Tissue ligating device

A tissue ligating device to which a suture is attached and which ligates a tissue includes a suture fix member which is attached to the suture, and which includes a housing part which one part of the suture can be hooked; and a hooked suture locking part configured to prevent the suture hooked in the housing part from disengaging from the housing part.

BACKGROUND OF THE INVENTION

1. Field of Invention

The present invention relates to a tissue ligating device, and more specifically relates to a tissue ligating device including a suture and a suture fix member. Priority is claimed on Japanese Patent Application No. 2010-267776, filed Nov. 30, 2010, and Japanese Patent Application No. 2011-258684, filed Nov. 28, 2011, the contents of which are incorporated herein by reference.

2. Description of Related Art

The suturing and ligating tissue are very important operations in the field of medical treatment. These operations are also extremely difficult and require considerable skill. Recently, for the purpose of reducing the invasiveness for the patient, various types of procedures in surgery or the like using an endoscope, a laparoscope, a thoracoscope or the like, have been attempted. A suture instrument for medical treatment proposed in Japanese Published Unexamined Application No. H 8-140982 includes a suture unit where a suture is connected to a suture fix member. The suture fix member has a housing part capable of housing one part of the suture. After the suture which is threaded into tissue using a curved needle or the like, is inserted into the housing part and is drawn tight, the housing part is deformed by swage or ultrasonic waves or the like, whereby one part of the suture trapped in the housing part is fixed to the suture fix member. As a result, since a knot is formed, the knot can be formed easily.

SUMMARY OF THE INVENTION

A tissue ligating device according to a first aspect of the invention is a tissue ligating device to which a suture is attached and which ligates a tissue, and includes a suture fix member which is attached to the suture, and which includes a housing part where one part of the suture can be hooked, and a hooked suture locking part configured to prevent the suture hooked in the housing part from disengaging from the housing part.

In a tissue ligating device according a second aspect of the invention, the hooked suture locking part is formed on the suture fix member.

The hooked suture locking part may include a protrusion protruding into the housing part. The hooked suture locking part may include a constriction part causes the size of the housing part to become smaller than at other points viewed from at least one direction.

Moreover, the configuration may be one where the housing part bends viewed from at least one direction, and in this bent state the housing part functions as the hooked suture locking part.

The tissue ligating device according a third aspect of the invention further includes a suture attached to the suture fix member.

The tissue ligating device according to a fourth aspect of the invention further includes a suture needle attached to one end of the suture.

DETAILED DESCRIPTION OF THE INVENTION

A first embodiment of the invention will be explained with reference toFIGS. 1 to 12B.

FIG. 1is a view of a tissue ligating device (hereinafter referred as ‘ligating device’)1of this embodiment. The ligating device1includes a suture10, a suture needle20attached to a first end10A of the suture10, and a suture fix member30attached to a second end10B of the suture10.

The suture10is preferably a member made of resin or metal that maintains a linear shape and has a certain degree of elasticity; however, a member without elasticity can also be used. For example, when the suture10is made of resin, it is preferably made of a bioabsorbable resin, since this has advantages such as eliminating the need for suture removal (in this case, the suture fix member is preferably also made of absorbable resin). However, the suture10can be made of a non-absorbable resin. As the suture10, a monofilament member (single wire) or a multifilament member (plural wires) can be used depending on the intended purpose. A member with a multiple-layer structure can be used as the monofilament member, such as a single wire made from a single material, or a member with a two-layer structure including a core made from a material with high tensile strength and a cladding made from a material with good welding properties. As the multifilament member, either of a member made by weaving a plurality of wires and a member made by twisting can be used. The multifilament member can also be formed by combining wires made from a plurality of different materials.

