JPH04226643A - Implement for medical treatment - Google Patents

Abstract

PURPOSE:To easily, rapidly, safely, and surely fix the front abdominal wall and the visceral wall by having a piercing needle for gripping suture provided in nearly parallel with a piercing needle for inserting suture apart a prescribed distance therefrom and a stylet slidably inserted into the piercing needle for gripping suture. CONSTITUTION:This implement 1 for medical treatments consists of the piercing needle 3 for inserting suture, the piercing needle 2 for gripping suture which is provided in nearly parallel with the piercing needle 3 for inserting suture apart the prescribed distance therefrom, the stylet 4 which is slidably inserted into the inserting suture 2 for gripping suture, and a fixing member 6 which fixes the base ends of the piercing needle 3 for inserting suture and the piercing needle 2 for gripping suture. The stylet 4 has an annular member 5 formed of an elastic material at the tip and this annular member 5 is formed to extend toward the piercing needle 3 for inserting suture in such a manner that the center line of the piercing needle 3 for inserting suture or the extension line thereof penetrates the inside of the annular member 5 when the annular member is projected from the tip of the piercing needle 2 for gripping suture.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical instrument used when percutaneously inserting a catheter into abdominal viscera. In particular, it is used to secure the anterior abdominal wall and visceral wall to facilitate catheter insertion during endoscopic gastrostomy, which is performed for the purpose of supplying nutrients and draining body fluids. This article relates to medical equipment.

0002

BACKGROUND OF THE INVENTION In recent years, with the development of enteral nutritional preparations and their administration methods, long-term enteral nutritional management, which was previously considered difficult, has become easier. The administration may be carried out by inserting a feeding tube into the stomach or intestine through the nose, a so-called nasogastric tube, or by forming a gastrostomy. However, with nasogastric tubes, complications such as mucosal erosion of the nasal cavity, pharynx, and esophagus and ingestion pneumonia may occur due to long-term indwelling. Therefore, open gastrostomy is performed for patients who require long-term nutritional support. However, the common gastrostomy procedure involves excessive surgical invasion, so it is often impossible to perform the surgery depending on the patient's condition.

[0003] Recently, gastrostomy techniques that minimize surgical invasion have been considered, and medical instruments used for this purpose have also been proposed. Specifically, for example, there is a built-in anchor as shown in Japanese Patent Application Laid-Open No. 63-23651. The visceral anchor includes an elongated biocompatible crossbar having two ends, a first suture secured at one end to the central portion of the crossbar, and a first suture secured at one end to either end of the crossbar. 2 sutures.

[Problem to be solved by the invention]

[0004] The anterior wall of the stomach body and the anterior abdominal wall are fixed using the above-mentioned visceral anchor by inserting the crossbar portion of the visceral anchor into the stomach through the abdominal skin using a hollow needle. It will be done. Although this visceral anchor has some effect in fixing the anterior wall of the stomach body and the anterior abdominal wall, it is necessary to remove the crossbar inserted into the stomach after the catheter is placed. Therefore, a new hollow needle needs to be punctured, and removal work is also not easy. Furthermore, if trouble occurs during the removal operation, the crossbar portion may remain in the stomach, posing the risk of damaging the stomach wall and other inner walls of the digestive tract.

[0005]

[Means for Solving the Problems] Therefore, an object of the present invention is to solve the problems of the prior art described above, and to easily and quickly repair the anterior abdominal wall and the visceral wall, for example, the anterior abdominal wall and the anterior wall of the stomach body. Furthermore, it is an object of the present invention to provide a medical instrument that can be fixed more safely and reliably, is less invasive to the patient during fixation, and is less burdensome to the patient.

[0006] The device that achieves the above object includes a puncture needle for suture insertion, a puncture needle for suture gripping which is provided approximately parallel to the suture insertion puncture needle at a predetermined distance from the suture insertion puncture needle, and the suture thread. It consists of a stylet slidably inserted into the grasping puncture needle, and a fixing member to which the proximal ends of the suture insertion puncture needle and the suture grasping puncture needle are fixed, and the stylet is has an annular member formed of an elastic material at its tip, and when the annular member is made to protrude beyond the tip of the suture gripping puncture needle, the annular member is aligned with the central axis of the suture thread insertion puncture needle or The extension line is a medical instrument that extends in the direction of the suture insertion puncture needle so as to penetrate inside the annular member.

