50 that receives the puncture portion 32 of the suture needle 30A and is capable of capturing the suture thread 5 that has been inserted through the distal end opening 32a of the puncture portion 32.

[0139] According to the above aspect, the suture instruments 10A, 10B further include the capturing tool 50 capable of capturing the suture thread 5, so that the suture thread 5 can be captured reliably, and the part to be sutured 1 can be securely sutured.

[0140] Furthermore, the capturing devices 50, 50A, and 50B shown in Figures 10, 15, and 16 can capture the suture by rotating the capturing device regardless of the relative positions of the suture thread and the suture needle, that is, regardless of the direction from which the suture thread is inserted into the suture needle, as long as the thread is arranged around the needle. This makes it possible to easily capture the suture thread without having to check the relative positions of the suture needle and the suture thread before puncturing.

[0141] Furthermore, when the suture needles 30, 30A are supported by the needle supports 20, 20A so that the angle of the extension direction L2 of the suture needles 30, 30A relative to the extension direction L1 of the insertion portions 21, 21A is inclined at an angle of 30° or less, it becomes easier to narrow the distance between the insertion portions 21, 21A and the suture needles 30, 30A so as to be suitable for suturing the sutured portion 1.

[0142] Furthermore, the suture needles 30, 30A in the above embodiment are supported by the needle supports 20, 20A in a parallel arrangement along the extension direction L1 of the insertion portions 21, 21A, making it easier to narrow the distance between the insertion portions 21, 21A and the suture needles 30, 30A to suit suturing the sutured portion 1.

[0143] (First Modification of the Third Embodiment of the Suturing Instrument) Figure 15 shows a first modification of the third embodiment of the suture instrument according to the present invention. Note that parts that are essentially the same as those in the previous embodiment are given the same reference numerals and their description will be omitted. In this modification, the structure of the capturing portion 54 of the capturing device 50A that captures the suture thread 5 differs from that of the capturing device 50 shown in Figure 4.

[0144] That is, this capturing tool 50A has a capturing portion 54 made of a metal mesh or the like with multiple thorns made of fiber resin mixed in, at the rear side in the extension direction of the main body 51. Then, as shown in Figures 15(a) to 15(c), by pulling out the capturing tool 50A toward the base end from a state in which the suture 5 is received within the capturing portion 54 of the capturing tool 50A, the suture 5 inserted from the distal end opening 32a of the suture needle 30A becomes caught in the capturing portion 54, and the suture 5 can be captured.

[0145] (Second Modification of the Third Embodiment of the Suturing Instrument) Figure 16 shows a second modification of the third embodiment of the suture instrument according to the present invention. Note that parts that are essentially the same as those in the previous embodiment are given the same reference numerals and their description will be omitted. In this modification, the structure of the capturing portion 55 of the capturing device 50B that captures the suture thread 5 differs from that of the capturing devices 50 and 50A shown in Figures 4 and 15.

[0146] That is, the capturing tool 50B is provided with a capturing portion 55 on the inner peripheral surface of the body 51 in the extending direction, in which a hook portion made of resin fiber is formed around the entire periphery in the circumferential direction.

[0147] As shown in Figures 16(a) to (c), when the suture 5 is received in the capturing portion 55 of the capturing device 50B, the capturing device 50B is pulled out toward the base end, whereby the suture 5 inserted from the distal end opening 32a of the suture needle 30A becomes caught in the capturing portion 55, making it possible to capture the suture 5.

[0148] (Fourth embodiment of suturing instrument) A fourth embodiment of the suturing instrument according to the present invention is shown in Figure 17. Note that parts that are essentially the same as those in the previous embodiments are given the same reference numerals and their description will be omitted.

[0149] As shown in FIG. 17, the suture instrument 10C of this embodiment does not use a straight suture needle 30 as in the first to third embodiments, but is configured to use a so-called curved suture needle 30C that extends while bending.

[0150] That is, the suture needle 30C in this embodiment has a base end 31 to which the suture thread 5 is connected, a curved portion 34 that extends from the base end 31 while bending at a predetermined curvature toward the base end 21b in the extension direction L1 of the insertion portion 21C (here, it extends while curving like a bow), and a puncture portion 32 provided at the tip of the curved portion 34 in the extension direction.

