JP2017148133A - Zygote for anastomosis - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a zygote for anastomosis easy to be inserted into a tubular body.SOLUTION: A zygote for anastomosis 5 is provided with a first part 10 disposed on one side of a hole 3 formed in a first tubular body 1; second parts 20 disposed on the other side of the hole 3 formed in the first tubular body 1; and a third part 30 structured so as to engage with the inner surface of the second tubular body 2. The third part 30 is connected to the first part 10 via a first connection part 40, and connected to the second parts 20 via a second connection part 50. The first part 10 includes a first ring member 11 or a first gap-attached ring member. The second part 20 includes a second ring member 21 or a second gap-attached ring member. The third part 30 includes an annular part 31. The annular part 31 includes a wave-form circumferential part alternately provided with a plurality of peak parts 32 and a plurality of bottom parts 33.SELECTED DRAWING: Figure 2

Description

  The present invention relates to an anastomotic connector.

  When anastomosing the first tubular body and the second tubular body, an anastomotic connector may be used.

  In Patent Document 1 and Patent Document 2, a first end of a vascular joint is inserted into a graft blood vessel, and a second end and a third end of the vascular joint are inserted into a target blood vessel, whereby a graft blood vessel is inserted. An anastomosis of the end of the target blood vessel and the side of the target blood vessel (see FIGS. 13 to 16 of Patent Document 1, FIGS. 17 to 18 of Patent Document 2, and the like).

Special Table 2002-534208 Japanese translation of PCT publication No. 2002-542872

  The vascular joint described in Patent Document 1 and Patent Document 2 includes a plurality of frame elements on one side and a plurality of frame elements on the other side (see FIG. 14 of Patent Document 1 and FIG. 17 of Patent Document 2). . For this reason, an operation for inserting a plurality of frame elements into a target blood vessel is difficult.

  Accordingly, an object of the present invention is to provide an anastomotic connector that can be easily inserted into a tubular body. An additional object of the present invention is to provide an anastomotic zygote that is easy to manufacture.

  The means for solving the problem will be described below using the numbers used in the (DETAILED DESCRIPTION). These numbers are added to clarify the correspondence between the description of (Claims) and (Mode for Carrying Out the Invention). However, these numbers should not be used to interpret the technical scope of the invention described in (Claims).

  An anastomotic connector according to some embodiments includes an anastomosis joining a side portion of a first tubular body (1) extending in a first direction and an end portion of a second tubular body (2) extending in a second direction. Connector (5). The anastomotic connector (5) is provided in the first tubular body (1) and the first portion (10) disposed on one side of the hole (3) provided in the first tubular body (1). A second portion (20) disposed on the other side of the formed hole (3), and connected to the first portion (10) by a first connecting portion (40), and connected to the second portion (20). And a third portion (30) connected by two connecting portions (50). The first portion (10) includes a first ring member (11) or a first gap ring member configured to be engageable with the inner surface of the first tubular body (1). The second portion (20) includes a second ring member (21) or a second ring member with a gap that is configured to be engageable with the inner surface of the first tubular body (1). The third portion (30) includes an annular portion (31) configured to be engageable with the inner surface of the second tubular body (2). The annular portion (31) includes a corrugated circumferential portion having a plurality of top portions (32) and a plurality of bottom portions (33) alternately.

  The said anastomosis connector WHEREIN: The number of the said waveform circumferential part with which the said annular part (31) is provided may be one.

  In the anastomotic connector, the annular portion (31) may not include a closed loop disposed so as to surround a virtual straight line (T1) parallel to the radial direction of the third portion (30).

  The anastomotic connector may further include arcuate members (80A, 80B) that are cantilevered by at least one bottom of the plurality of bottoms (33).

  In the anastomotic connector, the third portion (30) is cantilevered by at least one top portion of the plurality of top portions (12), and has an elongated member (35) extending in parallel with the second direction. You may prepare.

  In the anastomotic connector, the shape constituted by the first portion (10), the second portion (20), and the third portion (30) is cut out from one cylindrical sheet body (70). It may be a shape that can be produced from a single member.

  The anastomotic connector according to some embodiments is an anastomotic connector (5) that joins the side of the first tubular body (1) and the end of the second tubular body (2). The anastomotic connector (5) includes a first part (10) having a central axis (X) parallel to the first direction and a second part (10) having a central axis (X) parallel to the first direction. 20), connected to the first part (10) by a first connection part (40), connected to the second part (20) by a second connection part (50), and the first direction. And a third portion (30) having a central axis (Y) parallel to different second directions. The first part (10) comprises a first ring member (11) or a first gapped ring member. The second part (20) comprises a second ring member (21) or a second gapped ring member. The third part (30) comprises an annular part (31). The annular portion (31) includes a corrugated circumferential portion having a plurality of top portions (32) and a plurality of bottom portions (33) alternately.

  The method for manufacturing an anastomotic connector according to some embodiments includes, from one cylindrical sheet body (70), a third portion (30) having a central axis parallel to the central axis of the cylindrical sheet body, A first part (10) connected to the third part (30) by a first connection part (40) and a second part (20) connected to the third part (30) by a second connection part (50). ), A step of bending the first portion (10) relative to the third portion (30) in the first connection portion (40), and the second connection portion (50). And bending the second part (20) relative to the third part (30). Immediately after the cutting step, the first portion (10) includes a first ring member (11) or a first ring member with a gap. The second part (20) comprises a second ring member (21) or a second gapped ring member. Moreover, the said 3rd part (30) contains the waveform circumference part provided with a some top part (32) and a some bottom part (33) alternately.