Various types of well-known suture needles can be used as the suture needle20. After considering the suture position, the suture needle20can be selected as appropriate from among a linear suture needle, a curved suture needle, a suture needle that has a curved tip and is otherwise straight, and so on. There are no particular restrictions on the manner of connecting the suture10and the suture needle20. The only requirement is that the suture10and the suture needle20can maintain their state of connection with respect to the amount of force acting on the point where they are connected during a knot-formation operation and an operation of passing the suture through tissue described below. Specific methods for tying the suture10to the suture needle20that can be used include adhesion, welding, or passing one end of the suture10through a hole formed in one end of the suture needle20.

FIG. 2is an enlarged perspective view of the suture fix member30. The suture fix member30is made from metal, resin, or the like. The suture fix member30includes a connection part31which the second end10B of the suture10is connected to, and an arm part32that extends from the connection part31.

The connection part31is substantially a rectangular parallelepiped, and has an insertion hole31A which the second end10B of the suture10is inserted into. The second end10B is inserted into the insertion hole31A. The suture10and the suture fix member30are then connected and attached to the second end10B using an adhesive or the like.

The arm part32includes a first arm part32A that extends from the connection part31, and second arm parts32B that branch from the first arm part32A and extend after being folded to the connection part side. The first arm part32A extends from one side part31B in a front view of the suture fix member30(when the suture fix member30is viewed from the face where the insertion hole31A opens), and extends linearly in a direction that substantially intersects the extension direction of the insertion hole31A (hereinafter this direction will be abbreviated as the ‘thickness direction’ of the suture fix member30). The two second arm parts32B branch from the end of the first arm part32A to both sides of the wide direction of the first arm part32A, curve and fold180degrees as a hair pin shape, and extend towards the connection part31. In this structure, housing parts33, which one part of the suture10is hooked, are formed on both sides of the wide direction of the first arm part32A along the thick direction of the suture fix member30. Due to the shape of the arm part32, the housing parts33at those two points extend substantially parallel with the first arm part32A in a front view of the suture fix member30.

The first arm part32A and the second arm parts32B are approximately the same width. This width is shorter than the one side31B of the connection part31along which the first arm part32A extends. The first arm part32A extends from an intermediate part in the long direction of the one side31B. Consequently, regions of the connection part31that belong to ends on both sides of the long direction of the side part31B are formed as protrusions34protruding into the housing parts33. In the knot-formation operation, the protrusions34function as hooked suture locking parts for preventing the suture10hooked the housing part33from escaping from the suture fix member30.

There are no particular restrictions on the size of the suture fix member30, which can be set as appropriate after considering the suture position and so on. When the suture fix member30is set at a small size of, for example, 1 mm square, it can be manufactured by subjecting a cube with side length of 1 mm formed from, for example, stainless steel or the like, to laser processing, wire electrical discharging machining, cutting, and so on.

An operation when using the ligating device1having the configuration described above will be explained, taking as an example a case where a wound is sutured.

The operator inserts the ligating device1in the vicinity of treatment target tissue (hereinafter ‘target tissue’). An applicator including a sheath, such as that disclosed in Japanese Published Unexamined Application No. H 8-140982 mentioned above, can be used to insert the ligating device1in the vicinity of target tissue.

After inserting the ligating device1into the body, the operator grips the suture needle20with a forceps or the like, and, as shown inFIG. 3, applies it to the target tissue T around the wound W. As shown inFIG. 4, the operator clips the wound W, applies the suture needle20to the target tissue T2opposite the target tissue T1, and passes the suture10through the target tissue so that the wound W can be sutured.

As shown inFIG. 5, the operator then grips the suture10or the suture needle20and passes (hook) one part of the suture10through the housing part33of the suture fix member30. The suture10can be hooked either of the two housing parts33. As shown inFIG. 6, when the first end10A side of the suture10is pulled away from the target tissue, the suture fix member30connected to the second end10B approaches the target tissue T1and presses against it. Also, the suture10passing the target tissue is drawn tight, pulling the target tissues T1and T2closer to each other.

In the above operation, due to the elasticity or due to the application of an external force, the suture10sometimes moves in a direction of escaping (disengaging) from the housing part33. However, as shown inFIG. 7B, this movement of the suture10described above is obstructed by the protrusion34protruding into the housing part33. This favorably prevents the suture10from disengaging from the housing part33and escaping from the suture fix member30. That is, in this ligating device, whether the suture10has elasticity or not, it can be prevented from disengaging from the housing part33.

