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ORGAN RESECTION STUMP FIXING CLIP NEW 新技術説明会

外国特許コード F200010247
整理番号 (S2019-0246-N0)
掲載日 2020年10月30日
出願国 世界知的所有権機関(WIPO)
国際出願番号 2020JP011641
国際公開番号 WO2020189666
国際出願日 令和2年3月17日(2020.3.17)
国際公開日 令和2年9月24日(2020.9.24)
優先権データ
  • 特願2019-050488 (2019.3.18) JP
発明の名称 (英語) ORGAN RESECTION STUMP FIXING CLIP NEW 新技術説明会
発明の概要(英語) The purpose of the present invention is to provide a means for fixing a pancreas resection stump that is generated during surgery in which a portion of the pancreas is resected. The present invention provides a polymer surgical clip that comprises a first arm part, a second arm part, and an elastic hinge part that connects the first and second arm parts. The polymer surgical clip is characterized in that base parts of the arm parts are connected to the elastic hinge part, in that the first arm part has a protruding outside surface and a recessed inside surface that is to clamp the pancreas, in that the second arm part has a protruding or flat outside surface and a recessed or flat inside surface that is to clamp the pancreas, in that a flexible hook part that curves toward the second arm part is formed at the tip of the first arm part, and in that, in a closed position, the tip of the second arm part enters and engages the curved hook part, locking the clip in the closed position.
従来技術、競合技術の概要(英語) BACKGROUND ART
Pancreatic juice fistula occurring after pancreas excision is a phenomenon in which pancreatic juice leaks continuously or intermittently. Although pancreatic tail excision has been performed as a root treatment of pancreatic tail tumor, pancreatic juice fistula in which pancreatic juice (digestive enzyme) leaks from pancreatic stumps after pancreatic tail excision may occur, which is one of the complications that have not been solved yet. Pancreatic fluid fistula sometimes melts), such as the surrounding tissue (artery, causing major bleeding and becoming lethal. Postoperative pancreatic juice fistula occurs at about 30 % of pancreatic tail resection, which also causes life-threatening complications.
In pancreatic tail resection, the main pancreatic duct was ligated and the pancreatic parenchyma on the side of the head was closed to prevent the leakage of pancreatic juice.
Various techniques have been used to close pancreatic parenchyma on the side of the resected pancreatic head in pancreatic tail resection. Stapling, liver circle-patching method (teres ligament patching), puck method, TachoSil (Registered trademark) patching method, and pancreatic duct, jejunum (pancreatic duct, stomach) anastomosis, although which technique is suitable is discussed. With the increase of laparoscopic pancreatic tail resection, the closure of resected stumps by staplers has become more common in recent years.
In this paper, we propose a new stapler for pancreatic parenchyma separation. in this paper, we propose a new stapler for pancreatic parenchyma separation. Therefore, we reported that grade B or C pancreatic juice fistula is significantly reduced compared to normal staplers using a set of (Non-Patent Document 1: Yamashita et al . , Anticancer Res. 37: 1865-1868 , 2017). In this report, it is reported that the error 30 % in the case of using the normal stapler is 5 % in the case of using the set.
On the other hand, clips have been proposed for ligating blood vessels during surgery to stop blood flow. For example, it is composed of 1 th and 2 th curved leg members, both leg members being joined at their close ends by elastic hinge means, the 1 th leg member being a flexible hook part curved toward the 2 th leg member at its end, On the other hand, the end of the 2 th leg member serves as a lock portion complementarily to the hook portion, and a polymer surgical clip is proposed. Here, the blood vessel clamping inner surface of the 1 th leg member and the blood vessel clamping inner surface of the 2 th leg member face each other, and the radius of curvature of the inner concave surface of the 1 th leg member and the radius of curvature of the inner convex surface of the 2 th leg member are substantially the same. For this reason, as shown in Fig. 7 E, the vessel clamping inner surfaces of the leg members overlap each other from the proximal end to the distal end thereof.
And a 1 th and 2 th curves connected by resilient hinge means, each having a vessel clamping inner surface such that one vessel clamping inner surface faces the other vessel clamping inner surface, A polymer surgical clip in which each blood vessel clamping inner surface has a plurality of projections is proposed. Wherein the radius of curvature of the inner concave surface for vessel clamping of the 1 th curve set and the radius of curvature of the inner convex surface for vessel clamping of the 2 th curve set are substantially the same, As shown in Fig. 12 E, the respective vessel clamping inner surfaces overlap each other from the proximal end (hinge means proximal portion) to the distal end of both curves.