  In the method for manufacturing an anastomotic connector, the first portion (10) may be formed using a first end side region (70-1) of the cylindrical sheet body (70). The second portion (20) may be formed using the first end side region (70-1) of the cylindrical sheet body (70). The third portion (30) may be formed using a second end side region (70-2) of the cylindrical sheet body (70).

  According to the present invention, it is possible to provide an anastomotic connector that can be easily inserted into a tubular body.

FIG. 1A is a schematic perspective view schematically showing a state after two tubular bodies are joined to each other. FIG. 1B is a schematic perspective view schematically showing a state after two tubular bodies are joined to each other. FIG. 2 is a diagram schematically showing a state inside the tubular body after joining the two tubular bodies to each other. FIG. 3 is a schematic perspective view schematically showing the connector for anastomosis according to the embodiment. FIG. 4 is a diagram schematically showing the structure of the anastomotic connector in the comparative example. FIG. 5 is a diagram schematically showing the structure of the anastomotic connector in the comparative example. FIG. 6 is a schematic development view schematically illustrating the connector for anastomosis according to the embodiment. FIG. 7 is a flowchart showing a method for manufacturing an anastomotic connector. FIG. 8 is a diagram schematically illustrating cutting out the anastomotic connector from the cylindrical sheet body. FIG. 9 is a diagram schematically showing that the shape of the first ring member is rounded and the shape of the second ring member is rounded. FIG. 10 is a schematic development view schematically showing the anastomotic connector according to the first modified example of the embodiment. FIG. 11 is a schematic development view schematically showing an anastomotic connector according to a second modification of the embodiment. FIG. 12 is a schematic development view schematically showing an anastomotic connector according to a second modification of the embodiment. FIG. 13 is a schematic development view schematically showing an anastomotic connector according to a third modified example of the embodiment. FIG. 14 is a flowchart showing a method for manufacturing the anastomotic connector of the third modified example. FIG. 15 is a diagram schematically illustrating cutting out the anastomosis connector from the cylindrical sheet body. FIG. 16 is a schematic development view schematically showing the anastomotic connector of the embodiment.

  Hereinafter, embodiments will be described with reference to the accompanying drawings.

  First, with reference to FIG. 1A and FIG. 1B, two tubular bodies (the 1st tubular body 1 and the 2nd tubular body 2) joined using the anastomosis connector in embodiment are demonstrated. In the example illustrated in FIG. 1A, the side portion of the first tubular body 1 and the end portion of the second tubular body 2 are joined. A hole 3 is provided in the side wall of the first tubular body 1, and the inside of the first tubular body 1 and the inside of the second tubular body 2 communicate with each other through the hole 3. A first portion 10 and a second portion 20 of an after-mentioned anastomotic connector can be inserted into the first tubular body 1 from the outside of the first tubular body 1 through the hole 3. Further, a third portion 30 of the below-described anastomotic connector can be inserted into the second tubular body 2. The step of inserting the first portion 10 and the second portion 20 into the first tubular body 1 may be before or after the step of inserting the third portion 30 into the second tubular body 2. .

  In the example illustrated in FIG. 1A, two cuts are provided at the distal end of the second tubular body 2. Two tongue pieces 2 </ b> A and 2 </ b> B are formed at the distal end of the second tubular body 2 by the two cuts. The tongue piece 2A and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like. Similarly, the tongue piece 2B and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like.

  The example described in FIG. 1B is different from the example described in FIG. 1A in that a cut 3A and a cut 3B are provided continuously to the hole 3. Note that only one of the cut 3A and the cut 3B may be provided. In the example shown in FIG. 1B, since the notch 3B is provided, the operator can easily insert the first portion 10 of the below-mentioned anastomotic connector into the first tubular body 1. is there. Further, since the notch 3A is provided, the operator can easily insert the second portion 20 of the below-described anastomotic connector into the first tubular body 1. In the example illustrated in FIG. 1B, four cuts are provided at the distal end of the second tubular body 2. Due to the four notches, four tongue pieces 2A, 2B, 2C, and 2D (the tongue piece 2A is not shown because it is located behind the second tubular body 2) are distant from the second tubular body 2. Formed at the end. Each of the tongue pieces 2A to 2D and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like. In the example shown in FIG. 1B, the notch 3A is blocked by the tongue 2C, and the notch 3B is blocked by the tongue 2D.

  1A and 1B, the first tubular body 1 is a blood vessel such as a coronary artery. Moreover, the 2nd tubular body 2 is blood vessels, such as a bypass pipe, for example. The bypass tube may be a patient's own blood vessel, a blood vessel provided with cellular tissue, or an artificial blood vessel.

  FIG. 2 is a view schematically showing a state inside the tubular body after joining the two tubular bodies (first tubular body 1 and second tubular body 2) to each other. For easy understanding of the state inside the tubular body, the first tubular body 1, the second tubular body 2, and the plaque 7 are shown in cross section, and the anastomotic connector 5 is a perspective view. It is shown.

  Referring to FIG. 2, plaque 7 or a thrombus is present inside the first tubular body 1. In the example described in FIG. 2, the side of the first tubular body 1 and the end of the second tubular body 2 are joined, so that the blood bypasses the portion blocked by the plaque 7, Flowing.

