JPS61209647A - 血管吻合用の切開口拡開器 - Google Patents
血管吻合用の切開口拡開器Info
- Publication number
- JPS61209647A JPS61209647A JP60051352A JP5135285A JPS61209647A JP S61209647 A JPS61209647 A JP S61209647A JP 60051352 A JP60051352 A JP 60051352A JP 5135285 A JP5135285 A JP 5135285A JP S61209647 A JPS61209647 A JP S61209647A
- Authority
- JP
- Japan
- Prior art keywords
- blood vessel
- inner cylinder
- outer cylinder
- incision
- cylinder
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000004204 blood vessel Anatomy 0.000 title claims description 23
- 230000003872 anastomosis Effects 0.000 claims description 19
- 230000006835 compression Effects 0.000 claims description 2
- 238000007906 compression Methods 0.000 claims description 2
- 238000001356 surgical procedure Methods 0.000 description 14
- 210000004351 coronary vessel Anatomy 0.000 description 8
- 210000003462 vein Anatomy 0.000 description 8
- 230000002792 vascular Effects 0.000 description 3
- 208000007536 Thrombosis Diseases 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000004555 blood preservation Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
- A61B17/0218—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Pathology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。
め要約のデータは記録されません。
Description
【発明の詳細な説明】
(1)発明の目的
産業上の利用分野
本発明は手術時、特に血管吻合時に用いる血管グラフト
の切開口拡開器に関するものである。
の切開口拡開器に関するものである。
従来の技術
従来、血管吻合手術に際しては、医師による指先とビン
セット、針及び糸により縫合する手技が主であった。唯
、血v縫合器といわれる長手方向に血管を接合する器具
は知られているが、このような器具は血管側壁に設けた
切開口にバ・イパスを縫合するような血管吻合には用い
ることができない。
セット、針及び糸により縫合する手技が主であった。唯
、血v縫合器といわれる長手方向に血管を接合する器具
は知られているが、このような器具は血管側壁に設けた
切開口にバ・イパスを縫合するような血管吻合には用い
ることができない。
発明が解決しようとする問題点
静脈グラフトを用いて、冠動脈と吻合する冠動脈バイパ
ス手術のような場合、血管の吻合口が立体時に展開され
、良好な視野のもとで手術を行なうことが、手術後のグ
ラフトの開存性を向上させるため重要なことである。
ス手術のような場合、血管の吻合口が立体時に展開され
、良好な視野のもとで手術を行なうことが、手術後のグ
ラフトの開存性を向上させるため重要なことである。
しかるに、前記のようにピンセットを用いて、吻合口の
展開を試みても、静止状態で立体的に、良好な視野が得
られるように切開口を保持することは極めて難しい手術
となる。
展開を試みても、静止状態で立体的に、良好な視野が得
られるように切開口を保持することは極めて難しい手術
となる。
従って、本発明は、血管吻合時にグラフトの切開口を十
分に拡開でき、安全で視野の十分とれる器具を提供しよ
うとするものである。
分に拡開でき、安全で視野の十分とれる器具を提供しよ
うとするものである。
(2)発明の構成
問題点を解決するめだの手段
上記目的達成のため、本発明では血管内腔へ挿入可能な
細長い外筒と、この外筒とほぼ同じ長さで、外筒内へ摺
動可能に挿入された内筒と、この内筒の一端に取付けら
れ掌に入る程度の把持部と、基部が前記内筒の他端に固
定され、外筒内に収納可能で、且つ、前記内筒が摺動し