[0151] As shown in FIG. 17(b), the detachable portions 25, 26 of the insertion portion 21C constituting the needle support device 20C, which detachably grip the suture needle 30C, are provided with anti-slip portions 25a, 26a having a roughly sawtooth shape on their inner surfaces (opposite surfaces).

[0152] As shown in Figure 17, when the shortest distance between the base end 31' of the suture needle 30C in the extension direction L2 and a corresponding point P1 of the insertion section 21C in the extension direction L1 of the insertion section 21C relative to the base end 31' of the suture needle 30C in the extension direction L2 of the insertion section 21C is defined as D1, and the shortest distance between the puncture section 32 of the suture needle 30C and a corresponding point P2 of the insertion section 21C in the extension direction L1 of the insertion section 21C relative to the puncture section 32 is defined as D2, the suture needle 30C is configured to be supported by the needle support device 20C so that D2 > D1.

[0153] The shortest distance D1 refers to the shortest distance between the protruding portion of the detachable portions 25, 26, which are the spacing support portions, at the base end 31' in the extension direction L2 of the suture needle 30C, from the edge portion on the base end 21b side in the extension direction L1 of the insertion portion 21C, and a position P1 corresponding to the protruding portion in the extension direction L1 of the insertion portion 21C. In this embodiment, the shortest distance D1 is preferably 1 to 7 mm, and more preferably 2 to 5 mm.

[0154] Furthermore, the extension direction L2 of the suture needle 30C, which is a curved needle, means the direction along the tangent S at the maximum bending portion of the suture needle 30C, i.e., the bending portion 34 between the base end portion 31' and the puncture portion 32 in the extension direction of the suture needle 30C.

[0155] Furthermore, this suture needle 30C is supported by the needle support device 20 so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion section 21, and so that the puncturing portion 32 faces the base end 21b in the extension direction L1 of the insertion section 21. It can also be said that the suture needle 30 is supported by the spacing support portion of the needle support device 20 so that the base end 31' in the extension direction L2 is spaced apart from the tip end 21' in the extension direction L1 of the insertion section 21, and so that the puncturing portion 32 faces the base end 21b in the extension direction L1 of the insertion section 21.

[0156] Furthermore, the base end 31' of the suture needle 30C in the extension direction L2 is grasped by the detachable parts 25, 26 at an angle to the extension direction of the insertion part 21C (see the partially enlarged view in Figure 17(a)). However, as described above, the peaks of the anti-slip parts 25a, 26a, which are approximately sawtooth-shaped on the inner surface of the detachable parts 25, 26, engage with the outer periphery of the base end 31' in the extension direction L2 of the suture needle 30C with a large engaging force, so that the base end 31' in the extension direction L2 of the suture needle 30C can be grasped by the detachable parts 25, 26 in a manner that makes it less likely to slip or become displaced.

[0157] In addition, in this embodiment, the suture needle 30C is supported by the needle support device 20C as described above, and is configured to be supported by the needle support device 20C so that the shortest distance to the insertion portion 21C gradually widens from the base end 31 in the extension direction L1 of the suture needle 30C toward the puncture portion 32 at the tip end in the extension direction L1.

[0158] The anti-slip portion on the inner surface of the detachable part may have a shape or structure that makes it difficult to grip the base end of the suturing needle by, for example, roughening the surface, providing irregularities, providing grooves, or attaching a separate soft material. Also, the inner surface of the detachable part may have a recess or groove formed at an angle to the insertion direction of the insertion part into the part to be sutured, so that the base end of the suturing needle can be gripped at an angle to the insertion direction of the insertion part.

[0159] It should be noted that the degree of bending of the suture needle in this embodiment is not limited to the form shown in Figure 17. For example, it may be modified as shown in Figures 18(a), (b), (c) or Figure 19. Figures 18(a) to (c) show a line segment A that is parallel to the extension direction L1 of the insertion section 21C and a line segment B that is perpendicular to line segment A. The intersection of line segment A and line segment B is designated as O.

[0160] The suture needle 30C1 of the first modified example shown in Fig. 18(a) has a bending accuracy, i.e., an angle θ3 formed by the tip of the puncture portion 32 with respect to the line segment A (meaning the angle θ3 formed by the line segment A and the line segment B extending from the intersection point O) of approximately 72 degrees. The suture needle 30C2 of the second modified example shown in Fig. 18(b) has an angle θ3 formed by the tip of the puncture portion 32 with respect to the line segment A of approximately 90 degrees. The suture needle 30C3 of the third modified example shown in Fig. 18(c) has an angle θ3 formed by the tip of the puncture portion 32 with respect to the line segment A of approximately 135 degrees. The angle θ3 is preferably equal to or less than 90 degrees, more preferably equal to or less than 60 degrees, and most preferably equal to or less than 45 degrees.