  Inside the joined tubular body, the anastomotic connector 5 according to the embodiment is arranged. The anastomotic connector 5 includes a first portion 10, a second portion 20, and a third portion 30. The first portion 10 is disposed on one side of the hole 3 provided in the first tubular body 1 (the side opposite to the first direction shown in FIG. 2). The first portion 10 is engaged with the inner surface of the first tubular body 1. The second portion 20 is disposed on the other side (the first direction side shown in FIG. 2) of the hole 3 provided in the first tubular body 1. The second portion 20 is engaged with the inner surface of the first tubular body 1. The third portion 30 is engaged with the inner surface of the second tubular body 2.

  The first portion 10 and the third portion 30 are connected by the first connecting portion 40. In the example illustrated in FIG. 2, the first portion 10 and the third portion 30 are connected to each other only at one place, and therefore, for anastomosis with respect to an angle change between the first tubular body 1 and the second tubular body 2. The adaptability of the connector 5 is high. Alternatively, the first portion 10 and the third portion 30 may be connected at two or more locations (there may be two or more first connecting portions 40). However, in this case, the adaptive performance of the anastomotic connector 5 with respect to the angle change between the first tubular body 1 and the second tubular body 2 is lowered.

  The second part 20 and the third part 30 are connected by a second connection part 50. In the example illustrated in FIG. 2, the second portion 20 and the third portion 30 are connected to each other only at one place, and therefore, for anastomosis with respect to an angle change between the first tubular body 1 and the second tubular body 2. The adaptability of the connector 5 is high. Alternatively, the second portion 20 and the third portion 30 may be connected at two or more locations (there may be two or more second connection portions 50). However, in this case, the adaptive performance of the anastomotic connector 5 with respect to the angle change between the first tubular body 1 and the second tubular body 2 is lowered.

  The third portion 30 includes an annular portion 31 configured to be engageable with the inner surface of the second tubular body 2. When the annular portion 31 is viewed along the second direction, the annular portion 31 forms a closed loop. The third portion 30 may include a plurality of elongated members 35 extending in parallel with the second direction. When the plurality of elongated members 35 are provided, the posture of the third portion 30 with respect to the second tubular body 2 is stabilized. The third portion 30 may include an engaging portion 36 that can engage with the inner surface of the tubular body. When the engagement portion 36 is provided, the engagement characteristics of the third portion 30 with respect to the second tubular body 2 are improved.

  In the example shown in FIG. 2, the first portion 10 and the second portion 20 of the anastomotic connector are inserted into the first tubular body 1, and the third portion 30 of the anastomotic connector is the second tubular body. 2, the displacement between the hole 3 of the first tubular body 1 and the distal end of the second tubular body 2 is small. On the other hand, when the anastomosis is performed without using the anastomotic connector inserted into the tubular body, the positional deviation between the hole 3 of the first tubular body 1 and the distal end of the second tubular body 2 becomes large. Sometimes. As a result, a part of the first tubular body 1 may largely protrude toward the opening located at the distal end of the second tubular body 2. In such a case, the blood flow may be hindered by the protruding portion, and the occurrence of a thrombus may be induced by the protruding portion.

  With reference to FIG. 3, the connector 5 for anastomosis of embodiment is demonstrated in detail. FIG. 3 is a schematic perspective view schematically showing the connector for anastomosis according to the embodiment.

(First part 10)
The first portion 10 includes a first ring member 11. The central axis of the first ring member 11 is the axis X. The first ring member 11 forms a closed loop. Alternatively, the first portion 10 may comprise a first gapped ring member. The first ring member with a gap is, for example, a ring member having a gap at a portion illustrated by an arrow A1 in FIG. The first gapped ring member forms an open loop. When the first portion 10 includes the first ring member 11, the outer diameter of the first ring member 11 is set to be slightly larger than the inner diameter of the first tubular body 1 in the natural state. As a result, the outer surface of the first ring member 11 is engaged with the inner surface of the first tubular body 1. Alternatively, if the first portion 10 comprises a first gapped ring member, the outer diameter of the first gapped ring member in the natural state where no external force is acting (ie, the first gapped ring The maximum value of the distance between any two points on the member is set to be slightly larger than the inner diameter of the first tubular body 1 in the natural state. As a result, the first ring member with a gap presses the inner surface of the first tubular body 1 by an elastic force.

(Second part 20)
The second portion 20 includes a second ring member 21. The central axis of the second ring member 21 is the axis X. The second ring member 21 forms a closed loop. Alternatively, the second portion 20 may comprise a second gapped ring member. A 2nd ring member with a gap is a ring member provided with a gap in the portion illustrated by arrow A2 of Drawing 3, for example. The second gapped ring member forms an open loop. When the second portion 20 includes the second ring member 21, the outer diameter of the second ring member 21 is set to be slightly larger than the inner diameter of the first tubular body 1 in the natural state. As a result, the outer surface of the second ring member 21 is engaged with the inner surface of the first tubular body 1. Alternatively, if the second portion 20 comprises a second gapped ring member, the outer diameter of the second gapped ring member in the natural state where no external force is acting (ie, the second gapped ring The maximum value of the distance between any two points on the member is set to be slightly larger than the inner diameter of the first tubular body 1 in the natural state. As a result, the second ring member with a gap presses the inner surface of the first tubular body 1 by an elastic force.