[0007] Furthermore, the device that achieves the above object includes a first puncture needle for suture insertion, and a first puncture needle provided approximately parallel to the first puncture needle for suture insertion, and spaced apart from the first puncture needle for suture insertion by a predetermined distance. a suture gripping puncture needle, a first stylet slidably inserted into the first suture gripping puncture needle, a second suture insertion puncture needle, and the second suture A second suture gripping puncture needle provided at a predetermined distance from and substantially parallel to the suture insertion puncture needle, and a first suture gripping puncture needle slidably inserted into the second suture gripping puncture needle. a stylet, the first suture insertion puncture needle, the first suture gripping puncture needle,
The second suture insertion puncture needle and the second suture gripping puncture needle each include a fixing member that fixes the proximal ends of the second suture thread insertion puncture needle and the second suture grasping puncture needle to form the apexes of a quadrangle, and The let has a first part formed of an elastic material at the tip.
The first annular member has a central axis of the first suture insertion puncture needle when projected from the tip of the first suture grasping puncture needle. or an extension line thereof extends in the direction of the first suture insertion puncture needle so as to penetrate inside the first annular member, and further, the second stylet has a tip formed of an elastic material. and a second annular member that, when protruding from the tip of the second suture gripping puncture needle, This is a medical instrument in which a central axis or an extension thereof extends in the direction of the second suture insertion puncture needle so as to penetrate inside the second annular member.

[0008] Preferably, the medical instrument has a flat member through which the suture thread insertion puncture needle and the suture thread gripping puncture needle are slidably penetrated. Similarly, the medical instruments include the first suture insertion puncture needle, the first suture gripping puncture needle, the second suture insertion puncture needle, and the second suture gripping puncture needle. Preferably, the puncture needle has a flat member slidably penetrated therethrough. Furthermore, it is preferable that the fixing member has a flat plate shape. Moreover, it is preferable that the blade surface at the tip of the suture thread grasping puncture needle is open toward the direction of the suture thread insertion puncture needle.

[0009]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The medical instrument of the present invention will be explained using embodiments shown in the drawings. The medical instrument 1 of the present invention includes a suture insertion puncture needle 3, a suture gripping puncture needle 2 that is provided approximately parallel to the suture insertion puncture needle 3 at a predetermined distance from the suture insertion puncture needle 3, and The stylet consists of a stylet 4 slidably inserted into the interior of the puncture needle 2, and a fixing member 6 that fixes the proximal ends of the suture insertion puncture needle 3 and the suture gripping puncture needle 2. 4 has an annular member 5 formed of an elastic material at its tip, and when this annular member 5 is made to protrude from the tip of the suture gripping puncture needle 2, the suture thread insertion puncture needle 3 The central axis or its extension line is formed to extend in the direction of the suture thread insertion puncture needle 3 so as to penetrate inside the annular member 5 . According to this medical device 1, the anterior abdominal wall and the visceral wall, for example, the anterior abdominal wall and the anterior wall of the stomach body, can be easily and quickly fixed, and furthermore, safely and reliably. Invasion to the patient is extremely small, such as puncturing with a puncture needle, and the burden on the patient is also small.

An embodiment of the medical instrument of the present invention will be described with reference to FIGS. 1 and 2. FIG. 1 is a cross-sectional view of an embodiment of the medical device of the present invention, FIG. 2 is a side view of the medical device shown in FIG. 1, and FIG. 3 is a cross-sectional view taken along line A-A in FIG. FIG. 4 is a sectional view of an embodiment of the medical instrument of the present invention in which the annular member at the distal end of the stylet does not protrude.