[0161] Furthermore, the suture needle 30C4 of the fourth modified example shown in Figure 19 has a bending angle of approximately 72 degrees, similar to the suture needle 30C1 of the first modified example shown in Figure 18(a), but the support state of the base end 31' of the suture needle 30C4 in the extension direction L2 by the detachable parts 25, 26, which are the spaced support parts of the needle support device 20C, is different.

[0162] That is, the suture needle 30C4 of this fourth modified example is supported by the needle support device 20C in a position in which the suture needle 30C4 is tilted with respect to the extension direction L1 of the insertion portion 21C so that the distance between the puncture portion 32 and the insertion portion 21C is narrower than the distance between the puncture portion 32 and the insertion portion 21C in the suture needle 30C1 of Figure 18 (a).

[0163] In the case of a suture needle using a curved needle as described above, the posture of the suture needle relative to the insertion part changes depending on the support state by the needle support device, but the support posture and support mode of the suture needle by the needle support device can be selected appropriately as long as it is within the range compatible with the present invention.

[0164] The length of the suture needle is not particularly limited, but when the suture needle is curved, its chord length G (the shortest distance from the most proximal end to the most distal end of the curved part of the suture needle (see Figure 18)) is preferably 3 to 15 mm, and more preferably 7 to 12 mm.

[0165] As described above, the suture needle in this embodiment is a curved needle that extends while bending toward the base end in the extension direction of the insertion portion, and is configured so that the shortest distance D2 is greater than the shortest distance D1 (D2 > D1).

[0166] Furthermore, although the suture needle in this embodiment is a curved needle, the suture needle may be a straight needle, and the shortest distance between the base end in the extension direction of the straight needle and the point of the insertion part of the needle support device that corresponds to the base end in the extension direction of the suture needle in the extension direction of the insertion part is defined as D1, and the shortest distance between the puncture part of the suture needle and the point of the insertion part of the needle support device that corresponds to the puncture part in the extension direction of the insertion part is defined as D2, and the needle may be configured to be supported by the needle support device so that D2 > D1.

[0167] (Suturing Method Using the Suturing Instrument of the Fourth Embodiment) Next, a suturing method using the suture instrument 10C will be described with reference to FIG.

[0168] The suturing method using the suture instrument of this fourth embodiment differs from the third method in the previous embodiment in that the third method in this suturing method involves tilting the insertion portion 21C obliquely with respect to the insertion direction F of the insertion portion 21C into the part to be sutured 1, pressing the inner periphery of the edge portion 2 of the part to be sutured 1, while pulling the suture needle 30C back toward the proximal end, and passing the suture thread 5 through the edge portion 2 of the part to be sutured 1 and pulling it out to the near side 3 of the part to be sutured 1.

[0169] More specifically, first, the insertion portion 21C of the needle support 20C is inserted from the tip 21a side from the front side 3 of the sutured portion 1 (see Figure 20(a)), and the puncture portion 32 of the suture needle 30C is aligned with a predetermined location (location 2c away from the opening portion 2a) of the edge portion 2 at the rear side 4 of the sutured portion 1 (see Figure 20(b)).

[0170] In this case, since the suture needle 30C is configured so that the shortest distance D2 is greater than the shortest distance D1, as shown in Figure 20 (b), the puncture portion 32 of the suture needle 30C is positioned at a location 2c away from the opening portion 2a within the edge portion 2, rather than at a location 2b close to the opening portion 2a.

[0171] Thereafter, the needle support device 20C is pulled back toward the base end, and the puncture portion 32 of the suture needle 30C is punctured from the rear side 4 to the front side 3 of the sutured portion 1 at a location 2c separated from the opening portion 2a of the edge portion 2 of the sutured portion 1 (see Figure 20 (c)).