(Third portion 30)
The annular portion 31 of the third portion 30 is a corrugated circumferential portion provided with a plurality of top portions 32 and a plurality of bottom portions 33 alternately. As can be understood from FIGS. 2 and 3, the top portion 32 is a portion to be inserted deeper into the second tubular body 2 than the bottom portion 33. In addition, the top part 32 and the bottom part 33 may each be an inflection part in the waveform circumferential part. The central axis of the waveform circumference is the axis Y. The corrugated circumferential portion is a repeating structure of a top portion 32, a first connecting portion 34A that connects the top portion 32 and the bottom portion 33, and a second connecting portion 34B that connects the bottom portion 33 and the bottom portion 33 and the top portion 32. The corrugated circumference is, for example, a one-stroke shape without an end. In the example illustrated in FIG. 3, the annular portion 31 has one corrugated circumferential portion. In other words, in the third portion 30, the annular portion 31 that is a corrugated circumferential portion is not directly or indirectly connected to another corrugated circumferential portion. And the connection member which mutually connects two adjacent top parts 32 is only the 1st connection part 34A, the bottom part 33, and the 2nd connection part 34B which comprise the said one waveform circumference part. Moreover, the connection member which mutually connects the two adjacent bottom parts 33 is only the 1st connection part 34A, the top part 32, and the 2nd connection part 34B which comprise the said one waveform circumference part.

  FIG. 4 shows an anastomotic connector in a comparative example. As shown in FIG. 4, when the corrugated circumferential portion 310 is connected to another corrugated circumferential portion, for example, when a root side portion (a portion on the second direction side) of the third portion 30 is sandwiched The overall contraction of the third portion 30 tends to be uneven. In particular, when the base portion (the second direction portion) of the third portion 30 is sandwiched, the diameter reduction of the tip side portion (the portion on the opposite side to the second direction) of the third portion 30 becomes insufficient. there is a possibility. As a result, it may be difficult to insert the distal end portion of the third portion 30 into the second tubular body 2. On the other hand, in the example shown in FIG. 3, the number of the corrugated circumferential portions provided in the annular portion 31 is one, so when the root side portion (the portion on the second direction side) of the third portion 30 is sandwiched. The entire third portion 30 tends to shrink uniformly. In particular, when the base portion (the second direction portion) of the third portion 30 is sandwiched, the diameter of the tip end portion (the portion on the opposite side to the second direction) of the third portion 30 is sufficient. As a result, the third portion 30 can be easily inserted into the second tubular body 2.

  Further, in the example shown in FIG. 3, the annular portion 31 (third portion 30) has a radial direction of the third portion 30 (a direction perpendicular to the second direction and outward from the central axis Y of the third portion). (Closed direction) is not provided with a closed loop arranged so as to surround a virtual straight line T1. For this reason, when the third portion 30 contracts, the entire third portion 30 tends to contract uniformly. On the other hand, in the example shown in FIG. 4 or FIG. 5, the closed loop (hatched line shown in FIG. 4 or FIG. 5) is arranged so that the annular portion surrounds the virtual straight line T1 parallel to the radial direction of the third portion 30. Part corresponds to closed loop 311, 311 ′). For this reason, in the example described in FIG. 4 or 5, when the third portion 30 contracts, the entire contraction of the third portion 30 tends to be uneven.

  Referring to FIG. 3, the third portion 30 includes an elongated member 35 that is connected to at least one of the plurality of top portions 32 and extends parallel to the second direction. The elongated member 35 is supported in a cantilevered manner by the corresponding top portion 32. In FIG. 3, eight elongated members 35 are shown. However, the number of the elongated members 35 is not necessarily eight, and is arbitrary.

  In the example shown in FIG. 3, the distal end of each elongated member 35 is provided with an engaging portion 36 that can engage with the inner surface of the second tubular body 2. The engaging portion 36 prevents the third portion 30 from sliding in the second direction with respect to the second tubular body 2 by engaging with the inner surface of the second tubular body 2. Each engaging portion 36 has, for example, an arrowhead shape (substantially triangular shape) with rounded corners. Each engaging part 36 is comprised by the flat member, for example. Each engaging portion 36 has an insertion resistance in a direction (a direction opposite to the second direction) in which the extraction resistance in the direction (second direction) taken out from the second tubular body 2 is inserted into the second tubular body 2. Bigger than. For this reason, the insertion of the third portion 30 into the second tubular body 2 is easy, and displacement of the third portion 30 after the insertion with respect to the second tubular body 2 is prevented. Note that the shape of the engaging portion 36 is not limited to the arrowhead shape. The shape of the engaging portion 36 may include a shape like a returning portion of a fishing hook (in other words, the engaging portion 36 may include a returning portion).

(4th part 80)
The anastomotic connector 5 may optionally include a fourth portion 80. The fourth portion 80 is a portion that is cantilevered by the bottom 33 and is engageable with the inner surface of the first tubular body 1. In the example illustrated in FIG. 3, the fourth portion 80 includes a first arcuate member 80 </ b> A that is cantilevered on one bottom 33 and a second arcuate member 80 </ b> B supported on the other bottom 33. The first arc-shaped member 80 </ b> A and the second arc-shaped member 80 </ b> B are preferably arranged symmetrically with respect to the central axis Y of the third portion 30. When the anastomotic connector 5 includes the fourth portion 80, displacement of the distal end of the second tubular body 2 with respect to the hole 3 of the first tubular body 1 is further prevented.

