JP2021049191A - Concrescence acceleration device - Google Patents

Abstract

To provide a concrescence acceleration device capable of reducing a risk of anastomotic leaks after a surgical operation or the like.SOLUTION: A concrescence acceleration device 100 comprises: a body 10 which is disposed between biological organs to be joined and accelerates concrescence of biological tissues; an elastic part 20 which is provided inside the body and has higher elasticity than the body; and an adhesion part 30 which is configured such that an engaged part 711 of a first engaging tool 710 used for a procedure of joining the biological organs is insertable, and causes the elastic part to adhere to the engaged part of the first engaging tool, in a state where the first engaging tool is inserted.SELECTED DRAWING: Figure 1

Description

The present invention relates to a fusion promoting device.

In the medical field, a technique of surgically joining living organs (for example, gastrointestinal anastomosis) is known. It is also known that when the above procedure is performed, it is important as a postoperative prognosis determinant that there is no delay in fusion at the joint where the biological organs are joined.

Various methods and medical instruments are used in the technique of joining living organs. For example, a method of suturing a living organ with a biodegradable suture and a mechanical joining device for anastomosis with a stapler (Patent Document 1). A method using (see) has been proposed. In particular, when anastomosis is performed using a mechanical joining device, the bonding force between biological organs at the joint can be increased as compared with the method using sutures, which reduces the risk of suture failure. Will be possible.

Japanese Patent Application Laid-Open No. 2007-505708

However, the degree of progression of fusion at the junction also depends on the condition of the living tissue at the junction target site (joint site) of the patient. Therefore, for example, even when a joining device as described in Patent Document 1 is used, the risk of suture failure may not be sufficiently reduced depending on the condition of the patient's living tissue.

Therefore, an object of the present invention is to provide a fusion promoting device capable of reducing the risk of suture failure after surgery or the like.

The fusion promoting device according to the embodiment of the present invention is arranged between the biological organs to be joined, and is provided in the main body portion for promoting the fusion of the biological tissue and the inside of the main body portion, and is provided from the main body portion. Also, a highly elastic stretchable portion and at least a part of the medical device used for the procedure for joining the biological organ are configured to be insertable, and in a state where the medical device is inserted, at least one of the outer peripheral portions of the medical device is inserted. It has a close contact portion for bringing the stretchable portion into close contact with the portion.

According to the fusion promoting device according to the present invention, the fusion of the biological tissues of the biological organs can be promoted by sandwiching the main body portion between the biological organs to be joined. Further, since the close contact portion brings the elastic portion into close contact with at least a part of the outer peripheral portion of the medical device, it is possible to prevent the fusion promoting device from falling off from the living organ. From the above, the operator can effectively reduce the risk of anastomotic insufficiency of the living organ.

It is a schematic perspective view which shows the fusion promotion device which concerns on embodiment of this invention. It is the schematic sectional drawing for demonstrating the structure of the through hole of the main body part. It is a flowchart which shows each procedure of the treatment method using a fusion promotion device. It is a flowchart which shows the procedure of embodiment (colon anastomosis) of a treatment method. It is a schematic cross-sectional view for demonstrating colorectal anastomosis. It is a schematic cross-sectional view for demonstrating colorectal anastomosis. It is a schematic cross-sectional view for demonstrating colorectal anastomosis. It is a schematic perspective view which shows the fusion promotion device which concerns on modification 1, and is the figure which shows the state which the support part supports the close contact part. It is a front sectional view which shows the fusion promotion device which concerns on the modification 1 in the state of FIG. It is a schematic perspective view which shows the fusion promotion device which concerns on modification 1, and is the figure which shows the state which the support part and the contact part are separated. It is a front sectional view which shows the fusion promotion device which concerns on the modification 1 in the state of FIG. It is a front sectional view which shows the fusion promotion device which concerns on modification 2, and is the figure which shows the state which the support part supports the close contact part. It is a front sectional view which shows the fusion promotion device which concerns on modification 2, and is the figure which shows the state which the support part and the contact part are separated.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In the description of the drawings, the same elements are designated by the same reference numerals, and duplicate description will be omitted. In addition, the dimensional ratios in the drawings are exaggerated for convenience of explanation and may differ from the actual ratios.

1 and 2 are diagrams for explaining the configuration of the fusion promoting device 100 according to the embodiment of the present invention.

<Union promotion device 100>
As shown in FIGS. 5 to 7, the fusion promoting device 100 can be applied to a procedure for joining predetermined biological organs (for example, gastrointestinal anastomosis). As will be described later, in the description of the present specification, colon anastomosis will be described as an example of a procedure using the fusion promoting device 100.

As shown in FIG. 1, the fusion promoting device 100 includes a main body portion 10 arranged between biological organs to be joined, an expansion / contraction portion 20 provided inside the main body portion 10, and a first joining device 700. It has a close contact portion 30 that brings the telescopic portion 20 into close contact with the engaging device 710. Hereinafter, each configuration of the fusion promoting device 100 will be described.