When the suture10is inserted into the housing part33, as shown inFIG. 7A, the suture10passes beside the connection part31and is inserted into the housing part33from the outer side of the wide direction of the second arm part32B. Therefore, the protrusion34hardly obstructs the hooking operation of passing the suture10through the housing part33.

When the operator has drawn the suture10sufficiently tight, the operator uses a forceps or the like to grip the first arm part32A and the second arm parts32B, making the second arm parts32B deform and thereby securing the suture10and the suture fix member30as shown inFIG. 8.

Then, the point where the suture10and the suture fix member30are secured functions as a suture knot Kn, and, as shown inFIG. 9, the target tissue T1and the target tissue T2are sutured so as to cover the wound W. This completes the knot-formation operation using the ligating device1. In forming the knot Kn, the suturing can be done more reliably by applying tension while pulling the suture10.

After the knot Kn has been formed, the operator cuts off the excess part of the suture10, and collects the suture needle20and the suture10that was cut off from outside the body cavity. In the case of a large wound W or the like, the operator continues by introducing a new ligating device1and repeating the knot-formation operation described above. Then, the operator ends the procedure when the operator has completely sutured the wound W.

The point where the suture10and the suture fix member30are secured is actually different from a knot made by a method such as a square knot or a granny knot. However, this point functions similarly to a conventional knot made by a surgical method in that it holds the suture10applied to the target tissue so that it does not become loose. For that reason, in this invention, this point is termed a knot.

In the ligating device1of this embodiment, the suture fix member30includes the protrusion34protruding into the housing part33that the suture10is hooked. Therefore, even if the suture10moves in a direction of disengaging from the housing part33due to elasticity or the like, the protrusion34favorably prevents the suture10from disengaging from the housing part33. That is, the protrusion34functions as a hooked suture locking part. Therefore, the knot-formation operation can be performed easily and smoothly, and a stable knot can be formed.

In the ligating device1of this embodiment, the housing part33is formed in the thick direction of the suture fix member30. Therefore, since the arm part32is able to deform sufficiently merely by the application of force from both sides of the wide direction of the arm part32, the suture fix member30and the suture10can be easily secured by a simple operation.

In a procedure using an endoscope, a laparoscope, and the like, the space for moving the forceps and the like is limited. The advantageous effects of the ligating device of the invention described above are therefore even more noticeable.

In this embodiment, the external shape of the suture fix member30is substantially anchor-shaped, having one first arm part32A and two second arm parts32B, and with one part of the connection part31being formed as the protrusion34. However, the shape of the suture fix member can be altered in various ways.

One way of modifying the anchor-shape described above is to provide only one first arm part32A, as in the modified example shown inFIG. 10A. This makes it easy to reduce the size of the suture fix member, and is convenient for a procedure in a very small region. Also, the region where the first arm part32A is deformed during knot-formation is smaller, facilitating the deformation operation.

The protrusion can be formed separately from one part of the connection part. For example, as in the modified example ofFIG. 10B, a plurality of protrusions36can be formed on a side face of the first arm part32A (or a side face of the second arm part32B) that forms the inner face of the housing part33. Alternatively, as in the modified example ofFIG. 10C, one protrusion37protruding into each housing part33can be formed separate from the connection part31. When the protrusions include parts projecting in a direction away from the opening33A of the housing part33where the suture10is introduced into, as is the case with the protrusions36, the protrusions36are unlikely to obstruct the movement of the suture10when the suture10passes the housing part33. Therefore, it is possible to favorably obstruct only the movement of the suture10in the direction of disengaging from the housing part33. The protrusions in the modified examples ofFIGS. 10B and 10Ccan also actively obstruct the movement of the suture, while more effectively preventing the suture10from disengaging from the housing parts33.