  In the example illustrated in FIG. 3, a second engagement portion 81 </ b> A that can engage with the inner surface of the first tubular body 1 is provided at the distal end of the first arcuate member 80 </ b> A. The second arcuate member 80B is provided with a second engaging portion 81B that can engage with the inner surface of the first tubular body 1 at the distal end thereof. The shape of the second engaging portions 81A and 81B may be the same as the shape of the engaging portion 36, may be similar to the shape of the engaging portion 36, or may be the engaging portion 36. The shape may be different from the shape.

(First connection part 40)
The first connection part 40 is a part that connects the first part 10 and the third part 30. In the example illustrated in FIG. 3, the first connecting portion 40 is provided between the first ring member 11 (or the first gap-attached ring member) and the bottom portion 33 of the corrugated circumferential portion. The first connection portion 40 includes a portion extending in parallel with the axis X. For this reason, the first portion 10 is set at a position away from the hole 3 of the first tubular body 1. As a result, the first portion 10 set inside the first tubular body 1 is effectively suppressed from coming out of the hole 3. In the example illustrated in FIG. 3, the first connection portion 40 includes a first bent portion 41 and a second bent portion 42.

(Second connection part 50)
The second connection portion 50 is a portion that connects the second portion 20 and the third portion 30. In the example illustrated in FIG. 3, the second connection portion 50 is provided between the second ring member 21 (or the second gap ring member) and the bottom 33 of the corrugated circumferential portion. The second connection portion 50 includes a portion extending in parallel with the axis X. For this reason, the second portion 20 is set at a position away from the hole 3 of the first tubular body 1. As a result, the second portion 20 set inside the first tubular body 1 is effectively prevented from coming out of the hole 3. In the example illustrated in FIG. 3, the second connection portion 50 includes a first bent portion 51 and a second bent portion 52.

  FIG. 6 is a schematic development view schematically showing the anastomotic connector 5 of the embodiment. In FIG. 6, the portion indicated by C1 is actually the same portion as the portion indicated by C2. For example, the engaging portion 36B described on the upper side (on C2) in FIG. 6 is the engaging portion 36B itself described on the lower side (on C1) in FIG.

  In the example illustrated in FIG. 6, the annular portion 31 (the corrugated circumferential portion) includes eight top portions 32 and eight bottom portions 33. In the example illustrated in FIG. 6, an elongated member 35 is connected to each top portion 32. That is, the number of the elongated members 35 is equal to the number of the top portions 32. Alternatively, the number of elongate members 35 may be less than the number of tops 32. That is, at least one of the plurality of top portions may not be provided with the elongated member 35, and at least one of the plurality of top portions may be provided with the elongated member 35.

(Method for producing anastomotic connector)
Next, with reference to FIG. 7 thru | or FIG. 9, the manufacturing method of the connector for anastomosis is demonstrated. FIG. 7 is a flowchart showing a method for manufacturing the anastomotic connector 5. FIG. 8 is a diagram schematically illustrating cutting out the anastomosis connector 5 from the cylindrical sheet body 70. FIG. 9 is a diagram schematically showing that the shape of the first ring member is rounded and the shape of the second ring member is rounded.

  In the first step S1, one cylindrical sheet body 70 is prepared. As shown in FIG. 8, in the second step S <b> 2, from one cylindrical sheet body 70, a third portion 30 having a central axis parallel to the central axis of the cylindrical sheet body and a first portion in the third portion 30. The first portion 10 connected by the connecting portion 40 and the second portion 20 (not shown in FIG. 8) connected to the third portion 30 by the second connecting portion 50 are cut out. In addition, in FIG. 8, since the 2nd connection part 50 and the 2nd part 20 are in the back | inner side rather than the near side part of the cylindrical sheet body 70, they are not illustrated. In the example illustrated in FIG. 8, the center axis of the first ring member 11 (or the first ring member with a gap) to be cut out and the center axis of the cylindrical sheet body 70 during the cutting process are as follows: They are perpendicular to each other. Alternatively, the center axis of the first ring member 11 (or the first gap ring member) to be cut out and the center axis of the cylindrical sheet body 70 may coincide with each other during the cutting process. Good (see, for example, FIG. 15 below). FIG. 8 shows a state in which a cut 90 is provided in the cylindrical sheet body 70 and the first portion 10, the second portion 20, and the third portion 30 are cut out from the cylindrical sheet body 70. The formation of the cut 90 may be performed by laser processing, or may be performed by another processing method.

  When the anastomotic connector 5 includes the fourth portion 80, the fourth portion 80 is also cut out in the second step S2. The fourth portion 80 immediately after being cut out is constituted by extending portions 80 </ b> A and 80 </ b> B extending from the bottom portion 33 in parallel with the central axis of the third portion 30.

  In the third step S3, the shape of the first ring member 11 (or first gap ring member) is rounded, and the shape of the second ring member 21 (or second gap ring member) is true. It is turned into a circle. The rounding may not be a rounding in a strict sense. In the present specification, rounding means that, for example, the aspect ratio (long axis length / short axis length) of the ring member (or the ring member with gap) after the rounding step is rounded. It means that it is smaller than the aspect ratio (length of major axis / length of minor axis) of the ring member (or the ring member with gap) before the process.

  FIG. 9 shows, as an example, a state in which the shape of the first ring member 11 and the shape of the second ring member 21 are simultaneously rounded. In the example illustrated in FIG. 9, the first ring member 11 and the second ring member 21 are inserted into the correction tool 200 having a cylindrical outer surface. In the state shown in FIG. 9, the first ring member 11 and the second ring member 21 are heated, and as a result, the shape of the first ring member 11 and the shape of the second ring member 21 are rounded. The heating may be performed by heating the straightening tool 200 itself, or may be performed by placing the straightening tool 200 in the heating chamber. In the example illustrated in FIG. 9, the shape of the first ring member 11 and the shape of the second ring member 21 are simultaneously rounded. Alternatively, however, the first ring member 11 (or the first ring member 11) The shape of one of the ring member with a gap) and the second ring member 21 (or the second ring member with a gap) may be rounded, and then the other shape may be rounded.