て外筒による圧縮が開放された時立体的に拡開するよう
附勢された複数本の線状部とから成る血管吻合用の切開
口拡開器とした。
細長い外筒と、この外筒とほぼ同じ長さで、外筒内へ摺
動可能に挿入された内筒と、この内筒の一端に取付けら
れ掌に入る程度の把持部と、基部が前記内筒の他端に固
定され、外筒内に収納可能で、且つ、前記内筒が摺動し
て外筒による圧縮が開放された時立体的に拡開するよう
附勢された複数本の線状部とから成る血管吻合用の切開
口拡開器とした。
作 用
本発明の血管吻合用の切開口拡開器は、外筒が血管内腔
へ挿入可能な細長いものとしたので、冠動脈バイパス手
術のような場合、静脈片をグラフトとして、中枢側断端
より血管内腔へ挿入し、先端がグラフトの切開口に位置
するところで、把持部と外筒を利用して、内筒を摺動さ
せ、複数本の線状部が外筒外へ出るようにすることによ
り、線状部が拡開されて、切開口を外筒径より大きく拡
げることがてきるようになる。
へ挿入可能な細長いものとしたので、冠動脈バイパス手
術のような場合、静脈片をグラフトとして、中枢側断端
より血管内腔へ挿入し、先端がグラフトの切開口に位置
するところで、把持部と外筒を利用して、内筒を摺動さ
せ、複数本の線状部が外筒外へ出るようにすることによ
り、線状部が拡開されて、切開口を外筒径より大きく拡
げることがてきるようになる。
複数本の線状部の拡開には、外筒と把持部をもって相対
的に摺動させ、線状部が外筒外へでるようにすればよく
、又血管内腔へ入れる場合、又術後引出す場合には、線
状部を外筒内に引込めれば血管に何んらの傷を与えるこ
となく、円滑に操作ができる。
的に摺動させ、線状部が外筒外へでるようにすればよく
、又血管内腔へ入れる場合、又術後引出す場合には、線
状部を外筒内に引込めれば血管に何んらの傷を与えるこ
となく、円滑に操作ができる。
実施例
図面は実施例を示すものである。第1図は本発明切開口
拡開器の斜視図で、第2図は内筒の線状部が突出した状
態を示す。
拡開器の斜視図で、第2図は内筒の線状部が突出した状
態を示す。
1は外筒、2は内筒である。この内筒2は外筒とほぼ同
じ程度の長さで、外筒内で摺動可能に挿入されている。
じ程度の長さで、外筒内で摺動可能に挿入されている。
内筒2の一端には把持部3が取付けられ、この把持部は
掌に入る程度の大きさとなっている。内筒2の他端には
、基部4が内筒端に固定された複数本の線状部5が取付
けられ、これら線状部5は外筒内に収納可能であると共
に外筒外へ出たときには、それぞれ外方へ拡開されるよ
う附勢されている。勿論、外方へ拡がる附勢力は、血管
の切開口を手術し易い程度に拡開するものであって、血
管を破壊するようなものであってはならない。又線状部
5を先端に設けた丸み6は血管内腔を保護するものであ
る。
掌に入る程度の大きさとなっている。内筒2の他端には
、基部4が内筒端に固定された複数本の線状部5が取付
けられ、これら線状部5は外筒内に収納可能であると共
に外筒外へ出たときには、それぞれ外方へ拡開されるよ
う附勢されている。勿論、外方へ拡がる附勢力は、血管
の切開口を手術し易い程度に拡開するものであって、血
管を破壊するようなものであってはならない。又線状部
5を先端に設けた丸み6は血管内腔を保護するものであ
る。
外筒1と内筒2とは摺動可能で、相対的に摺動され、内
筒先端の線状部が外筒から出たところで立体的に拡開さ
れるようになっている。外筒lには突出した係合部7が
あり、把持部3には係止部8があるので、両者を嵌合さ
せることにより、内筒又は外筒の回転を確実に押えて、
安定して使用できるようなっている。
筒先端の線状部が外筒から出たところで立体的に拡開さ
れるようになっている。外筒lには突出した係合部7が
あり、把持部3には係止部8があるので、両者を嵌合さ
せることにより、内筒又は外筒の回転を確実に押えて、
安定して使用できるようなっている。
冠動脈バイパス手術時の使用例を、第3図〜第5図で示
す。9は静脈グラフト、10は切開口、11は第1吻合
部、12は側々吻合をした第2吻合部である。13は冠
動脈、14は血栓、15は縫合用糸を示す。
す。9は静脈グラフト、10は切開口、11は第1吻合
部、12は側々吻合をした第2吻合部である。13は冠
動脈、14は血栓、15は縫合用糸を示す。
第1図に示すように、本発明切開口拡開器を、静脈グラ
フト9の中枢側断端より挿入する。この際、内筒2は線
状部5が外筒1内に収納された状態である。先端が静脈
グラフト9の切開口lOの位置に来た時、内筒2を摺動
させて、線状部5を外筒外へ出すことにより切開口10
は大きく拡開される。その結果、静脈グラフト9は、端
部の第1吻合部11及び側々吻合としての第2吻合部1
2とも縫合され、冠動脈13の2つの血管において血栓
14がそれぞれ発生している場合でも、1本の静脈グラ
フトによって容易にバイパス手術が可能となった。
フト9の中枢側断端より挿入する。この際、内筒2は線
状部5が外筒1内に収納された状態である。先端が静脈
グラフト9の切開口lOの位置に来た時、内筒2を摺動
