Suture instrument

Abstract

A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, consisting of: an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility; a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided with a side hole through which the anchors are capable of passing; a pusher whose remote end abuts the anchor that is housed in the needle and is disposed in a manner to be capable of moving in the axial direction of the elongated member; and a push-out control portion that is provided in the needle or the pusher and changes the movement direction of the anchor that has been moved to a formation position of the side hole by the pusher from the length-wise direction of the needle to a direction heading toward the side hole.

1 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided with a side hole through which the anchors are capable of passing;   a pusher whose remote end abuts the anchor that is housed in the needle and is disposed in a manner to be capable of moving in the axial direction of the elongated member; and   a push-out control portion that is provided in the needle or the pusher and changes the movement direction of the anchor that has been moved to a formation position of the side hole by the pusher from the length-wise direction of the needle to a direction heading toward the side hole.   
   
   
       2 . The suture instrument according to  claim 1 , wherein the push-out control portion is a plate spring that is provided in the needle and projects toward the side hole. 
   
   
       3 . The suture instrument according to  claim 1 , wherein the push-out control portion is a erecting hook that is attached to the needle in a manner to freely rotate and is capable of rising toward the side hole. 
   
   
       4 . The suture instrument according to  claim 1 , wherein the push-out control portion is a slanted face that is obliquely provided at the distal end of the pusher in a manner facing the side hole and abuts the base end portion of the anchor that is housed at the base end side among the two anchors, and at the distal end portion of the anchor that is housed at the base end side is formed with a face that slants toward the side hole and abuts the base end portion of the anchor that is housed at the distal end side. 
   
   
       5 . The suture instrument according to  claim 1 , wherein the needle additionally has an opening portion at the sharp end portion, the push-out control portion consists of a projection that protrudes so as to press the distal end side first anchor toward the side hole, the distal end side first anchor has an outer shape that is pushed out from the side hole by being guided by the projection, and the base-end side second anchor has an outer shape that enables it to be pushed out from the opening portion without interference from the projection. 
   
   
       6 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, and is capable of housing a plurality of the anchors inside; and   a side hole that is provided in the side portion of the needle along the lengthwise direction of the needle;   wherein by compressing the anchors in a direction that perpendicularly intersects the lengthwise direction thereof, the anchors are housed in the needle in the state of the dimension in this direction decreasing and the dimension in the lengthwise direction being extended.   
   
   
       7 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, and is capable of housing a plurality of the anchors inside; and   a side hole that is provided in the side portion of the needle along the lengthwise direction of the needle and has an opening length that is shorter than the extended length of the one anchor.   
   
   
       8 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, and is capable of housing a first anchor and a second anchor inside;   a first pusher that pushes out the first anchor that is housed at the distal end side from the needle; and   a second pusher that is provided to freely move forward or backward with respect to the first pusher and pushes out the second anchor from the needle.   
   
   
       9 . The suture instrument according to  claim 8 , wherein a housing portion that holds the second anchor is provided in the first pusher, and the second pusher is passed in a manner to freely move forward or backward in the first pusher. 
   
   
       10 . The suture instrument according to  claim 8 , wherein the first pusher is passed in the second pusher and, by passing through a through hole that is formed in the second anchor, pushes out the first anchor. 
   
   
       11 . The suture instrument according to  claim 10 , wherein the second pusher is passed in the lengthwise direction of the needle in a manner to be capable of being pushed and pulled therethrough, and the base end portion of the first pusher is engaged with the second pusher in a manner to be capable of screwing thereon. 
   
   
       12 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided at the sharp tip with an opening portion that is capable of pushing out the anchors;   a pusher that pushes out the anchors from the needle through the opening portion; and   a side hole that is provided in an extended manner from the opening portion of the needle and through which a suture thread that is attached to each of the anchors is passed, being formed in a shape that enables the anchors to be pushed out from the opening portion of the needle one at a time.   
   
   
       13 . The suture instrument according to  claim 12 , wherein a portion of the side hole that passes the suture thread extending from a first anchor that is housed at the distal end side has a crooked shape so as to shift in the circumferential direction of the needle with respect to a portion that passes the suture thread extending from a second anchor that is housed at the base-end side, and the pusher has a distal end portion that engages in the circumferential direction with the second anchor. 
   
   
       14 . The suture instrument according to  claim 12 , wherein a portion of the side hole that passes the suture thread extending from a first anchor that is housed at the distal end side has a curved shape so as to shift in the circumferential direction of the needle with respect to a portion that passes the suture thread extending from a second anchor that is housed at the base-end side. 
   
   
       15 . The suture instrument according to  claim 12 , wherein a narrowed portion in which the opening width is partially narrowed is formed in the side hole. 
   