  If the shape of the ring member (the shape of the ring member with a gap) is already close to a perfect circle immediately after the cutting step (second step S2), the third step S3 may be omitted.

  In the fourth step S <b> 4, the first portion 10 is bent relative to the third portion 30 in the first connection portion 40. As a result of the bending, the relative arrangement of the first portion 10 with respect to the third portion 30 is the arrangement shown in FIG. In addition, in order to fix the shape after bending, you may heat the 1st connection part 40 (bending part) after 4th step S4. In the example illustrated in FIG. 3, the first bent portion 41 and the second bent portion 42 are bent portions.

  In the fifth step S <b> 5, the second portion 20 is bent relative to the third portion 30 in the second connection portion 50. As a result of the bending, the relative arrangement of the second portion 20 with respect to the third portion 30 is the arrangement shown in FIG. In addition, in order to fix the shape after bending, you may heat the 2nd connection part 50 (bending part) after 5th step S5. In the example illustrated in FIG. 3, the first bent portion 51 and the second bent portion 52 are bent portions.

  The fifth step S5 may be executed before the fourth step S4, may be executed after the fourth step S4, or may be executed simultaneously with the fourth step S4.

  When the anastomotic connector 5 includes the fourth portion 80 (extending portion extending from the bottom 33), the extending portion constituting the fourth portion 80 is plastically deformed after the execution of the second step S2. It is preferable to form arcuate members (the first arcuate member 80A and the second arcuate member 80B) by plastic deformation (for example, by heating). The step of forming the arc-shaped member may be before the third step S3, after the third step S3, or at the same time as the third step.

  In the manufacturing method of the anastomotic connector in the embodiment, the anastomotic connector 5 can be manufactured from one member cut out from one cylindrical sheet body. In other words, in the anastomotic connector of the embodiment, one member obtained by cutting the shape constituted by the first portion 10, the second portion 20, and the third portion 30 from one cylindrical sheet body 70. From this, it is possible to make a shape that can be manufactured. For this reason, in the manufacturing method of the connector for anastomosis in the embodiment, a joining step such as welding or welding is not necessarily required. And it is easy to manufacture an anastomotic connector.

  In the method for manufacturing the anastomotic connector in the embodiment, the curved surface of the cylindrical sheet 70 is used as it is as the shape of the annular portion 31 of the third portion. For this reason, about the annular part 31 of the 3rd part, the plastic working after cutting out is not necessarily required.

  In the method for manufacturing the anastomotic connector in the above-described embodiment, as shown in FIG. 8, the first portion 10 and the second portion 20 are formed from the first end side region 70-1 of the cylindrical sheet body 70. The third portion 30 is formed from the second end side region 70-2 of the cylindrical sheet body 70. As a result, it is possible to manufacture an anastomotic connector from the cylindrical sheet 70 having a relatively short length. Note that the region from which the first portion 10 is cut out and the region from which the second portion 20 is cut out may be symmetric with respect to the central axis of the cylindrical sheet body 70.

(First modification)
A first modification of the embodiment will be described with reference to FIG. FIG. 10 is a schematic development view schematically showing an anastomotic connector according to a modification of the embodiment. In addition, about each component in a 1st modification, the same drawing number is attached | subjected about the component which has the same function as the component in the above-mentioned embodiment. A repetitive description of components having the same drawing number will be omitted.

  In the first modified example shown in FIG. 10, the first portion 10 is not a ring member but includes a gap ring member 11 ′, and the second portion 20 is not a ring member but a gap ring member 21. It differs from embodiment described in FIGS. 2-3 and 6-9 by the point provided with '. In other respects, the first modification is the same as the embodiment described in FIGS.

  In the example illustrated in FIG. 10, the ring member 11 ′ with the gap includes an arcuate portion extending from the connection point between the first connection portion 40 and the first portion 10 toward the first end 14 </ b> A, the first connection portion 40, and the first connection portion 40. An arcuate portion extending from the connection point with the first portion 10 toward the second end 14B. A gap 13 exists between the first end 14A and the second end 14B. The ring member 21 ′ with a gap is connected to the arc-shaped portion extending from the connection point between the second connection portion 50 and the second portion 20 toward the first end 24 </ b> A, and to the second connection portion 50 and the second portion 20. And an arcuate portion extending from the point toward the second end 24B. A gap 23 exists between the first end 24A and the second end 24B.

  In the first modification, both the first portion 10 and the second portion 20 include a ring member with a gap. Alternatively, one of the first portion 10 and the second portion 20 may include a ring member, and the other of the first portion 10 and the second portion 20 may include a ring member with a gap.

  The anastomotic connector 5 in the first modified example has the same effects as the anastomotic connector in the above-described embodiment. In addition, the diameter of the gap ring member 11 ′ and the gap ring member 21 ′ can be automatically increased by elasticity. For this reason, the connector for anastomosis in the first modification can be flexibly applied to various first tubular bodies 1 having different inner diameters.