The medical instrument 1 of this embodiment includes a suture insertion puncture needle 3, and a suture gripping puncture needle 2 that is provided approximately parallel to the suture insertion puncture needle 3 at a predetermined distance from the suture insertion puncture needle 3. ,
It has a stylet 4 slidably inserted into the suture gripping puncture needle 2, and a fixing member 6 that fixes the proximal ends of the suture insertion puncture needle 3 and the suture gripping puncture needle 2. are doing. The puncture needle 3 for suture insertion has a hollow shape into which a suture can be inserted, is made of metal, for example, stainless steel, and has a blade surface at the tip for puncturing the skin. ing. The puncture needle 3 for suture insertion may be of any type as long as it can puncture the skin and insert the suture, but specifically, the outer diameter is preferably about 21G to 17G, particularly preferably about 20G. ~18G, length is 7
The diameter is preferably about 0 mm to 120 mm, especially about 80 mm.
A thickness of about 100 mm is preferable. A suture thread insertion puncture needle hub 8 is attached to the rear end of the suture thread insertion puncture needle 3, and the open end of this hub 8 forms a suture thread insertion port. The hub 8 is made of polyolefin such as vinyl chloride resin, polypropylene, and polyethylene, and synthetic resin such as polycarbonate. Further, the hub 8 is fixed to a fixing member 6, and as a result, the fixing member 6 fixes the proximal end of the puncture needle 3 for suture insertion.

The suture grasping puncture needle 2 is hollow, into which the stylet 4 is slidably inserted, and is made of metal, such as stainless steel, and has a tip for puncturing the skin. It has a blade surface of The puncture needle 2 for suture insertion may be any needle as long as it can puncture the skin and insert the stylet, but specifically, one with an outer diameter of 19G to 16G is preferable, especially one with an outer diameter of 17G (approx. 1
．． 40 mm) to 18G (approximately 1.20 mm) is preferable. Further, the length is preferably about 60 mm to 120 mm, particularly preferably about 70 to 90 mm. Furthermore, the annular member 5 of the stylet 4, which will be described later,
In order to ensure that the needle extends in the direction of the suture insertion puncture needle, the blade surface at the tip of the suture gripping puncture needle 2 is opened toward the direction of the suture insertion puncture needle 3, as shown in FIG. It is preferable that you do so. In addition, this suture grasping puncture needle 2
Although it may be a normal straight pipe, it is preferable to use one with a curved tip including the blade surface, as shown in FIG. In this way, the annular member 5 of the stylet 4, which will be described later, can be more reliably extended in the direction of the puncture needle for suture insertion. A suture gripping puncture needle hub 7 is attached to the rear end of the suture gripping puncture needle 2, and the open end of this hub 7 is configured to engage with a stylet hub 9, which will be described later. has been done. The hub 7 is made of vinyl chloride resin, polyolefin such as polypropylene or polyethylene, or synthetic resin such as polycarbonate. Furthermore, this hub 7 is fixed to a fixed member 6,
As a result, the fixing member 6 fixes the proximal end of the suture gripping puncture needle 2. For this reason, the puncture needle for suture grasping is
It is spaced apart from the puncture needle 3 for suture thread insertion by a predetermined distance and is approximately parallel to it. The distance between the two is the length that allows the suture to fix the anterior abdominal wall and the visceral wall, and is between 5 mm and 3 mm.
Approximately 0 mm is suitable. Within the above range, the anterior abdominal wall and the visceral wall can be sufficiently fixed, and the resistance when puncturing two puncture needles will not be too large. Particularly preferably, it is 10 to 20 mm.

The fixing member 6 serves as a grip when puncturing the medical instrument 1, and preferably has portions 6a, 6a on which fingers can be placed, as shown in FIG. Furthermore, in order to make it easy to hold the fixing member 6, as shown in FIGS. 1 and 2, it is preferable that the fixing member 6 has a flat plate shape. The fixing member 6 is made of synthetic resin, such as vinyl chloride resin, polyolefin such as polypropylene or polyethylene, or polycarbonate.