<Main body 10>
The main body 10 is formed of a sheet shape that promotes fusion of living tissues. The main body 10 can be formed of, for example, a biodegradable sheet member (thin film-like member).

A plurality of through holes 15 are formed in the main body 10. As shown in FIG. 1, the plurality of through holes 15 are regularly and periodically provided in the surface direction of the main body 10. However, the plurality of through holes 15 may be randomly provided in the surface direction of the main body 10.

As shown in FIG. 2, the through hole 15 extends substantially vertically between the front surface 11 and the back surface 12 along the thickness direction of the main body 10 (vertical direction in FIG. 2). The through hole 15 may be bent or curved in a zigzag shape between the front surface 11 and the back surface 12 in a cross section along the thickness direction of the main body 10.

The through hole 15 has a substantially circular planar shape (shape when the front surface 11 or the back surface 12 of the main body 10 is viewed in a plan view). However, the planar shape of the through hole 15 is not particularly limited, and may be, for example, an ellipse or a polygon (rectangle, triangle, etc.). Further, the planar shape and the cross-sectional shape may be different for each through hole 15.

The main body 10 has a substantially circular shape. However, the shape of the main body 10 is not particularly limited, and may be, for example, an ellipse or a polygon (rectangle, triangle, etc.).

The thickness T (see FIG. 2) of the main body 10 is not particularly limited, but is preferably 0.05 to 0.3 mm, more preferably 0.1 to 0.2 mm. When the thickness of the main body 10 is 0.05 mm or more (particularly 0.1 mm or more), the strength is such that the main body 10 is not damaged when the fusion promoting device 100 is handled. On the other hand, when the thickness of the main body 10 is 0.3 mm or less (particularly 0.2 mm or less), the main body 10 adheres to the biological tissue to which the main body 10 is applied and follows the biological tissue. It can be provided with sufficient flexibility.

The main body 10 is a value of the ratio of the hole diameter D (distance D shown in FIG. 2) of the through hole 15 to the pitch P of the through hole 15 (distance P shown in FIG. 2 and the distance between adjacent through holes 15). However, it is preferably 0.25 or more and less than 40. When the planar shape of the through hole 15 is a perfect circle, the hole diameter D of the through hole 15 is equal to the diameter of the perfect circle. On the other hand, when the planar shape of the through hole 15 is not a perfect circle, the diameter of a perfect circle having the same area as the area of the opening of the through hole 15 (the portion of the through hole 15 facing the front surface 11 or the back surface 12) ( The equivalent circle diameter) can be the hole diameter D of the through hole 15.

Since the main body 10 has a plurality of through holes 15, there are a plurality of values of the hole diameter D corresponding to each through hole 15. Therefore, in the present embodiment, in calculating the above-mentioned ratio value, the arithmetic mean value of two or more points of the hole diameter D values corresponding to the plurality of through holes 15 is used as the representative value of the hole diameter D. .. On the other hand, the pitch P of the plurality of through holes 15 is defined by the shortest distance between the openings of the two through holes 15. However, as for the value of the pitch P, there are a plurality of values of the pitch P corresponding to the combination of the adjacent through holes 15. Therefore, in the present embodiment, in calculating the above-mentioned ratio value, the arithmetic mean value of two or more points of the pitch P values corresponding to the combinations of the adjacent through holes 15 is used as the representative value of the pitch P. And.

The pitch P, the hole diameter D, the ratio of the hole diameter D to the pitch P, and the like of the through hole 15 are examples, and are not limited thereto.

The main body 10 can be made of a biodegradable material. The constituent material of the main body 10 is not particularly limited, and examples thereof include biodegradable resins. Known biodegradable resins include those described in, for example, Japanese Patent Publication No. 2011-528275, Japanese Patent Publication No. 2008-514719, International Publication No. 2008-1952, and Japanese Patent Publication No. 2004-509205. Biodegradable (co) polymers can be used. Specifically, it is selected from the group consisting of (1) aliphatic polyester, polyester, polyacid anhydride, polyorthoester, polycarbonate, polyphosphazene, polyphosphate ester, polyvinyl alcohol, polypeptide, polysaccharide, protein, and cellulose. Polymer; (2) A copolymer composed of one or more monomers constituting the above (1) and the like can be mentioned. That is, the biodegradable sheet is selected from the group consisting of aliphatic polyesters, polyesters, polyacid anhydrides, polyorthoesters, polycarbonates, polyphosphazenes, polyphosphates, polyvinyl alcohols, polypeptides, polysaccharides, proteins, and celluloses. It preferably contains at least one biodegradable resin selected from the group consisting of a polymer and a copolymer composed of one or more monomers constituting the polymer.