The suture fix member of this embodiment is not limited to the anchor-shaped configuration described above.

Each ofFIGS. 11A to 11Iillustrates another modified example of the suture fix member30.

In the suture fix member30A shown inFIG. 11A, the second arm part32B is longer than the first arm part32A. In this case, the larger region of the connection part31functions as a protrusion.

Moreover, since the second arm part32B functions as a guide when passing the suture10through the housing part33, the knot-formation operation can be performed more easily.

In the suture fix members30B and30C shown respectively inFIGS. 11B and 11C, the second arm parts32B are folded at an acute angle so that the housing parts33have angular parts33A.

The protrusions38are provided at the ends of the second arm parts32B. In this instance, the behavior of the suture10during the knot-formation operation is stabilized by drawing and tightening the suture10in a direction of pushing it against the angular part33A when the suture10is hooked the housing part33. Moreover, since the suture10being directed into the angular part33A is not easily loosen, the knot Kn can be formed more stably.

When the protrusions38are formed on the second arm parts32B, as with the suture fix member30D shown inFIG. 11D, the connection part40can be the same width as the arm parts. In this instance, unlike the suture fix member30A, the first arm part32A functions as a guide for the suture10.

In a suture fix member30E shown inFIG. 11, the housing parts33are substantially circular in front view. Since the housing parts are comparatively large with respect to the suture fix member, this configuration has an advantage that the housing parts are easy to confirm visually. At the arm part32, the interface between the first arm part and the second arm part is unclear, and a region of a predetermined length including the tip of the arm part32functions as the protrusion39.

At this time, as in the suture fix member30F shown inFIG. 11F, a protrusion41can be provided separately from the arm part32. In this case, an opening for passing the suture through the housing part is formed further away from insertion hole31A than the suture fix member30E. This can prevent problems such as the suture becoming entangled, or the operator mistaking the side for drawing the suture during in the knot-formation operation.

In suture fix members30G,30H, and30I shown respectively inFIGS. 11G to 11I, the arm part is not folded back and the second arm part is not provided. In this case, protrusions44A,44B, and44C are provided in a housing part43formed between two arm parts42, thereby favorably preventing the suture10from disengaging from the housing part43.

In each of the suture fix members30G,30H, and30I, instead of aiming for the arm part, the knot can be formed by gripping and crushing the whole suture fix member with a forceps or the like, thereby making the operation easier.

When the suture fix member is formed in the shape of the suture fix member30G, as shown inFIG. 12A, a notch42A can be formed with a region corresponding to the length of the protrusion44A from the end of the arm part42where the protrusion44A is formed, such that the width of the arm part42decreases. With this configuration, when the suture fix member deforms and is secured to the suture10, as shown inFIG. 12B, the protrusion44A is housed in the notch42A. The suture fix member thus deforms favorably. As a result, the suture and the suture fix member can be secured together more reliably.

Subsequently, a second embodiment of the invention will be explained with reference toFIGS. 13 to 16F.

A ligating device51of this embodiment differs from the ligating device1described above in regard to the aspect of a suture fix part of the suture fix member. In the explanation below, constitutive elements that are common to those already described above are designated with like reference numerals and will not be repetitiously explained.

FIG. 13is an enlarged view of a suture fix member52of the ligating device51, and its vicinity. A single arm part54extends from a connection part53. The arm part54extends while curving in a shape that is substantially oval in a front view of the suture fix member52. A substantially oval housing part55is formed inside the curving arm part54. The end of the curved arm part54extends towards the connection part53, and forms a constriction part54A that constricts an opening55A in the substantially oval housing part55that the suture10passes through when being housed. In the ligating device51, this constriction part54A functions as a hooked suture locking part.

In the ligating device51of this embodiment, in a front view of the suture fix member52, the constriction part54A constricts the opening55A, which is one part of the housing part55. Therefore, even if the suture10moves inside the housing55due to elasticity or the like, as shown by the arrows A1and A2inFIG. 14, the suture10strikes against the arm part54including the constriction part54A, thereby reducing the probability that the suture10will pass the opening55A and disengage from the housing part55. Therefore, as in the ligating device1, the suture10can be favorably prevented from disengaging from the housing part55during the knot-formation operation.