させて、線状部5を外筒外へ出すことにより切開口10
は大きく拡開される。その結果、静脈グラフト9は、端
部の第1吻合部11及び側々吻合としての第2吻合部1
2とも縫合され、冠動脈13の2つの血管において血栓
14がそれぞれ発生している場合でも、1本の静脈グラ
フトによって容易にバイパス手術が可能となった。
本発明切開口拡開器を使用すると、切開口が十分に立体
的に拡開されるので、ピンセット、針、糸を利用して、
視野を十分とりながら、早急に確実に手術を行なうこと
ができるようになった。
的に拡開されるので、ピンセット、針、糸を利用して、
視野を十分とりながら、早急に確実に手術を行なうこと
ができるようになった。
(3)発明の効果
本発明の血省・吻合用の切開口拡開器を用いることによ
り、血管のような2〜6fflI11程度の細いグラフ
ト内腔に容易に確実に挿入でき、切開口の近辺において
、外筒と把持部を利用して内筒を摺動させ、線状部を突
出させることができる。外筒から出た線状部は複数本の
それぞれが立体的に拡開するよう附勢されているので、
切開口を良好に展開するので、吻合口縁に正確に針を通
す手術が容易且つ安全にできるようになった。従って、
冠動脈バイパス手術のように静脈グラフトを用いた側々
吻合も容易に行なえるようになり、外科手術に及ぼす効
果は誠に大きい。
り、血管のような2〜6fflI11程度の細いグラフ
ト内腔に容易に確実に挿入でき、切開口の近辺において
、外筒と把持部を利用して内筒を摺動させ、線状部を突
出させることができる。外筒から出た線状部は複数本の
それぞれが立体的に拡開するよう附勢されているので、
切開口を良好に展開するので、吻合口縁に正確に針を通
す手術が容易且つ安全にできるようになった。従って、
冠動脈バイパス手術のように静脈グラフトを用いた側々
吻合も容易に行なえるようになり、外科手術に及ぼす効
果は誠に大きい。
手術後は再び内筒を外筒内へ引込めば、線状部も圧縮さ
れて収納される。
れて収納される。
第1図は本発明血管吻合用の切開口拡開器の斜視図、第
2図は同斜視図で、線状部を突出yせた状態を示す。第
3図〜第5図は冠状動脈のバイパス手術時の使用例を示
す説明図である。 1・・・外筒 2・・・内筒 3・・・把持部4・
・・基部 5・・・線状部 6・・・丸み7・・・
係合部 8・・・係止部 代理人 弁理士 大 島 −公 第3図 第5図
2図は同斜視図で、線状部を突出yせた状態を示す。第
3図〜第5図は冠状動脈のバイパス手術時の使用例を示
す説明図である。 1・・・外筒 2・・・内筒 3・・・把持部4・
・・基部 5・・・線状部 6・・・丸み7・・・
係合部 8・・・係止部 代理人 弁理士 大 島 −公 第3図 第5図
Claims (3)
- (1)血管内腔へ挿入可能な細長い外筒と、この外筒と
ほぼ同じ長さで、外筒内へ摺動可能に挿入された内筒と
、この内筒の一端に取付けられ掌に入る程度の把持部と
、基部が前記内筒の他端に固定され、外筒内に収納可能
で、且つ、前記内筒が摺動して外筒による圧縮が開放さ
れた時立体的に拡開するよう附勢された複数本の線状部
とから成る血管吻合用の切開口拡開器。 - (2)内筒の一端に取付けられた把持部として、外筒の
端部に設けた係合部と嵌合する係止部を有する把持部を
用いた特許請求の範囲第1項記載の血管吻合用の切開口
拡開器。 - (3)内筒の他端に設けた複数本の線状部が、基部を内
筒他端に固定すると共に3本の線状自由端部が3方に拡
がるよう附勢され且つ先端に保護用丸みを設けたもので
ある特許請求の範囲第1項記載の血管吻合用の切開口拡
開器。
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP60051352A JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
US06/823,950 US4654028A (en) | 1985-03-14 | 1986-01-29 | Incision opening expansion holder for inosculation |
DE19863607933 DE3607933A1 (de) | 1985-03-14 | 1986-03-11 | Dehnungshalter fuer schnittoeffnungen zum gebrauch bei chirurgischen operationen |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP60051352A JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPS61209647A true JPS61209647A (ja) | 1986-09-17 |
JPH0237773B2 JPH0237773B2 (ja) | 1990-08-27 |
Family
ID=12884533