The method for producing the main body 10 is not particularly limited, and examples thereof include a method for producing a fiber made of the biodegradable resin described above and using the fiber to produce a mesh-shaped sheet. The method for producing the fiber made of a biodegradable resin is not particularly limited, and examples thereof include an electrospinning method (electrospinning method / electrostatic spinning method) and a melt blow method. As the main body 10, only one of the above methods may be selected and used, or two or more of the above methods may be selected and appropriately combined. As another example of the method for manufacturing the main body 10, the biodegradable sheet according to the present invention is obtained by spinning the fibers made of the biodegradable resin described above according to a conventional method and knitting the obtained fibers into a mesh shape. It may be manufactured.

The main body 10 induces a biological reaction by a constituent material such as a biodegradable resin constituting the main body 10. The main body 10 induces the expression of biological components such as fibrin by this action. The biological components induced in this way can promote fusion by accumulating so as to penetrate through the through hole 15 of the main body 10. Therefore, by arranging the main body portion 10 between the biological organs to be joined, the fusion is promoted by the above mechanism.

The material of the main body 10 does not have to be biodegradable as long as it can promote the fusion of biological organs. Further, the main body portion 10 may not have a through hole 15 formed regardless of the material as long as it can promote the fusion of living organs.

As shown in FIG. 1, the main body portion 10 has an inner edge reinforcing portion 13 arranged along the inner edge of the main body portion 10 and an outer edge reinforcing portion 14 arranged along the outer edge of the main body portion 10.

The inner edge reinforcing portion 13 is configured to have a higher rigidity than the other portions of the main body portion 10. The inner edge reinforcing portion 13 is formed over the entire range along the circumferential direction of the main body portion 10. Since the main body portion 10 has the inner edge reinforcing portion 13 in this way, it is possible to prevent the inner edge of the main body portion 10 from being twisted and deformed. The inner edge reinforcing portion 13 may be formed only on a part of the inner peripheral edge.

The outer edge reinforcing portion 14 is configured to have higher rigidity than the other portions of the main body portion 10. The outer edge reinforcing portion 14 is formed over the entire range along the circumferential direction of the main body portion 10. Since the main body portion 10 has the outer edge reinforcing portion 14 in this way, it is possible to prevent the outer edge of the main body portion 10 from being twisted and deformed. The outer edge reinforcing portion 14 may be formed only on a part of the outer peripheral edge.

The method for forming the inner edge reinforcing portion 13 and the outer edge reinforcing portion 14 is not particularly limited. The inner edge reinforcing portion 13 and the outer edge reinforcing portion 14 may be integrally formed on a part of the outer surface of the main body portion 10, are separate from the main body portion 10, and are connected to a part of the outer surface of the main body portion 10. You may be. For example, a reinforcing member formed separately from the main body portion 10 may be provided by fixing it to the outer peripheral edge or the inner peripheral edge of the main body portion 10. The reinforcing member may be, for example, a biodegradable sheet having no holes formed therein, a resin sheet having a higher rigidity than the main body portion 10, or the like.

Further, it is also possible to provide the inner edge reinforcing portion 13 and the outer edge reinforcing portion 14 in the main body portion 10 by not forming the through holes 15 in the outer peripheral edge and the inner peripheral edge of the biodegradable sheet which is the constituent material of the main body portion 10. ..

Further, after forming through holes 15 in the outer peripheral edge and the inner peripheral edge of the biodegradable sheet which is a constituent material of the main body 10, only the outer peripheral edge and the inner peripheral edge are compressed or heated in the thickness direction to form the through holes. By crushing 15, a portion where the constituent materials of the biodegradable sheet are densely assembled may be formed, and the portions may be used as the inner edge reinforcing portion 13 and the outer edge reinforcing portion 14.

<Expandable part 20>
As shown in FIG. 1, the telescopic portion 20 is provided inside the inner edge reinforcing portion 13 of the main body portion 10. The stretchable portion 20 is configured to have higher elasticity than the portion where the through hole 15 of the main body portion 10 is provided. The stretchable portion 20 is fixed to the main body portion 10 with, for example, an adhesive.

The material constituting the elastic portion 20 is not particularly limited, and examples thereof include silicone rubber, latex rubber, butyl rubber, and isoprene rubber, which are elastic members.

The telescopic portion 20 is inside the region E1 (see FIG. 7) in which the first engaging instrument 710 and the second engaging instrument 720 of the joining device 700 shown in FIG. 5 are opposed to each other with the main body portion 10 sandwiched between them. It is preferably located on the side.

By configuring the telescopic portion 20 in this way, when the fusion promoting device 100 is punched out by the joining device 700, the telescopic portion 20 can be punched out, and only the main body portion 10 is between the pair of biological organs. Because of the arrangement, a pair of biological organs can be suitably joined.