   
       16 . The suture instrument according to any one of  claims 12  to  15 , wherein the anchors have a projection that is inserted into the side hole. 
   
   
       17 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided at the sharp tip with an opening portion that is capable of pushing out the anchors; and   a pusher that pushes out the anchors from the needle through the opening portion;   wherein the needle is manufactured to have resilience with a projection that reduces the inner diameter being formed therein, and a first anchor that is disposed at the distal end side has an outer diameter that is capable of passing the projection while a second anchor that is disposed at the base-end side has an outer diameter that interferes with the projection.   
   
   
       18 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided at the sharp tip with an opening portion that is capable of pushing out the anchors;   a pusher that pushes out the anchors from the needle through the opening portion;   a first connecting portion that connects a first anchor that is disposed at the distal end side and a second anchor that is disposed at the base-end side and is breakable; and   a second connecting portion that connects the second anchor and the pusher and is breakable.   
   
   
       19 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is obliquely provided at the sharp tip with an opening portion that is capable of pushing out the anchors; and   a pusher that pushes out the anchors from the needle through the opening portion;   wherein the needle is capable of housing two anchors arranged in the radial direction along the slanting direction of the sharp tip.   
   
   
       20 . The suture instrument according to  claim 19 , wherein the distal end portion of the pusher is capable of pushing each of the two anchors, and the base-end side of the sharp tip that slants protrudes. 
   
   
       21 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is obliquely provided at the sharp tip with an opening portion that is capable of pushing out the anchors; and   a pusher that pushes out the anchors from the needle through the opening portion;   wherein the distal end portion of the pusher has two recessed portions that are capable of housing each of the anchors one by one in the lengthwise direction of the needle, with the distal end side recessed portion being formed facing the opening direction of the opening portion, and the base-end side recessed portion formed facing the opposite side of the distal end side opening portion.   
   
   
       22 . A suture instrument that is inserted into a body and ejects an elongated anchor to be engaged to tissue, comprising:
 an elongated member that extends from a proximal end on a hand side to a remote end that is introduced to tissue and has flexibility;   a needle that is provided at the remote end of the elongated member, has at the distal end a sharp tip that is capable of puncturing tissue, is capable of housing a plurality of the anchors inside, and is provided at the sharp tip with an opening portion that is capable of pushing out the anchors; and   a pusher that pushes out the anchors from the needle through the opening portion;   wherein a push-out control portion that is capable of engaging and disengaging with at least one of the anchors to cause the anchors to be pushed out one at a time from the opening portion is provided in the needle or the pusher.   
   
   
       23 . The suture instrument according to  claim 22 , wherein the push-out control portion consists of projections that are formed facing the inner side of the needle, and recessed portions that are capable of engaging and disengaging with the projections are provided on the anchors. 
   
   
       24 . The suture instrument according to  claim 22 , wherein the push-out control portion is mounted on the needle and has a projection that passes through the needle to protrude toward the inner side thereof, and a recessed portion that is capable of engaging and disengaging with the projection is provided on the anchors. 
   
   
       25 . The suture instrument according to  claim 22 , wherein the push-out control portion consists of an elongated spring that has a projection that is biased to be capable of engaging and disengaging with a recessed portion that is formed on the anchors. 
   
   
       26 . The suture instrument according to any one of  claims 23  to  25 , wherein two of the anchors are housed in the needle, and the recessed portion is formed on only one of the anchors. 
   
   
       27 . The suture instrument according to  claim 22 , wherein the push-out control portion is a spring that expands in diameter in the radial direction when compressed in the lengthwise direction of the needle to release the engagement with the anchor. 
   
   
       28 . The suture instrument according to  claim 22 , wherein an intermediate member that freely engages and disengages with the second anchor is provided at the distal end portion of the pusher as a push-out control portion, and a side hole is provided that biases the intermediate member so that the second anchor engages with the intermediate member at the base end side of the needle and releases the bias of the intermediate member so that the engagement of the intermediate member and the second anchor is released at the distal end side. 
   
   
       29 . The suture instrument according to  claim 22 , wherein an intermediate member that freely engages and disengages with the second anchor is provided at the distal end portion of the pusher as a push-out control portion, and either one of the second anchor and the intermediate member is manufactured from a permanent magnet and the other is manufactured from a magnetic body. 
   
   
       30 . The suture instrument according to  claim 22 , wherein a hook is provided at the distal end portion of the pusher as a push-out control portion, is inserted and engaged with a recessed portion of an anchor that is housed in the base-end side of the needle, and when pulled out from the recessed portion expands to be capable of pressing the base-end portion of the anchor.