Furthermore, the medical instrument 1 is shown in FIGS. 1 and 2.
As shown in FIG. 2, it is preferable that the suture thread insertion puncture needle 3 and the suture thread gripping puncture needle 2 have a flat member 10 slidably penetrated therethrough. Such a flat member 10
By providing this, it is possible to prevent the distance between the suture thread insertion puncture needle 3 and the suture thread grasping puncture needle 2 from changing during puncturing, specifically, from becoming closer to each other. In addition, if it is formed to be slidable, the flat member 10 will not interfere with the puncturing operation at the time of puncturing. Flat member 1
0, for example, a circle with a flat bottom surface that does not irritate the skin, or a polygonal plate shape,
Preferably, it has two holes through which two puncture needles are inserted.

As shown in FIGS. 1 and 2, the stylet 4 includes a rod-shaped member 13 having an outer diameter smaller than the inner diameter of the suture grasping puncture needle 2, and an annular member fixed to the tip of the rod-shaped member 13. 5 and a stylet hub 9 fixed to the proximal end of the rod-shaped member 13. The annular member 5 is made of an elastic material, and in a state protruding from the tip of the suture grasping puncture needle 2, the annular member 5 is shown in FIGS. 1 and 2.
When it is in an annular shape as shown in FIG. 4 and not protruding, it becomes substantially straight as shown in FIG. 4 and can be stored inside the suture grasping puncture needle 2. Therefore, the rod-shaped member 13 and the annular member 5 portion of the stylet 4 can slide inside the suture gripping puncture needle 2. The stylet 4 of this embodiment can be removed from the puncture needle 2. Further, the stylet 4 is not necessarily removable from the puncture needle 2 as long as the annular member 5 can be housed inside the puncture needle 2 and can be slid so as to protrude from the tip of the puncture needle 2. You don't have to. When the annular member 5 of the stylet 4 protrudes from the tip of the puncture needle 2, as shown in FIGS. The puncture needle for suture insertion is formed to extend in the direction of the suture thread insertion puncture needle 3 so as to penetrate through the interior of the suture thread insertion puncture needle 5 . Specifically, as shown in FIG. 1, the annular member 5 is fixed to the tip of the rod-shaped member 13 at a certain angle, and furthermore, the annular member 5 is fixed at a central portion or at a certain angle when viewed from the side. It is preferable to have a curved shape with the bottom portion being slightly closer to the tip than the center portion. By forming in this way, the central axis of the puncture needle 3 for suture insertion or its extension line more reliably penetrates the inside of the annular member 5. Furthermore, it is preferable that the distal end of the annular member 5 has a V-shape or U-shape with the distal end as the center, forming a suture gripping portion 14 with a narrow distance. By providing such a suture gripping portion 14, the suture 12 protruding from the suture insertion puncture needle 3 can be gripped more reliably.

The material for forming the rod-like member 13 of the stylet 4 is metal (for example, stainless steel, amorphous).
, synthetic resins (for example, polyolefins such as polypropylene and polyethylene, and fluororesins such as PTFE and ETFE) can be suitably used. Further, the forming material of the annular member 5 includes stainless steel wire (preferably high-tensile stainless steel for springs), piano wire (preferably nickel-plated or chrome-plated piano wire),
or superelastic alloy wire, such as Ti-Ni alloy, Cu-
Zn alloy, Cu-Zn-X alloy (X=Be, Si, Sn
, Al, Ga), Ni-Al alloy, etc. are preferably used. Moreover, the stylet hub 9 is connected to the rod-shaped member 1
3, and is configured to engage with the suture gripping puncture needle hub 7. Furthermore, as shown in FIGS. 1 and 2, a rib 16 is provided on the stylet hub 9.
It is preferable that the puncture needle hub 7 is provided with a slit 17 that engages with the rib 16 to ensure that the stylet 4 is completely inserted into the suture grasping puncture needle 2. By doing so, it is possible to ensure that the annular member 5 of the stylet 4 faces the direction of the puncture needle 3 for suture insertion. The stylet hub 7 is made of vinyl chloride resin, polyolefin such as polypropylene, polyethylene, or synthetic resin such as polycarbonate.