<Adhesion part 30>
As shown in FIGS. 5 to 7, the close contact portion 30 is configured so that the engaged portion 711 (corresponding to the shaft) of the first engaging device 710 described later can be inserted, and the engaged portion 711 is inserted. In the state, the expansion / contraction portion 20 is brought into close contact with the engaged portion 711.

As shown in FIG. 1, the close contact portion 30 has an inner portion 31 located inward of the telescopic portion 20 and a hole portion 32 located inward of the telescopic portion 20. The inner portion 31 constitutes a part of the telescopic portion 20. The hole diameter of the hole portion 32 is smaller than the outer diameter of the engaged portion 711 of the first engaging instrument 710. According to the close contact portion 30 configured in this way, the inner portion 31 is brought into close contact with the engaged portion 711 in a state where the engaged portion 711 is inserted through the hole portion 32. Therefore, it is possible to prevent the fusion promoting device 100 from falling out of the living organ during the procedure.

<Example of treatment method (living organ anastomosis)>
Next, a treatment method using the fusion promoting device 100 according to the present embodiment will be described.

FIG. 3 is a flowchart showing each procedure of the treatment method using the fusion promoting device 100 according to the present embodiment.

The treatment method is to dispose a fusion promoting device 100 having a sheet-shaped main body portion 10 that promotes fusion of living tissues between one bonded site to be joined and the other bonded site of the living organ ( S11), one joined portion and the other joined portion are joined in a state where at least a part of the main body 10 of the fusion promoting device 100 is arranged between one joined portion and the other joined portion. That (S12), including.

The living organ to be joined by the treatment method and the site to be joined in the living organ are not particularly limited and can be arbitrarily selected. However, in the following description, colon anastomosis will be described as an example. Further, in each of the procedures described below, detailed description of known procedure procedures and known joining devices will be omitted as appropriate.

Hereinafter, in the description of the present specification, "arranging the fusion promoting device 100 between the biological organs" means that the fusion promoting device 100 is arranged in a state of direct or indirect contact with the biological organ, that is, the living body. The fusion promoting device 100 is arranged in a state where a spatial gap is formed between the organ and the fusion promoting device 100, or the fusion promoting device 100 is arranged in both states (for example, fusion promoting in one biological organ). It means at least one of (the device 100 is in contact with the other biological organ and the fusion promoting device 100 is placed in a non-contact state). Further, in the description of the present specification, the term "periphery" does not define a strict range (region), but a predetermined range (region) as long as the purpose of treatment (bonding between biological organs) can be achieved. Means. In addition, the order of the procedure procedures described in each treatment method can be changed as appropriate as long as the purpose of the treatment can be achieved. Further, in the description of the present specification, "relatively approaching" means both bringing two or more objects to be approached close to each other and bringing only one close to the other.

<Example of treatment method (colon anastomosis)>
FIG. 4 is a flowchart showing the procedure of the embodiment of the treatment method (colon anastomosis), and FIGS. 5 to 7 are diagrams used for explaining the colon anastomosis.

In the treatment method of the fusion promoting device 100 according to the present embodiment, the biological organ to be joined is the large intestine that has been cut due to the excision of the cancer tumor. Specifically, the biological organs to be joined are the oral side A1 of the cut large intestine and the anal side A2 of the cut large intestine. In the following description, the procedure for joining the area around the mouth of the cut colon on the oral side A1 (one joined site) and a part of the intestinal wall on the anal side A2 of the cut large intestine (the other joined site) will be described. explain.

As shown in FIG. 4, the treatment method according to the present embodiment is to dispose the fusion promoting device 100 between the area around the mouth of the large intestine and the intestinal wall of the large intestine (S101), the area around the mouth of the large intestine and the intestine of the large intestine. The walls are relatively close to each other (S102), the main body 10 of the fusion promoting device 100 is sandwiched between the area around the mouth of the large intestine and the intestinal wall of the large intestine (S103), the area around the mouth of the large intestine and the intestine of the large intestine. The main body 10 is sandwiched between the fusion promoting device 100 and the wall (S104), and the main body 10 of the large intestine is placed between the vicinity of the mouth of the large intestine and the intestinal wall of the large intestine. (S105), including.

Next, the treatment method according to the present embodiment will be specifically described with reference to FIGS. 5 to 7.

As shown in FIG. 5, the operator inserts the first engaging instrument 710 of the joining device 700 into the oral side A1 of the large intestine. In addition, the operator places the second engaging device 720 of the joining device 700 on the anal side A2 of the large intestine. As the second engaging device 720 is placed (inserted) on the anal side A2 of the large intestine, a through hole A21 is formed in the anal side A2 of the large intestine. The timing of forming the through hole A21 is not particularly limited as long as it is before the second engaging device 720 is arranged.