In the ligating device51of this embodiment, the faces of the connection part53and the arm part54formed opposite the constriction part54A with the opening55A therebetween are flat. Therefore, when inserting the suture10into the housing part55, the suture10follows the connection part53and the arm part54, enabling the suture10to move smoothly into the housing part55.

As in the first embodiment, the suture fix member including the constriction part as a suture fix part is not limited to the shape of the suture fix member52described above, and can be formed in various aspects.

FIG. 15AandFIG. 15Bare modified examples based on a substantially anchor-shaped suture fix member such as the suture fix member30. In the modified example ofFIG. 15A, two arm parts54extend from the connection part31. In the modified example ofFIG. 15B, four arm parts54extend from the connection part31.

In each of the modified examples shown inFIGS. 15A and 15B, two adjacent arm parts form a housing part56that is substantially triangular in front view. In the modified example ofFIG. 15A, the tip-end side of the arm part54functions as a constriction part that constricts the opening56A of the housing part56. In the modified example ofFIG. 15B, a protrusion54B provided on the arm part54functions as a constriction part that constricts the opening56A of the housing part56.

When housing parts are provided at a plurality of points, the dimension of the suture fix member increases slightly. However, when passing the suture through the housing part, there will be fewer cases that require the delicate operation of deciding to aim for a specific arm part of the suture fix member and then moving one part of the suture accordingly. This makes the knot-formation operation easier to perform.

FIGS. 16A to 16Feach illustrate other modified examples of a suture fix member having a constriction part. As in a suture fix member52A shown inFIG. 16A, the suture fix member of this embodiment can include a bent arm part57. in this instance, it is possible to ensure a certain amount of freedom in regard to the direction of applying a force for making the arm part57deform, and it is possible to make the knot-formation operation easier to perform. Furthermore, as in a suture fix member52B shown inFIG. 16B, an arm part59can bend at an acute angle such that the housing part58has an angular part58A. A suture fix member52C shown inFIG. 16Cincludes an arm part60having a bend angle that is middle of an angle of the suture fix member52A and an angle of the suture fix member52B. The suture fix members52B and52C are advantageous in that they deform more easily than the suture fix member52A, and they make the knot-formation operation easier to perform.

In addition, as in the suture fix member52D shown inFIG. 16D, a housing part61can be formed in a shape that is substantially circular in front view. Also, as in the suture fix member52E shown inFIG. 16E, one part of the arm part62can be formed in a linear shape.

As in the suture fix member52F shown inFIG. 16F, the arm part63can include a constriction part63A that constricts a part of the housing part that is not the opening. In this instance, since it is possible to make wider the opening64A in the housing part64, the suture10can be passed easily. Moreover, the housed suture10can be favorably prevented from disengaging from the housing part64.

Subsequently, a third embodiment of the invention will be explained with reference toFIGS. 17 to 19G. A ligating device71of this embodiment differs from those of the embodiments described above in regard to the shape of the housing part.

FIG. 17is a perspective view of a suture fix member72of the ligating device71, and its vicinity. In the suture fix member72, a first arm part74A and a second arm part74B extending from a connection part73are formed so that they bend in a front view of the suture fix member72. As a result, a housing part75formed between the first arm part74A and the second arm part74B is bent in a front view of the suture fix member72.

In the embodiments of this invention, ‘bent’ denotes a state where a line connecting a deepest part of the housing part, where the distance in alignment with form of the housing part from an opening in the housing part through which the suture enters is greatest, to the opening cannot be drawn so that, when viewed from at least one direction, the line does not make contact with the arm parts that define the housing part.

For example, in the suture fix member72, as shown inFIG. 18, the deepest part75A of the housing part75is located near the interface between the first arm part74A and the second arm part74B. In a front view of the suture fix member72, a line connecting the deepest part75A to the opening75B cannot be formed without making contact with the first arm part74A and the second arm part74B. That is, the housing part75of the suture fix member72bends in a front view of the suture fix member72.