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP60051352A Granted JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
Country Status (3)
Country | Link |
---|---|
US (1) | US4654028A (ja) |
JP (1) | JPS61209647A (ja) |
DE (1) | DE3607933A1 (ja) |
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US12239317B2 (en) | 2021-10-18 | 2025-03-04 | Cilag Gmbh International | Anvil comprising an arrangement of forming pockets proximal to tissue stop |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
US12089841B2 (en) | 2021-10-28 | 2024-09-17 | Cilag CmbH International | Staple cartridge identification systems |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE7736713U1 (ja) * | 1900-01-01 | Aesculap-Werke Ag Vormals Jetter & Scheerer, 7200 Tuttlingen | ||
US2137710A (en) * | 1937-12-13 | 1938-11-22 | Alfred W Anderson | Forceps |
FR2085427A1 (ja) * | 1970-04-20 | 1971-12-24 | Soichet Samuel | |
US3858586A (en) * | 1971-03-11 | 1975-01-07 | Martin Lessen | Surgical method and electrode therefor |
DE2326988B2 (de) * | 1973-05-26 | 1977-02-24 | Drägerwerk AG, 2400 Lübeck | Chirurgisches instrument zur sterilisation von frauen durch tubenligatur |
CA1018419A (en) * | 1973-07-04 | 1977-10-04 | Gerald Turp | Instrument for laparoscopic tubal cauterization |
US4174715A (en) * | 1977-03-28 | 1979-11-20 | Hasson Harrith M | Multi-pronged laparoscopy forceps |
US4249533A (en) * | 1977-05-16 | 1981-02-10 | Olympus Optical Co., Ltd. | Laser knife |
US4222380A (en) * | 1977-12-02 | 1980-09-16 | Olympus Optical Co., Ltd. | Celiac injector |
DE3012447C2 (de) * | 1980-03-31 | 1982-04-01 | Harald 7200 Tuttlingen Maslanka | Chirurgisches Greiferinstrument |
US4393872A (en) * | 1980-05-27 | 1983-07-19 | Eder Instrument Co., Inc. | Aspirating surgical forceps |
-
1985
- 1985-03-14 JP JP60051352A patent/JPS61209647A/ja active Granted
-
1986
- 1986-01-29 US US06/823,950 patent/US4654028A/en not_active Expired - Fee Related
- 1986-03-11 DE DE19863607933 patent/DE3607933A1/de active Granted
Also Published As
Publication number | Publication date |
---|---|
US4654028A (en) | 1987-03-31 |
DE3607933A1 (de) | 1986-09-25 |
DE3607933C2 (ja) | 1989-01-26 |
JPH0237773B2 (ja) | 1990-08-27 |
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