As the joining device 700, for example, a known device used for colorectal anastomosis can be used. Examples of the first engaging instrument 710 and the second engaging instrument 720 constituting the joining device 700 include an anvil and a trocar. With the engagement of the first engaging instrument 710 and the second engaging instrument 720, the joining device 700 together with excision of the biological tissue arranged between the first engaging instrument 710 and the second engaging instrument 720. The circumference of the excised living tissue is sewn in a circumferential shape with a staple. The first engaging instrument 710 is, for example, an instrument provided with a tubular engaged portion 711 (corresponding to a shaft), and the second engaging instrument 720 is, for example, an engaged portion of the first engaging instrument 710. An instrument comprising an engagement pin 721 that is inserted and engaged with the 711.

As shown in FIG. 5, the operator inserts the engaged portion 711 of the first engaging device 710 into the oral side A1 of the large intestine, purse-sews the engaged portion 711 in a protruding state, and sutures the sutured portion A11. To form. The outer surface of the sewn portion A11 has a shape that partially protrudes to the convex side with sewn.

Next, as shown in FIG. 5, the operator places the fusion promoting device 100 between the oral side A1 of the large intestine and the anal side A2 of the large intestine. Then, the operator passes the engaged portion 711 included in the first engaging instrument 710 through the hole portion 32 of the close contact portion 30. At this time, in a state where the engaged portion 711 of the first engaging device 710 is inserted into the hole 32 of the close contact portion 30, the inner portion 31 of the close contact portion 30 is brought into close contact with the engaged portion 711. Therefore, it is possible to prevent the fusion promoting device 100 from falling off from the oral side A1 of the large intestine while the operator is performing the procedure.

Next, as shown in FIG. 6, the operator brings the first engaging instrument 710 and the second engaging instrument 720 relatively close to each other and engages with each other. The surgeon formed a through hole formed between the first engaging device 710 and the second engaging device 720 around the mouth of the oral side A1 of the large intestine, the fusion promoting device 100, and the intestinal wall of the anal side A2 of the large intestine. The area around A21 is sandwiched. The surgeon puts a part of the oral side A1 of the large intestine sandwiched between the first engaging instrument 710 and the second engaging instrument 720, the telescopic portion 20 of the fusion promoting device 100, and the fusion promoting device 100 into close contact with each other. The portion 30 and a part of the anal side A2 of the large intestine are excised by the joining device 700. At the same time, the operator operates the joining device 700 to join the periphery of the excised portion with staples (not shown).

Next, as shown in FIG. 7, the operator takes out the joining device 700 from, for example, the anal side A2 of the large intestine to the outside of the living body via the anus. Here, in the above procedure, the joining device 700 punches each component sandwiched between the joining device 700 by a punching blade (not shown) built in the first engaging tool 710 or the second engaging tool 720. Therefore, the region E2 for punching the living organ to which the joining device 700 is joined is inward of the region E1 in which the first engaging device 710 and the second engaging device 720 are opposed to each other with the fusion promoting device 100 in between. Located on the side.

According to such a treatment method, a joining technique (for example, a joining technique (for example,) is performed by a simple method in which the sheet-shaped main body portion 10 included in the fusion promoting device 100 is sandwiched between one joined portion and the other joined portion. The risk of suture failure after gastrointestinal anastomosis) can be reduced.

As described above, the fusion promoting device 100 according to the present embodiment is arranged between the biological organs to be joined, and is provided inside the main body portion 10 and the main body portion 10 for promoting the fusion of living tissues. The joining device 700 is configured so that at least a part of the stretching portion 20 having higher elasticity than the main body portion 10 and the joining device 700 used for the procedure for joining the living organs can be inserted, and the joining device 700 is inserted. It has a close contact portion 30 that brings the stretchable portion 20 into close contact with at least a part of the outer peripheral portion of the above. According to the fusion promoting device 100 configured in this way, the fusion of the biological tissues of the biological organs can be promoted by sandwiching the main body portion 10 between the biological organs to be joined. Further, since the close contact portion 30 brings the elastic portion 20 into close contact with at least a part of the outer peripheral portion of the joining device 700, it is possible to prevent the fusion promoting device 100 from falling off from the living organ. From the above, the operator can effectively reduce the risk of anastomotic insufficiency of the living organ.

Further, the joining device 700 has a first engaging device 710 arranged at one of the joined parts of the living organ and a second engaging device 710 arranged at the other joined part of the living organ and facing the first engaging device 710. A joining device 700 including an engaging device 720. The close contact portion 30 is configured so that the engaged portion 711 of the first engaging device 710 can be inserted, and the telescopic portion 20 is brought into close contact with the engaged portion 711 in a state where the engaged portion 711 is inserted. .. According to the fusion promoting device 100 configured in this way, the adhesion promoting device 100 causes the fusion promoting device 100 to be brought into close contact with the engaged portion 711 of the first engaging device 710 of the joining device 700 because the contact portion 30 is brought into close contact with the engaged portion 711. It is possible to prevent it from falling out of a living organ.