Furthermore, in the embodiment shown in FIG. 1, the extension line of the central axis of the puncture needle 3 for suture insertion is configured to pass through the inside of the annular member 5. The central axis of the puncture needle 3 for suture insertion, as long as it does not impede the work of protruding from the inside of the puncture needle 2 and the work of storing it.
In other words, the tip of the puncture needle 3 for suture insertion may be configured to directly penetrate the annular space formed by the annular member 5.

Next, an embodiment of the medical device of the present invention shown in FIGS. 5 and 6 will be described. The medical instrument 20 of this embodiment includes a first suture insertion puncture needle 3a and a first suture thread provided substantially parallel to the first suture insertion puncture needle 3a at a predetermined distance from the first suture insertion puncture needle 3a. The grasping puncture needle 2a and the first
A first stylet 4a slidably inserted into the suture grasping puncture needle 2a, a second suture insertion puncture needle 3b, and a predetermined position from the second suture insertion puncture needle 3b. A second suture gripping puncture needle 2b provided substantially parallel to each other at a distance apart, and a second stylet 4b slidably inserted into the second suture gripping puncture needle 2b. , first suture insertion puncture needle 3a, first suture gripping puncture needle 2
a, a fixing member 26 that fixes the base end portions of the second suture insertion puncture needle 3b and the second suture grasping puncture needle 2b to form the apexes of a quadrangle; The stylet 4a has a first annular member 5a formed of an elastic material at its tip, and this first annular member 5a is closer to the tip of the first suture grasping puncture needle 2a. When protruding, the first suture insertion puncture needle 3
The first suture thread insertion puncture needle 3a is inserted so that the central axis of a or its extension line passes through the inside of the first annular member 5a.
The second stylet 4b further has a second annular member 5b formed of an elastic material at its distal end, and this second annular member 5b is adapted to support a second suture thread. When protruding from the tip of the grasping puncture needle 2b, the second
The central axis of the suture insertion puncture needle 3b or its extension line is formed to extend in the direction of the second suture insertion puncture needle 3b so as to penetrate inside the second annular member 5b. .

The difference between the medical instrument 20 of this embodiment and the medical instrument 1 of the above-described embodiment is that this medical instrument 20 has two puncture needles 3a and 3b for suture insertion, and a suture gripper. As the suture grasping puncture needle, the suture insertion puncture needle, and the stylet, those described above can be suitably used. And, this medical instrument 20 is
The two suture thread insertion puncture needles 3a, 3b and the two suture thread gripping puncture needles 2a, 2b are integrally fixed by a fixing member 26. As a fixed form, for example, as shown in FIG. 6, the first suture insertion puncture needle 3a
, the base end portions of the first suture gripping puncture needle 2a, the second suture insertion puncture needle 3b, and the second suture gripping puncture needle 2b form the vertices of a quadrangle. There is. In other words, four puncture needles 2a, 2b, 3a, 3b
are each fixed by a fixing member 26 so as to form the apex of a quadrangular prism.

[0020]The distance between the first suture insertion puncture needle 3a and the first suture gripping puncture needle 2a is 5 mm.
Approximately 30 mm is suitable. Moreover, the distance between the second suture thread insertion puncture needle 3b and the second suture thread gripping puncture needle 2b is preferably about 10 mm to 20 mm. Furthermore, the distance between the first suture insertion puncture needle 3a and the second suture insertion puncture needle 3b is preferably about 10 mm to 40 mm. The distance between the first suture gripping puncture needle 2a and the second suture gripping puncture needle 2b is 15 mm to 30 mm.
Approximately mm is suitable. In addition, a quadrangle surrounded by the base end portions of the four puncture needles, in other words, a quadrangle surrounded by the cut surfaces of the four puncture needles when the medical instrument 20 is cut in a direction perpendicular to the axial direction of the puncture needles, Furthermore, in other words, the rectangle surrounded by the tips of the four puncture needles is the part where the catheter is placed, which will be described later, and its area is preferably about 150 to 450 mm2, more preferably about 200 to 450 mm2. It is about 300mm2. Moreover, the above-mentioned quadrilateral is not limited to a square as shown in FIG. 6, but may be a rectangle, a rhombus, or even a trapezoid. Within the above range, the anterior abdominal wall and visceral wall can be sufficiently fixed, and since the range is not too wide, organ movement will not be hindered.