Furthermore, a surgical clip including an upper jaw member and a lower jaw member that are joined together at a hinge section for movement about the hinge section has been proposed. Here, the maxillary member and mandibular member each include an inner convex section in a portion of the hinge section and are configured to pinch a proximal portion of tissue. The maxillary member has a generally convex outer surface and a S-shaped inner surface, and the mandibular member has a generally concave outer surface and a S-shaped inner surface that substantially matches or conforms to the profile of the inner surface of the maxillary member. Thus, as shown in Fig.4, the clamping inner surfaces of the jaws are configured to overlap each other from the hinged section to the distal end of the jaws.
In addition, a movement prevention surgical ligation clip for ligation of blood vessels or tissue structures has been proposed. There is provided a 1 th leg member including a 1 th inner surface and a plurality of 1 th protrusions disposed on the 1 th inner surface, a 2 th leg member including a 2 th inner surface and a plurality of 2 th protrusions disposed on the 2 th inner surface, and a hinge member joining the 1 th leg member and the 2 th leg member, A surgical clip for ligating a blood vessel or tissue structure is disclosed, wherein at least one of a plurality of 1 th projections and a plurality of 2 th projections includes a gable structure extending along a longitudinal direction of the 1 th inner surface or 2 th inner surface. As shown in Fig. 3 A, the inner surfaces disposed on the respective leg members overlap each other.
Also, as a clip for ligating blood vessels, a polymer Hem-o-lok (Registered trademark) is sold by Teleflex Company, where the Hem-o-lok (Registered trademark) is composed of 1 th and 2 th curved leg members curved in the same direction, Both leg members are joined at their close ends by an elastic hinge, and the end of the 1 th leg member is a flexible hook part curved toward the 2 th leg member, while the end of the 2 th leg member is a locking part complementarily to the hook part. Here, the blood vessel clamping inner surface of the 1 th leg member and the blood vessel clamping inner surface of the 2 th leg member face each other, and the radius of curvature of the inner concave surface of the 1 th leg member and the radius of curvature of the inner convex surface of the 2 th leg member are substantially the same. Therefore, the vessel clamping inner surfaces are configured to overlap each other from the proximal end to the distal end of both leg members (https:/ / www.teleflex. com / usa / en / product-areas / surgical / ligation-solutions / weck-polymer-ligation /).
In addition, (U.S. Patent No.6699258 is proposed a ligation clip comprising an upper jaw, a lower jaw and a hinge portion connecting the upper jaw and the lower jaw made of metal. There is provided a metal upper jaw comprising stress relief means (stress relief mechanism) and curved outwardly; Disclosed is a clip comprising a metal mandible including a latch portion at a 1 th distal end configured to engage a distal end of the maxilla when a curved portion of the maxilla is extended, and a hinge portion at a 2 th distal end opposite the 1 th distal end. In the clip, as shown in Fig.3, when the blood vessel is closed, the curved portion of the upper jaw is extended to be straight and permanently deformed, and the distal end of the upper jaw is engaged with the latch portion of the lower jaw. That is, the engagement is achieved by permanently extending the curved portion made of metal.
Also, as clips for appendectomy, AESCULAP (Registered trademark) DS clips are marketed by Shelper Co., Ltd., Parallel closure is achieved by permanently extending the upper and lower jaws of curved metal (https:/ / www.bbraun.jp / ja / products / b / ds-titanium-ligationclips.html).
  • 出願人(英語)
  • ※2012年7月以前掲載分については米国以外のすべての指定国
  • KUMAMOTO UNIVERSITY
  • KYUSHU UNIVERSITY
  • 発明者(英語)
  • BABA Hideo
  • YAMASHITA Yoichi
  • IJIMA Hiroyuki
国際特許分類(IPC)
指定国 National States: AE AG AL AM AO AT AU AZ BA BB BG BH BN BR BW BY BZ CA CH CL CN CO CR CU CZ DE DJ DK DM DO DZ EC EE EG ES FI GB GD GE GH GM GT HN HR HU ID IL IN IR IS JO JP KE KG KH KN KP KR KW KZ LA LC LK LR LS LU LY MA MD ME MG MK MN MW MX MY MZ NA NG NI NO NZ OM PA PE PG PH PL PT QA RO RS RU RW SA SC SD SE SG SK SL ST SV SY TH TJ TM TN TR TT TZ UA UG US UZ VC VN WS ZA ZM ZW
ARIPO: BW GH GM KE LR LS MW MZ NA RW SD SL SZ TZ UG ZM ZW
EAPO: AM AZ BY KG KZ RU TJ TM
EPO: AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR
OAPI: BF BJ CF CG CI CM GA GN GQ GW KM ML MR NE SN ST TD TG
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