Further, the close contact portion 30 has an inner portion 31 located inward of the telescopic portion 20 and a hole portion 32 located inward of the telescopic portion 20. According to the fusion promoting device 100 configured in this way, since a part of the expansion / contraction portion 20 becomes a component of the close contact portion 30, it is possible to suppress the detachment from the living organ with a simple configuration.

Further, the telescopic portion 20 and the close contact portion 30 are the first engaging instrument 710 and the second engaging instrument 720 when the main body portion 10 is joined to the living tissue by the first engaging instrument 710 and the second engaging instrument 720. Is located on the inner side of the region where the main body 10 is sandwiched between them and they face each other and overlap each other. According to the fusion promoting device 100 configured in this way, when the fusion promoting device 100 is punched out by the joining device 700, the expansion / contraction portion 20 and the close contact portion 30 can be reliably punched out, and only the main body portion 10 can be punched out. Since it is arranged between a pair of biological organs, the pair of biological organs can be suitably joined.

Further, the main body portion 10 has an inner edge reinforcing portion 13 that is arranged along the inner edge of the main body portion 10 and reinforces the main body portion 10. According to the fusion promoting device 100 configured in this way, it is possible to prevent the inner edge of the main body 10 from being twisted and deformed.

Further, the main body portion 10 has an outer edge reinforcing portion 14 that is arranged along the outer edge of the main body portion 10 and reinforces the main body portion 10. According to the fusion promoting device 100 configured in this way, it is possible to prevent the outer edge of the main body 10 from being twisted and deformed.

Although the fusion promoting device 100 has been described above through the embodiments, the device 100 is not limited to the description of the above embodiment, and various modifications can be made without departing from the gist thereof. Hereinafter, a modified example of the fusion promoting device will be described. In the description of the modified example, the description of the configuration and contents described in the fusion promoting device 100 according to the above-described embodiment will be omitted as appropriate.

<Modification example 1>
The configuration of the fusion promoting device 200 according to the first modification will be described with reference to FIGS. 8 to 11. FIG. 8 is a schematic perspective view showing the fusion promoting device 200 according to the first modification, showing a state in which the support portion 40 supports the close contact portion 30. FIG. 9 is a front sectional view showing the fusion promoting device 200 according to the modified example 1 in the state of FIG. FIG. 10 is a schematic perspective view showing the fusion promoting device 200 according to the first modification, showing a state in which the support portion 40 and the close contact portion 30 are separated from each other. FIG. 11 is a front sectional view showing the fusion promoting device 200 according to the modified example 1 in the state of FIG.

As shown in FIGS. 8 to 11, the fusion promoting device 200 according to the first modification has a main body portion 10 arranged between biological organs to be joined and an elastic portion 20 provided inside the main body portion 10. A close contact portion 30 that brings the telescopic portion 20 into close contact with the first engaging device 710 of the joining device 700, a support portion 40 that can support the inner portion 31 of the close contact portion 30, and the support portion 40 and the inner portion. It has a connecting portion 50 for connecting 31 and a connecting portion 50. Since the configuration of the main body portion 10, the telescopic portion 20, and the close contact portion 30 is the same as that of the fusion promoting device 100 according to the above-described embodiment, the description thereof will be omitted.

In FIGS. 9 and 11, the inner edge reinforcing portion 13 and the outer edge reinforcing portion 14 are not shown. Further, in FIG. 9, the connection portion 50 is not shown.

The support portion 40 is configured to be able to support the inner portion 31 of the close contact portion 30 in an expanded state. As shown in FIGS. 8 to 11, the support portion 40 has a groove portion 41 in which the inner portion 31 of the close contact portion 30 is held, and a through hole 42 provided inside the support portion 40. The outer diameter of the support portion 40 is configured to be smaller than the inner diameter of the inner portion 31 of the close contact portion 30 in the normal state where it does not expand (the outer diameter of the hole portion 32).

The groove 41 is provided in a concave shape along the inner side in the radial direction. The groove portion 41 has a shape in which the inner portion 31 of the close contact portion 30 is suitably fitted.

The diameter of the through hole 42 is configured to be larger than the outer diameter of the engaged portion 711 of the first engaging device 710.

As the support portion 40, a material that is less likely to be deformed than the telescopic portion 20 is used. As such a material, for example, plastic, metal, or the like can be used.

The connecting portion 50 connects the supporting portion 40 and the inner portion 31. The connecting portion 50 and the supporting portion 40 are fixed by, for example, an adhesive. The connecting portion 50 and the inner portion 31 are fixed by, for example, an adhesive.

The connecting portion 50 is configured to be foldable. The connection portion 50 is folded in the state of FIGS. 8 and 9. Further, in the states of FIGS. 10 and 11, the connecting portion 50 is configured such that the folded state is released and the support portion 40 and the inner portion 31 are separated from each other.