(Second modification)
A second modification of the embodiment will be described with reference to FIGS. 11 and 12. FIG. 11 and FIG. 12 are schematic development views schematically showing an anastomotic connector according to a second modified example of the embodiment. In addition, about each component in a 2nd modification, the same figure number is attached | subjected about the component which has the same function as the component in the above-mentioned embodiment. A repetitive description of components having the same drawing number will be omitted.

  11 and 12 is different from the embodiments described in FIGS. 2 to 3 and 6 to 9 in the configuration related to the first connection unit 40 and the configuration related to the second connection unit 50. In the example described in FIGS. 11 and 12, the first connection unit 40 includes a connection unit 40A and a connection unit 40B, and the second connection unit 50 includes a connection unit 50A and a connection unit 50B. In the anastomosis connector 5 according to the second modification, the first ring member 11 may be cut at a location indicated by an arrow D3 and a location indicated by an arrow D4. Further, in the anastomotic connector 5 in the second modification, the second ring member 21 may be cut at a location indicated by an arrow D1 and a location indicated by an arrow D2. In FIG. 12, the first ring member 11 is cut at the location indicated by the arrow D3 and the location indicated by the arrow D4, and the second ring member 21 is cut at the location indicated by the arrow D1 and the location indicated by the arrow D2. The anastomotic connector 5 is shown after being done.

  11 and 12 do not describe the first arcuate member 80A and the second arcuate member 80B (see FIG. 6) that are cantilevered by the bottom 33. However, the anastomotic connector 5 in the second modified example may include the first arcuate member 80A and the second arcuate member 80B that are cantilevered by the bottom 33.

(Third Modification)
A third modification of the embodiment will be described with reference to FIGS. 13 and 14. FIG. 13 is a schematic development view schematically showing an anastomotic connector according to a third modified example of the embodiment. In addition, about each component in a 3rd modification, the same drawing number is attached | subjected about the component which has the same function as the component in the above-mentioned embodiment. A repetitive description of components having the same drawing number will be omitted.

  The third modification example shown in FIG. 13 is the same as that in the configuration of the first portion 10, the configuration of the second portion 20, the configuration related to the first connection portion 40, and the configuration related to the second connection portion 50. Different from the embodiments described in -9.

  In the example described in FIG. 13, the first portion 10 includes a first ring member 11 ″. Alternatively, the first portion 10 may comprise a first gapped ring member. In this case, the first portion 10 may be cut at the position indicated by the arrow E1 and form a gap at the position indicated by the arrow E1. The first portion 10 is connected to the bottom 33 of the third portion 30 via the first connection portion 40. From the state shown in FIG. 13, the first portion 10 is bent relative to the third portion 30 in the first bent portion 41. As a result, the positional relationship between the first portion 10 and the third portion 30 shown in FIG. 3 is obtained. In the example illustrated in FIG. 13, it is not necessary to provide a bent portion (second bent portion) on the distal end side of the first connecting portion 40. That is, in FIG. 13, it is not necessary to bend the portion indicated by reference numeral 42 '.

  In the example described in FIG. 13, the second portion 20 includes a second gapped ring member 21 ''. FIG. 13 shows the gap 23 of the second gap ring member 21 ″. The second portion 20 is connected to the bottom 33 of the third portion 30 via the second connection portion 50. From the state shown in FIG. 13, the second portion 20 is bent relative to the third portion 30 in the first bent portion 51. As a result, the positional relationship between the second portion 20 and the third portion 30 shown in FIG. 3 is obtained. In the example illustrated in FIG. 13, it is not necessary to provide a bent portion (second bent portion) on the distal end side of the second connection portion 50. That is, in FIG. 13, there is no need to bend the portion indicated by reference numeral 52 '. In the example illustrated in FIG. 13, the length of the first connection portion 40 is longer than the length of the second connection portion 50.

  The anastomotic connector 5 in the third modified example has the same effects as the anastomotic connector in the above-described embodiment.

  Next, with reference to FIG. 14 and FIG. 15, the manufacturing method of the anastomosis connector 5 in a 3rd modification is demonstrated. FIG. 14 is a flowchart showing a method for manufacturing the anastomotic connector 5. FIG. 15 is a diagram schematically illustrating cutting out the anastomosis connector 5 from the cylindrical sheet body 70.

  In the first step S1, one cylindrical sheet body 70 is prepared. As shown in FIG. 15, in the second step S <b> 2, from one cylindrical sheet body 70, a third portion 30 having a central axis parallel to the central axis of the cylindrical sheet body and a first portion in the third portion 30. The first portion 10 connected by the connecting portion 40 and the second portion 20 connected to the third portion 30 by the second connecting portion 50 (not shown in FIG. 15) are cut out. In addition, in FIG. 15, since the 2nd connection part 50 exists in the back | inner side rather than the near side part of the cylindrical sheet body 70, it is not illustrated. In the example shown in FIG. 15, the center axis of the first ring member 11 ″ (or the first ring member with a gap) to be cut out and the center axis of the cylindrical sheet body 70 during the cutting process are Are consistent with each other. Further, during execution of the cutting process, the central axis of the second gapd ring member 21 ″ cut out and the central axis of the cylindrical sheet body 70 coincide with each other.

  When the anastomotic connector 5 includes the fourth portion 80, the fourth portion 80 is also cut out in the second step S2. The fourth portion 80 immediately after being cut out is constituted by extending portions 80 </ b> A and 80 </ b> B extending from the bottom portion 33 in parallel with the central axis of the third portion 30.