Furthermore, the fixing member 26 is attached to the medical instrument 20.
This is the part that serves as a grip when puncturing the needle, and as shown in FIG. 6, it is preferable to have a part on which a finger can be placed. Further, the fixing member 26 is preferably shaped like a flat plate, as shown in FIG. 5, in order to make it easy to hold. The fixing member 6 is made of synthetic resin, such as vinyl chloride resin, polyolefin such as polypropylene or polyethylene, or polycarbonate. Furthermore, the medical instrument 20, as shown in FIG.
It is preferable that the four puncture needles 2a, 2b, 3a, 3b have a flat member 28 slidably penetrated therethrough. By providing such a flat member 28, it is possible to prevent the positional relationship of the four puncture needles from changing during puncture, and specifically, to prevent the distance between the puncture needles from changing (for example, from coming close to each other). Moreover, if it is formed to be slidable, the flat plate-like member will not obstruct the puncturing operation during puncturing. The flat plate member 28 may be, for example, a circular or polygonal plate whose lower surface is a flat surface that does not irritate the skin, and into which four puncture needles are inserted.
Preferably, it has two holes.

[0022]

[Function] Next, regarding the function of the medical device 1 of the present invention,
A case where endoscopic gastrostomy is performed will be described as an example using FIGS. 1, 4, and 7 to 13. into the patient's stomach,
One of the surgeons inserts the endoscope and supplies sufficient air to fill the stomach with air, bringing the anterior wall of the stomach body into close contact with the anterior abdominal wall. Then, another surgeon disinfects the abdominal skin, confirms the position of the stomach using transmitted light from the endoscope, and administers local anesthesia to the abdominal wall in this area. As shown in FIG. 4, the annular member 5 of the stylet 4 is housed inside the suture grasping puncture needle 2, and the suture The medical device 1 of the present invention, in which the end of the thread 12 is inserted without protruding, is prepared, and the medical device 1 is punctured into the abdominal wall 50, as shown in FIG. Puncture needle 3 for inserting suture into the stomach from the wall 52
and the suture grasping puncture needle 2 is made to protrude.

[0023] After the endoscopist confirms this condition,
The medical instrument operator uses the stylet 4 as shown in FIG.
is pushed in, the stylet hub 9 and the suture gripping puncture needle hub 7 are engaged, and the annular member 5 of the stylet 4 is projected from the tip of the suture gripping puncture needle 2. continue,
The suture thread 12 is pushed in to protrude from the tip of the puncture needle 3 for suture insertion, and the endoscopist confirms that the suture thread 12 has passed through the inside of the annular member 5. After this confirmation, as shown in FIG. 9, the medical instrument operator pulls the stylet 4 and stores the annular member 5 inside the suture grasping puncture needle 2. By this operation, the annular member 5 gradually narrows the annular space formed by the annular member 5 and gradually changes its shape into an oval shape, and the suture thread 12 is held by the suture thread gripping portion 14 of the annular member 5. As shown in FIG.
is housed inside the suture gripping puncture needle 2 together with the annular member 5. After the endoscopist confirms this state, the medical instrument operator removes the medical instrument 1 from the patient. By this removal, the tip of the suture 12 inserted through the suture insertion puncture needle 3 is exposed outside the body, as shown in FIG. Each end of the exposed suture is then ligated as shown in FIG. This ligation allows
The anterior stomach wall 52 and the anterior abdominal wall 50 are fixed. Furthermore, the medical instrument 1 is punctured again at a position approximately parallel to the ligated portion of the suture at a predetermined distance, for example, approximately 20 to 30 mm, and the suture is used to puncture the stomach body. The anterior wall of the abdomen and the anterior abdominal wall are fixed. The medical instrument 1 used for this puncture may be the one used for the above-mentioned puncture, or it may be one prepared separately.