The connecting portion 50 is configured in a bag shape so as to be continuous along the circumferential direction. By forming the connecting portion 50 in a bag shape in this way, the suture portion A11 can be wrapped by the bag-shaped connecting portion 50 as described later. Therefore, it is possible to more preferably suppress the fusion promoting device 200 from falling off from the living organ. The connecting portion is not particularly limited as long as it has a foldable configuration, and the support portion 40 and the inner portion 31 may be connected by, for example, a string.

<Treatment method of fusion promoting device according to Modification 1>
Next, a treatment method for the fusion promoting device 200 according to the first modification will be described. In the treatment method of the fusion promoting device 200 according to the first modification, the fusion promoting device 200 is arranged between the mouth of the large intestine and the intestinal wall of the large intestine with respect to the treatment method of the fusion promoting device 100 according to the above-described embodiment. Since the steps after the above are different, the steps after arranging the fusion promoting device 200 between the mouth of the large intestine and the intestinal wall of the large intestine will be described.

After arranging the fusion promoting device 200 between the oral side A1 of the large intestine and the anal side A2 of the large intestine, when the engaged portion 711 of the first engaging device 710 is inserted into the fusion promoting device 200, the sutured portion A11 is inserted. Contact the support portion 40. As a result, the support portion 40 that supports the inner portion 31 in the expanded state (see FIG. 9) moves in the intersecting direction (upward in FIGS. 9 and 11) that intersects the surface direction of the main body portion 10. (See FIG. 11), the support state of the support portion 40 with respect to the inner portion 31 is released, and the support portion 40 and the close contact portion 30 are separated from each other along the intersecting direction. At this time, the close contact portion 30 is supported by the engaged portion 711 of the first engaging device 710 in a less expanded state than when it was supported by the support portion 40.

At this time, since the support portion 40 and the inner portion 31 are connected by the connecting portion 50, it is possible to preferably prevent the support portion 40 from being unintentionally separated from the inner portion 31. Further, the sutured portion A11 can be wrapped by the bag-shaped connecting portion 50. Therefore, it is possible to more preferably suppress the fusion promoting device 200 from falling off from the living organ.

As described above, in the fusion promoting device 200 according to the first modification, the engaged portion 711 of the first engaging device 710 is configured to be insertable, and the inner portion 31 can be supported in an expanded state. The portion 40 is connected to the support portion 40 and the inner portion 31, and further includes a foldable connecting portion 50. When the support portion 40 supporting the inner portion 31 in the expanded state moves in the intersecting direction intersecting the surface direction of the main body portion 10, the support state of the support portion 40 with respect to the inner portion 31 is released, and the support portion is released. The 40 and the close contact portion 30 are separated from each other along the intersecting direction. According to the fusion promoting device 200 configured in this way, it is possible to more preferably suppress the fusion promoting device 200 from falling off from the living organ.

<Modification 2>
Next, the configuration of the fusion promoting device 300 according to the second modification will be described with reference to FIGS. 12 and 13. FIG. 12 is a front sectional view showing the fusion promoting device 300 according to the second modification, showing a state in which the supporting portion 40 supports the close contact portion 330. FIG. 13 is a front sectional view showing the fusion promoting device 300 according to the second modification, showing a state in which the support portion 40 and the close contact portion 330 are separated from each other.

As shown in FIGS. 12 and 13, the fusion promoting device 300 according to the second modification has a main body portion 10 arranged between the biological organs to be joined and an elastic portion 320 provided inside the main body portion 10. A close contact portion 330 that brings the telescopic portion 320 into close contact with the first engaging device 710 of the joining device 700, and a support portion 40 that can support the close contact portion 330. Since the configuration of the main body portion 10 and the support portion 40 is the same as that of the fusion promoting device 100 according to the above-described embodiment or the fusion promoting device 200 according to the first modification, the description thereof will be omitted.

As shown in FIGS. 12 and 13, the telescopic portion 320 has a base portion 321 located inward of the main body portion 10 and an extending portion extending in an intersecting direction (vertical direction in FIGS. 12 and 13) from the base portion 321. 322 and. The extending portion 322 of the telescopic portion 320 fulfills the function of the connecting portion 50 of the fusion promoting device 200 according to the above-mentioned modification 1.

As shown in FIGS. 12 and 13, the close contact portion 330 is formed in a ring shape. As shown in FIGS. 12 and 13, the close contact portion 330 is arranged outside the boundary portion 323 located at the boundary between the base portion 321 and the extending portion 322.

<Treatment method of fusion promoting device according to Modification 2>
Next, a treatment method for the fusion promoting device 300 according to the second modification will be described. In the treatment method of the fusion promoting device 300 according to the second modification, the fusion promoting device 300 is arranged between the mouth of the large intestine and the intestinal wall of the large intestine with respect to the treatment method of the fusion promoting device 100 according to the above-described embodiment. Since the steps after the process are different, the process after arranging the fusion promoting device 300 between the mouth of the large intestine and the intestinal wall of the large intestine will be described.