In the ligating device71configured as described above, when passing the suture10into the housing part75, since the suture10follows the shape of the first arm part74A or the second arm part74B, it can easily be moved to the vicinity of the deepest part75A.

The movement of the suture10as it attempts to return to a linear shape due to its elasticity or the like, is generally a substantially linear movement in one direction. Therefore, whichever direction it moves in, the suture10that has hooked the bent housing part75will make contact with either the first arm part74A or the second arm part74B. It is thus practically impossible for the suture10to reach the opening75B only by the substantially linear movement mentioned above.

Therefore, due to its overall shape, the bending housing part75functions as a hooked suture locking part, and can favorably prevent the suture10from escaping from the suture fix member72.

In this embodiment, the specific bending shaped of the housing part can be varied.

The suture fix member72A shown inFIG. 19Ais a modified example including two housing parts shaped similar to the housing part75, and has line symmetry in front view. The suture fix member72A has a substantially anchor shape similar to that of the suture fix member30of the first embodiment, so that a suture passed through the housing part is more unlikely to become disengaged than from the suture fix member30. Since two housing parts are provided, the suture can easily be passed. Moreover, the suture fix member72A includes a release hole77for reducing the thickness of the first arm part76A. This enables the housing part to be easily deformed at the same time as the housing part is being bent. Moreover, there is a comparatively high degree of freedom in regard to the direction of deforming the housing part, making the knot-formation operation easier.

Suture fix members72B and72C shown respectively inFIGS. 19B and 19Cinclude bend points where the bend angle of the housing part is approximately 90 degrees. The remaining regions of the housing parts of the suture fix members72B and72C are substantially linear. This configuration enables the suture10to be passed easily through the housing part.

Suture fix members72D and72E shown respectively inFIGS. 19D and 19Einclude housing parts having comparatively complex shapes with a plurality of bend points. The bend points of the housing part can be formed smoothly curving shape like those inFIG. 19D, or the bend points of the housing part can be formed so that the bend points include angular parts like those inFIG. 19E. The bend points can be formed so that the shapes inFIGS. 19D and 19Ecan also be combined. The suture fix members72D and72E ensure that the suture is more unlikely to become disengaged from the housing part.

As in the suture fix member72F shown inFIG. 19F, the configuration can be one where the outer shape of the suture fix member does not bend, and only the housing part bends. In this case, since the outer face of the suture fix member is flat, a force for making the suture fix member deform can be applied stably. Therefore, it is possible to form the knot efficiency.

As in the suture fix member72G shown inFIG. 19G, the housing part can be shaped like a spiral in front view. In this instance, similar to the suture fix members72D and72E, a suture passed through the housing part more unlikely to become disengaged.

Subsequently, a fourth embodiment of the invention will be explained with reference toFIGS. 20A to 21C.

FIG. 20Ais an enlarged perspective view of a suture fix member152, and its vicinity, of a ligating device151of this embodiment. As shown inFIG. 20B, the suture fix member152is substantially oval in front view. A housing part153opens in the short diameter direction of the oval, and bends substantially in an L-shape.

In a front view of the suture fix member152, a first arm part154and a second arm part155that define the shape of the housing part153include wide parts156which are larger than the dimension W1of the wide direction (the direction orthogonal to the extension direction) of the housing part153.

The operation when using the ligating device151is broadly similar to that of the ligating devices of the embodiments described earlier: the suture10is positioned near a deepest part153A of the housing part153, which is then deformed to form a knot Kn.

As in the embodiments described above, the ligating device151of this embodiment enables the knot-formation operation to be performed easily and smoothly, and enables the knot to be formed stably.