[0172] At this time, the insertion portion 21C is tilted diagonally with respect to the insertion direction F of the insertion portion 21C relative to the sutured portion 1, and the inner circumference of the edge portion 2 of the sutured portion 1 is pressed (here, the inner circumference near the back side 4 of the edge portion 2 is mainly pressed), while the suture needle 30C is pulled back toward the base end.

[0173] Then, the puncture portion 32 and bent portion 34 of the suture needle 30C gradually penetrate deeper into the edge portion 2 of the sutured portion 1 at a point 2c away from the opening portion 2a (see Figure 20(d)), and the puncture portion 32 protrudes a predetermined length from the front side 3 of the sutured portion 1 (see Figure 20(e)).

[0174] Thereafter, the puncture portion 32 of the suture needle 30C, which protrudes a predetermined length from the front side of the part to be sutured 1, is supported by a needle support of the suture instrument (not shown), and the suture needle 30C is re-held. Note that the steps thereafter are basically the same as the suturing method shown in Figures 6 and 7 using the suture instrument of the first embodiment shown in Figures 1 to 9, and therefore a description thereof will be omitted (the suturing method is the same as the steps shown in Figure 6(d) and subsequent figures).

[0175] (Action and effect of the suture instrument and suturing method of the fourth embodiment) According to the suture instrument 10C of the fourth embodiment, as described above, the suture needle 30C is supported by the needle support device 20C so that the shortest distance D2 is greater than the shortest distance D1 (D2 > D1).

[0176] Therefore, after inserting the insertion portion 21C into the rear side 4 of the sutured portion 1 in order to suture the sutured portion 1, the needle support device 20C is pulled back toward the base end, and when the suture needle 30C is inserted into the edge portion 2 of the sutured portion 1 from the rear side 4 to the front side 3, the suture needle 30C can be inserted into the edge portion 2 of the sutured portion 1 at a location 2c away from the opening portion 2a, rather than at a location 2b close to the opening portion 2a.

[0177] As a result, the suture needle 30C can be reliably inserted into the edge portion 2 of the sutured portion 1 without damaging the area 2b of the edge portion 2 of the sutured portion 1 that is close to the opening portion 2a, and the suturing operation of the sutured portion 1 can be carried out stably.

[0178] Furthermore, in the suturing method using the suture instrument 10C of the fourth embodiment described above, the third method involves tilting the insertion portion 21C diagonally with respect to the insertion direction F of the insertion portion 21C into the sutured portion 1 to press against the inner circumference of the edge portion 2 of the sutured portion 1, while pulling the suture needle 30C back toward the base end, and passing the suture thread 5 through the edge portion 2 of the sutured portion 1 and pulling it out to the front side 3 of the sutured portion 1.

[0179] According to the above aspect, in order to suture the sutured portion 1, after inserting the insertion portion 21C into the rear side 4 of the sutured portion 1, the needle support device 20C is pulled back toward the base end, and when the suture needle 30C is punctured into the edge portion 2 of the sutured portion 1 from the rear side 4 to the front side 3, the insertion portion 21C is tilted diagonally to press against the inner circumference of the edge portion 2 of the sutured portion 1 while the suture needle 30C is pulled back, so that the suture needle 30C can be efficiently punctured into a location 2c of the edge portion 2 of the sutured portion 1 that is away from the opening portion 2a.

[0180] That is, because the insertion portion 21C is supported on the inner periphery of the edge portion 2 of the sutured part 1, the suture needle 30C can be firmly supported in an obliquely inclined state, making it easier to puncture the edge portion 2 at the desired location with the puncturing portion 32, thereby improving the puncturing performance of the puncturing portion 32 against the edge portion 2. Although the soft edge portion 2 is pressed and compressed by the insertion portion 21C, the edge portion 2 is elastic tissue and is assumed to be compressed by the suture 5 when ligated with the suture 5, so even if the edge portion 2 is compressed, the puncturing performance of the puncturing portion 32 against the edge portion 2 is not impaired.