As shown in FIG. 12, a metal needle 41 having a blade surface at the tip and a metal needle 41 inserted into the axial direction are placed approximately in the center of the two ligation sites thus formed. After puncturing the puncture device 40 consisting of a breakable resin tube 42 and removing the metal needle 41, the balloon catheter 4 is inserted into the tube 42 as shown in FIG.
Insert 3. After the endoscopist confirms that the distal end of the balloon catheter 43, including the balloon part, has reached the stomach, the endoscopist inflates the balloon with distilled water or the like and moves the proximal end of the tube 42 outward. to 2
The tube 42 is then pulled in the axial direction to break the tube 42 and removed from the patient. And balloon catheter 43
The balloon catheter is pulled proximally to bring the inflated balloon portion into close contact with the anterior wall of the gastric body, and then a suitable fixing device is applied and sutured to the portion of the balloon catheter exposed from the skin surface to fix the balloon catheter to the anterior abdominal wall. Through the above steps, the endoscopic gastrostomy is completed.

[0025] In the above explanation, the case where the medical instrument 1 was used was explained, but the medical instrument 2 shown in FIG.
Even if 0 is used, puncturing with a medical instrument is 1
It is almost the same except that it is twice.

[0026]

Effects of the Invention The medical instrument of the present invention includes a puncture needle for suture insertion, and a puncture needle spaced a predetermined distance from the puncture needle for suture insertion.
A suture gripping puncture needle provided substantially in parallel, a stylet slidably inserted into the suture gripping puncture needle, and the suture thread insertion puncture needle and the suture gripping puncture needle. and a fixing member having a fixed proximal end, and the stylet has an annular member made of an elastic material at its distal end, and the annular member is attached to the distal end of the suture grasping puncture needle. When the puncture needle for suture insertion is made to protrude further, the central axis of the puncture needle for suture insertion or its extension extends in the direction of the puncture needle for suture insertion so as to penetrate inside the annular member. By using equipment,
The anterior abdominal wall and the visceral wall, for example, the anterior abdominal wall and the anterior wall of the stomach body, can be fixed easily, quickly, safely and reliably, and the invasion to the patient associated with this fixation can be avoided by puncturing the puncture needle. This is extremely rare, and the burden on patients is also small.

Furthermore, the medical instrument of the present invention includes a first puncture needle for suture insertion, and a first puncture needle provided substantially parallel to the first puncture needle for suture insertion, and spaced apart from the first puncture needle for suture insertion by a predetermined distance. a suture gripping puncture needle, a first stylet slidably inserted into the first suture gripping puncture needle, a second suture insertion puncture needle, and the second suture A second suture gripping puncture needle provided at a predetermined distance from and substantially parallel to the suture insertion puncture needle, and a first suture gripping puncture needle slidably inserted into the second suture gripping puncture needle. each of the stylet, the first suture insertion puncture needle, the first suture gripping puncture needle, the second suture insertion puncture needle, and the second suture gripping puncture needle. the first stylet has an annular member formed of an elastic material at its distal end, and the first stylet has an annular member formed of an elastic material at its tip; The member is configured such that when the member protrudes beyond the tip of the first suture grasping puncture needle, the central axis of the first suture insertion puncture needle or its extension passes through the inside of the annular member. The second stylet extends in the direction of the first suture insertion puncture needle, and further includes:
The annular member has an annular member formed of an elastic material at its distal end, and when the annular member protrudes from the distal end of the second suture grasping puncture needle, the second suture insertion puncture needle Since the central axis of the needle or its extension extends in the direction of the second suture insertion puncture needle so as to penetrate the inside of the annular member, by using this medical device, the anterior abdominal wall and Visceral walls, for example, the anterior abdominal wall and the anterior wall of the stomach body, can be fixed easily, quickly, safely and reliably, and the invasion to the patient associated with this fixation can be avoided with just one use of this medical device. It requires very few punctures, and there is little burden on the patient.

[Brief explanation of the drawing]

FIG. 1 is a cross-sectional view of an embodiment of the medical device of the present invention.

FIG. 2 is a side view of the medical instrument shown in FIG. 1.