In the ligating device of this embodiment, as in the third embodiment, the housing part153is being bent, and the bending state functions as a hooked suture locking part. The region of the housing part153in which the suture10is actually housed is the region on the deepest part153A side from the bent intermediate part. An inner wall153C opposite the deepest part153A on the opening153B side from the intermediate part is especially effective in preventing disengagement, and practically functions as a hooked suture locking part.

In the ligating device of this embodiment, since the first arm part154and the second arm part155include the wide parts156, even if the dimension of the suture fix member152is small, the operator can easily recognize the whole suture fix member as a lump, thus ensuring that the ligating device is still easy to perceive visually.

Also, since the ligating device of this embodiment is substantially oval in front view, it can be efficiently manufactured using a column-shaped material that is oval in cross-section. That is, it can be efficiently manufactured by forming the shape of the housing part in the long direction of the column-shaped material by wire electrical discharge machining or the like, and then slicing the column-shaped material in its diameter direction.

While this embodiment describes an example where the suture fix member is substantially oval in front view, it can be circular, elliptical, or multi-angular in front view instead. Even if the suture fix member is formed in these shapes, it is possible to ensure good visual perceptibility by wide parts being provided on the first arm part and the second arm part, and to be efficiently manufactured using a column-shaped material having a cross-sectional shape that matches the shape of the ligating device in front view.

As in the modified example ofFIG. 21A, the width of the opening153B of the housing part153can be made wider than at the other points, whereby the suture can be introduced more easily into the housing part. This kind of processing can easily be performed using wire electrical discharge machining or the like mentioned above.

As inFIG. 21B, the opening153B can be provided with a protrusion157. This configuration increases the area of the suture fix member when viewed from the side, and thus enhances its visual perceptibility in side view. Furthermore, the position of the opening153B is easier to ascertain, and the operation of introducing a suture into the housing part becomes easier.

Moreover, as shown inFIG. 21C, the connection158can be provided at a different position.

While embodiments of the invention have been described above, the technical scope of the invention is limited not to these embodiments. Various additions, omissions, substitutions, and other modified examples can be made, and the constituent elements of the embodiments can be combined together, without departing from the main points of the invention.

For example, in each of the above embodiments, the example described is one where a hooked suture locking part is provided by forming at least one part of the suture fix member in a predetermined shape. However, instead of this configuration, the hooked suture locking part can be provided by attaching an another member. Several examples of such a modified example will be explained.

A suture fix member80shown inFIG. 22includes a brush-shaped hooked suture locking part82in which a plurality of hair-like members82A are attached to the inner face of a housing part81.

In a suture fix member85shown inFIG. 23, a wheel88with a plurality of protrusions88A is rotatably attached at a position that is near an opening in a housing part87of an arm part86. A stopper89with a constant elasticity is attached to the arm part86, and interferes with the protrusions88A. The wheel88can rotate in a direction of inducing a suture into the housing part87(the direction indicated by the arrow inFIG. 23), and cannot rotate in the reverse direction. Therefore, the wheel88prevents the suture from moving in a direction of disengaging from the housing part87. That is, in the suture fix member85, the wheel88and the stopper89constitute a hooked suture locking part.

FIG. 24illustrates a suture fix member90including elastic members91of rubber or the like, which are firmly attached such as to cover a housing part92in front view. Since the elastic members91elastically deform, the suture10can be passed into the housing part92using a forceps or the like. On the other hand, with only the movement of the suture10attempting to return to its linear shape, sufficient force cannot be obtained and the elastic members91are unlikely to deform. The elastic members91thus function as hooked suture locking parts.

FIG. 25illustrates a suture fix member95including a gel-like disengagement-prevention material97having constant viscosity arranged inside a housing part96. The suture10passed through the housing part96generates friction with the disengagement-prevention material97, thereby favorably suppressing the disengagement of the suture from the housing part96.

This modified example includes a hooked suture locking part constituted by the disengagement-prevention material97, which does not correspond to any of the embodiments described above. If the disengagement-prevention material97has high viscosity, a resistant force is generated when tightening the suture in the knot-formation operation, and this obstructs the operation.