After arranging the fusion promoting device 300 between the oral side A1 of the large intestine and the anal side A2 of the large intestine, when the engaged portion 711 of the first engaging device 710 is inserted into the fusion promoting device 300, the sutured portion A11 becomes Contact the support portion 40. As a result, when the support portion 40 supporting the close contact portion 330 in the expanded state moves in the crossing direction, the support state of the support portion 40 with respect to the close contact portion 330 is released, and the support portion 40 and the close contact portion 330 intersect. Separate along the direction.

As described above, in the fusion promoting device 300 according to the second modification, the engaged portion 711 of the first engaging device 710 is configured to be insertable, and the contact portion 330 formed in a ring shape is expanded. It further has a support portion 40 that can be supported by. Further, the telescopic portion 320 has a base portion 321 located inside the main body portion 10 and an extending portion 322 extending from the base portion 321 in the intersecting direction intersecting the surface direction of the main body portion 10. Further, the close contact portion 330 is arranged outside the boundary portion 323 of the base portion 321 and the extending portion 322. Further, when the support portion 40 supporting the close contact portion 330 in the expanded state moves in the crossing direction, the support state of the support portion 40 with respect to the close contact portion 330 is released, and the support portion 40 and the close contact portion 330 are in the crossing direction. Separate along.

According to the fusion promoting device 300 configured in this way, it is possible to more preferably suppress the fusion promoting device 300 from falling off from the living organ. Further, since the expansion / contraction portion 320 also functions as the connection portion 50 of the fusion promoting device 200 according to the modification 1, the fusion promotion device 300 is detached from the biological organ with fewer components than the fusion promotion device 200 according to the modification 1. Can be suppressed.

10 Main body,
13 Inner edge reinforcement,
14 Outer edge reinforcement,
20, 320 telescopic part,
30, 330 Adhesion,
31 Inner part,
32 holes,
40 Support,
50 connections,
321 base,
322 Extension,
323 Boundary,
700 joining equipment,
710 First Engagement Device,
711 Engaged part (shaft),
720 Second Engagement Device,
A1 mouth side,
A11 sutured part,
A2 anal side,
A21 through hole.

Claims (8)

The main body, which is placed between the biological organs to be joined and promotes the fusion of biological tissues,
An elastic portion provided inside the main body portion and having higher elasticity than the main body portion,
At least a part of the medical device used for the procedure of joining the biological organs is configured to be insertable, and in the state where the medical device is inserted, the telescopic part is brought into close contact with at least a part of the outer peripheral portion of the medical device. A fusion-promoting device that has a close contact, and The medical device has a first engaging device arranged at one of the joined parts of the living organ and a second engaging device placed at the other joined part of the living organ and facing the first engaging device. It is a joining device equipped with a combination tool,
The fusion promoting device according to claim 1, wherein the close contact portion is configured so that the shaft of the first engaging device can be inserted, and the telescopic portion is brought into close contact with the shaft in a state where the shaft is inserted. .. The close contact portion is
The inner part of the telescopic part located inward and
The fusion promoting device according to claim 1 or 2, further comprising a hole located inside the telescopic portion. A support portion that is configured to allow the medical device to be inserted and that can support the inner portion in an expanded state, and a support portion that can support the inner portion in an expanded state.
In addition to connecting the support portion and the inner portion, the support portion and the foldable connection portion are further provided.
When the support portion supporting the inner portion in the expanded state moves in an intersecting direction intersecting the surface direction of the main body portion, the support state of the support portion with respect to the inner portion is released, and the support The fusion promoting device according to claim 3, wherein the portion and the close contact portion are separated from each other along the crossing direction. The medical device is configured to be insertable, and further has a support portion capable of supporting the close contact portion formed in a ring shape in an expanded state.
The telescopic portion has a base portion located inward of the main body portion and an extending portion extending from the base portion in an intersecting direction intersecting the surface direction of the main body portion.
The close contact portion is arranged outside the boundary portion between the base portion and the extending portion.
When the support portion supporting the close contact portion in the expanded state moves in the crossing direction, the support state of the support portion with respect to the close contact portion is released, and the support portion and the close contact portion are in the crossing direction. The fusion promoting device according to claim 1 or 2, which is separated from the device. When the main body portion is joined to the living tissue by the first engaging device and the second engaging device, the telescopic portion and the close contact portion are formed by the first engaging device and the second engaging device. The fusion promoting device according to any one of claims 2 to 5, which is located on the inner side of an area where the main body portion is sandwiched between them and overlaps with each other. The fusion promoting device according to any one of claims 1 to 6, wherein the main body portion has an inner edge reinforcing portion that is arranged along the inner edge of the main body portion and reinforces the main body portion. The fusion promoting device according to any one of claims 1 to 7, wherein the main body portion has an outer edge reinforcing portion that is arranged along the outer edge of the main body portion and reinforces the main body portion.

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