FIG. 3 is a sectional view taken along line AA in FIG. 1;

FIG. 4 is a cross-sectional view of the embodiment of the medical instrument of the present invention in which the annular member at the distal end of the stylet does not protrude.

FIG. 5 is a side view of another embodiment of the medical device of the present invention.

FIG. 6 is a top view of the medical device shown in FIG. 5;

FIG. 7 is an explanatory diagram for explaining the action of the medical device of the present invention.

FIG. 8 is an explanatory diagram for explaining the action of the medical device of the present invention.

FIG. 9 is an explanatory diagram for explaining the action of the medical instrument of the present invention.

FIG. 10 is an explanatory diagram for explaining the action of the medical instrument of the present invention.

FIG. 11 is an explanatory diagram for explaining the action of the medical instrument of the present invention.

FIG. 12 is an explanatory diagram for explaining the action of the medical instrument of the present invention.

FIG. 13 is an explanatory diagram for explaining the action of the medical device of the present invention.

[Explanation of symbols]

1 Medical equipment 20 Medical equipment 2 Puncture needle for grasping suture thread 2a Puncture needle for suture grasping 2b Puncture needle for suture grasping 3 Puncture needle for suture insertion 3a Puncture needle for suture insertion 3b Puncture needle for suture insertion 4 Stylet 4a stylet 4b stylet 5 Annular member 5a Annular member 5b Annular member 6 Fixed member 26 Fixed member

Claims (6)

[Claims] Claim 1: A suture insertion puncture needle, a suture gripping puncture needle provided approximately parallel to the suture insertion puncture needle at a predetermined distance from the suture insertion puncture needle, and a suture gripping puncture needle provided inside the suture gripping puncture needle. It consists of a stylet slidably inserted, and a fixing member to which the proximal ends of the suture insertion puncture needle and the suture grasping puncture needle are fixed, and the stylet has a distal end made of an elastic material. The annular member has a formed annular member, and when the annular member is made to protrude from the tip of the suture gripping puncture needle, the central axis of the suture thread insertion puncture needle or its extension line is aligned with the A medical instrument, characterized in that it extends in the direction of the suture insertion puncture needle so as to penetrate the inside of the annular member. Claim 2: A first suture insertion puncture needle;
a first suture gripping puncture needle provided at a predetermined distance from and substantially parallel to the suture insertion puncture needle; and a first suture gripping puncture needle slidably inserted into the first suture gripping puncture needle. A first stylet, a second suture insertion puncture needle, and a second suture grasping puncture needle provided approximately parallel to the second suture insertion puncture needle at a predetermined distance from the second suture insertion puncture needle. a second stylet slidably inserted into the second suture gripping puncture needle; the first suture insertion puncture needle;
a fixing member for fixing the suture gripping puncture needle, the second suture insertion puncture needle, and the second suture gripping puncture needle so that their respective proximal ends form vertexes of a quadrangle; The first stylet has a first annular member formed of an elastic material at its tip, and the first annular member is connected to the first suture grasping puncture needle. When the first puncture needle for suture insertion is made to protrude from the tip thereof, the central axis of the first puncture needle for suture insertion or its extension line passes through the inside of the first annular member. the second stylet further has a second annular member formed of an elastic material at its distal end, and the second annular member extends in the second suture gripping direction. Insert the second suture thread such that the central axis of the second puncture needle for suture insertion or its extension passes through the inside of the second annular member when the needle for suture insertion protrudes from the tip of the puncture needle for suture insertion. A medical device characterized by extending in the direction of a puncture needle. 3. The medical instrument according to claim 1, wherein the medical device has a flat member through which the suture insertion puncture needle and the suture grasping puncture needle are slidably penetrated. utensils. 4. The medical instruments include the first suture insertion puncture needle, the first suture gripping puncture needle, the second suture insertion puncture needle, and the second suture thread. 3. The medical instrument according to claim 2, wherein the grasping puncture needle has a flat member slidably penetrated therethrough. 5. The medical instrument according to claim 1, wherein the fixing member has a flat plate shape. 6. The medical instrument according to claim 1, wherein the blade surface at the tip of the suture gripping puncture needle is open toward the suture insertion puncture needle.