[0181] 1 Part to be sutured, 2 Edge portion, 3 Front side, 4 Back side, 5 Suture thread, 10, 10A, 10B, 10C Suturing device, 20, 20A, 20C Needle support tool, 21, 21A, 21C Insertion part, 21a Tip, 21b Base end, 21' Tip portion, 25, 26 Detachable part, 30, 30A, 30C Suture needle, 31 Base end, 31' Base end, 32 Puncture part, 32a Tip opening, 40 Holder, 50, 50A, 50B Grasping tool, 52, 54, 55 Grasping part

Claims

1. A suture device for suturing a part to be sutured, comprising: a needle support device having an insertion part which is inserted into the part to be sutured and extends a predetermined length; and a suture needle supported by the needle support device and to which at least one end of a suture is connected or through which at least one end of a suture is inserted, the suture needle extending in a straight line or extending while curving, and having a puncturing part at its tip in the extension direction which punctures the part to be sutured, the suture needle being supported by the needle support device so that its base end in the extension direction is separated from the tip end in the extension direction of the insertion part and with the puncturing part facing the base end side in the extension direction of the insertion part, and the puncturing part punctures an edge portion of the part to be sutured from the back side to the front side of the part to be sutured.

2. A suturing instrument as claimed in claim 1, wherein a suture thread is connected to the suture needle, and a detachable part for detachably holding the suture needle is provided adjacent to the tip side of the insertion part in the extending direction.

3. A suture instrument as claimed in claim 1, wherein the insertion portion and the suture needle are tubular so that a suture thread can be inserted therethrough, and the tip side of the insertion portion in the extension direction and the base end side of the suture needle in the extension direction are connected via a connecting portion, so that the insertion portion and the suture needle are integrated.

4. A suture instrument as set forth in claim 3, further comprising a capture device capable of receiving the puncture portion of the suture needle and capturing the suture thread inserted through the tip opening of the puncture portion.

5. A suture instrument according to any one of claims 1 to 3, wherein the suture needle is supported by the needle support device so that D2 > D1, where D1 is the shortest distance between the base end of the suture needle in the extension direction and a portion of the insertion portion which corresponds to the base end of the suture needle in the extension direction of the insertion portion, and D2 is the shortest distance between the puncture portion and a portion of the insertion portion which corresponds to the puncture portion in the extension direction of the insertion portion.

6. A suture instrument according to claim 1 or 2, wherein the suture needle is supported by the needle support so that the angle of the extending direction L2 of the suture needle relative to the extending direction L1 of the insertion portion is inclined at an angle of 30° or less.

7. A suture instrument according to claim 1 or 2, wherein said suture needles are supported by said needle support in a state where they are aligned in the direction in which said insertion portion extends.

8. A needle support device for supporting a suture needle which sutures a part to be sutured, said needle support device having an insertion part which is inserted into said part to be sutured and extends a predetermined length, said needle support device supporting said suture needle such that a base end in the extension direction of said suture needle is spaced apart from a tip end in the extension direction of said insertion part, and supporting a puncture part located at the tip of said suture needle in the extension direction toward the base end side in the extension direction of said insertion part.

9. A first method using the suturing instrument according to any one of claims 1 to 4, in which the insertion portion of the needle support tool is inserted from the front side of the part to be sutured, and then the needle support tool is pulled back towards the base end, so that the suturing needle punctures the edge part of the part to be sutured from the back side to the front side of the part to be sutured; a second method in which the suturing needle itself is held by the needle support tool of another suturing instrument or a holder that holds the suturing needle, or the suture thread inserted into the suturing needle is held by a holder that can capture the suture thread; and a third method in which the suturing needle or the suture thread is pulled back towards the base end, so that the suture thread is passed through the edge part of the part to be sutured and drawn out to the front side of the part to be sutured. a fourth method of inserting the suture into two locations on the edge portion of the sutured part by repeating the first, second and third methods, with the suture needle to which the other end of the suture is connected or the other end of the suture being pierced through other locations on the edge portion of the sutured part; and a fifth method of grasping both ends of the suture and tying the suture.

10. A suturing method using a suture instrument as described in claim 9, wherein the shortest distance between the base end of the suture needle in the extension direction and a portion of the insertion portion that corresponds to the base end of the suture needle in the extension direction of the insertion portion in the extension direction is D1, and the shortest distance between the puncture portion and a portion of the insertion portion that corresponds to the puncture portion in the extension direction of the insertion portion is D2, wherein the suture needle is supported by the needle support device so that D2 > D1, and the third method involves tilting the insertion portion obliquely with respect to the insertion direction of the insertion portion into the sutured portion, pressing the inner circumference of the edge portion of the sutured portion while pulling the suture needle back towards the base end, and passing the suture thread through the edge portion of the sutured portion and pulling it out to the front side of the sutured portion.

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