The hooked suture locking part need not be provided in one piece with the suture fix member. In a ligating device100in the modified example shown inFIG. 26A, an insertion hole102formed with a suture fix member101penetrates the suture fix member101. A disengagement-prevention member103is connected and secured to a second end10B of a suture10hooked the insertion hole102. At least one part of the disengagement-prevention member103is larger than the width of arm part104. When the operator applies the suture10to a target tissue and pulls the suture10, as shown inFIG. 26B, the disengagement-prevention member103contacts the suture fix member101and obstructs the movement of the suture10in the housing part105. That is, the disengagement-prevention member103functions as a hooked suture locking part.

There are no particular restrictions on the shape of the disengagement-prevention member103, which need only be shaped so that at least one part is larger than the arm part104. As shown inFIG. 26A, the disengagement-prevention member103can be cubic, spherical, plate-shaped, or the like.

In this modified example, the suture fix member101and the suture10are attached so that they can slide.

In the ligating device according to this embodiment of the invention, the suture and the suture fix member can be attached in the manner described above.

Moreover, the hooked suture locking part can be provided in the thick direction of the suture fix member.

FIGS. 27A to 27Care examples of a suture fix member in which the protrusion is formed with only one part of the suture fix member in the thickness direction.FIG. 27Bis a view along the arrow XXVb ofFIG. 27A.FIG. 27Cis a view along the arrow XXVc ofFIG. 27A. The basic shape of a housing part111of a suture fix member110is substantially linear in a front view of the suture fix member110, and a protrusion112protrudes into the housing part111only in one part of the thick direction of the suture fix member110.

FIG. 28Ais an example of a suture fix member in which a constriction part is provided in the thick direction. An end of an arm part116of a suture fix member115curves and then overlaps with one part of the arm part116extending from a connection part117in the thickness direction thereof. A gap between the overlapping arm parts116has an enough dimension that a suture10can pass through it. The overlapping arm parts form a constriction part118. As shown inFIG. 28B, a suture10inserted through the constriction part118into a housing part119is unlikely to become disengaged from the housing part119. That is, the constriction part118functions as a hooked suture locking part.

FIGS. 29A to 29Care examples of a suture fix member in which the housing part bends in the thick direction.FIG. 29Bis a view along the arrow XXVIIb ofFIG. 29A, andFIG. 29Cis a view along the arrow XXVIIc ofFIG. 29A. A first arm part121A and a second arm part121B of a suture fix member120curve in the thick direction of the suture fix member120. As a result, the housing part122between the first arm part121A and the second arm part121B curves in the thick direction. With this configuration, as shown in the bottom side ofFIG. 29B, a suture10passed through the housing part122easily makes contact with the side faces of the arm parts121A and121B forming the inner face of the housing part122, and friction is easily generated between the side faces of the arm parts121A and121B and the suture10. This prevents the suture10from disengaging from the housing part122.

The hooked suture locking part formed in the thick direction in the manner described above can be combined with the configurations of the embodiments described above.

Moreover, the ligating device according to the embodiments of the invention need not include a suture needle. Even if a suture needle is not provided, the ligating device can be used for ligating a tissue without passing a suture needle through it. A conventional suture can be attached to the suture fix member just before the procedure. Therefore, a suture fix member including a hooked suture locking part can itself be distributed as a tissue ligating device.

The concepts of protrusion, constriction part, bend, and so on mentioned above are not mutually exclusive. For example, one part of an arm part forming a constriction part could be regarded as a protrusion protruding into the housing part, or vice versa. The aspect could be one where housing part curves due to the protrusion. Therefore, the hooked suture locking part is not a member that must comply with only one of the aspects described above, and can instead be formed by combining a plurality of elements.

While preferred embodiments of the invention have been described and illustrated above, it should be understood that these are exemplary of the invention and are not to be considered as limiting. Additions, omissions, substitutions, and other modified examples can be made without departing from the spirit or scope of the present invention. Accordingly, the invention is not to be considered as being limited by the foregoing description, and is only limited by the scope of the appended claims.