  In the example described in FIGS. 14 and 15, the first ring member 11 ″ (or the first gap ring member) is cut out along the circumferential direction of the cylindrical sheet body 70. As a result, the shape of the first ring member 11 ″ (or the first gap ring member) is close to a perfect circle. The second gap ring member 21 ″ is cut out along the circumferential direction of the cylindrical sheet body 70. As a result, the shape of the second gapd ring member 21 ″ is close to a perfect circle. For this reason, in the example described in FIGS. 14 and 15, it is possible to omit the step of rounding the shape of the ring member (or the ring member with gap).

  In the third step S <b> 3, the first portion 10 is bent relative to the third portion 30 in the first connection portion 40. As a result of the bending, the relative arrangement of the first portion 10 with respect to the third portion 30 is the arrangement shown in FIG. In addition, in order to fix the shape after bending, you may heat the 1st connection part 40 (bending part) after 3rd step S3. In the example shown in FIGS. 13 to 15, only the first bent portion 41 is a bent portion.

  In the fourth step S <b> 4, the second portion 20 is bent relative to the third portion 30 in the second connection portion 50. As a result of the bending, the relative arrangement of the second portion 20 with respect to the third portion 30 is the arrangement shown in FIG. In addition, in order to fix the shape after bending, you may heat the 2nd connection part 50 (bending part) after 4th step S4. In the examples illustrated in FIGS. 13 to 15, only the first bent portion 51 is a bent portion.

  The fourth step S4 may be executed before the third step S3, may be executed after the third step S3, or may be executed simultaneously with the third step S3.

  When the anastomotic connector 5 includes the fourth portion 80 (extending portion extending from the bottom 33), the extending portion constituting the fourth portion 80 is plastically deformed after the execution of the second step S2. It is preferable to form arcuate members (the first arcuate member 80A and the second arcuate member 80B) by plastic deformation (for example, by heating). The step of forming the arc-shaped member may be before the third step S3 and the fourth step S4, or after the third step S3 and the fourth step S4.

  In the method for manufacturing the anastomotic connector in the third modified example, the curved surface of the cylindrical sheet body 70 is used as it is as the shapes of the first portion 10, the second portion 20, and the third portion 30. For this reason, the first portion 10, the second portion 20, and the third portion 30 do not necessarily require plastic working after cutting.

  In the method for manufacturing the anastomotic connector in the above-described embodiment, as shown in FIG. 15, the first portion 10 and the second portion 20 are formed from the first end side region 70-1 of the cylindrical sheet body 70. The third portion 30 is formed from the second end side region 70-2 of the cylindrical sheet body 70. As a result, it is possible to manufacture an anastomotic connector from the cylindrical sheet 70 having a relatively short length. Referring to FIG. 15, the first portion 10 is formed from the first end side region 70 ′-1 of the cylindrical sheet body 70, and the third portion 30 is formed from the second end side region 70-2 of the cylindrical sheet body 70. It can be said that the second portion 20 is formed from the region 70-3 between the first end side region 70′-1 and the second end side region 70-2.

(Example of anastomotic connector size)
Next, with reference to FIG. 16, an example of the size of the anastomotic connector is shown. A length L1 along the second direction of the annular portion 31 (waveform circumferential portion) in a natural state where no external force acts is, for example, 2 mm or more and 8 mm or less. When the length L1 is less than 2 mm, the diameter at the time of expansion is insufficient, and the engagement of the anastomosis connector 5 to the first tubular body 1 may be insufficient. If the length L1 is greater than 8 mm, the flexibility of the second tubular body 2 may be impaired near the joint between the first tubular body 1 and the second tubular body 2.

  The length L2 of the elongated member 35 is, for example, not less than 0.5 mm and not more than 3 mm. When the length L2 is less than 0.5 mm, the engagement of the anastomotic connector 5 with the first tubular body may be insufficient. If the length L2 is more than 3 mm, the flexibility of the second tubular body 2 may be impaired in the vicinity of the joint between the first tubular body and the second tubular body.

  The length L3 of each engagement part (engagement part 36, 2nd engagement part 81A, 81B) is 0.15 mm or more and 0.6 mm or less, for example. If the area of the engaging portion is too large, the pressing force per unit area by which the engaging portion presses the tubular body is insufficient, and the anastomotic connector 5 may slide with respect to the tubular body. Moreover, when the area of an engaging part is too small, there exists a possibility that the said engaging part may stop functioning as a part engaged with a tubular body.

  Before the bending process, the length of the first connecting portion 40 (the length along the second direction in FIG. 16) is, for example, 1 mm or more and 6 mm or less. In addition, before the bending process, the length of the second connection portion 50 (the length along the second direction in FIG. 16) is, for example, 1 mm or more and 6 mm or less.

  The outer diameter of the third portion 30 in a natural state where no external force acts is, for example, not less than 2 mm and not more than 4 mm.

  The anastomotic connector according to the embodiment may use any biocompatible material (for example, a nickel-titanium alloy that has superelastic characteristics and is a shape memory alloy, or is absorbed by living tissue. A bioabsorbable material may be used).

  The present invention is not limited to the embodiments described above, and it is obvious that the embodiments can be appropriately modified or changed within the scope of the technical idea of the present invention. Various techniques used in each embodiment or modification can be applied to other embodiments or modifications as long as no technical contradiction arises.

1: 1st tubular body 2: 2nd tubular bodies 2A-2D: Tongue piece 3: Hole 3A-3B: Cut 5: Anastomotic connector 7: Plaque 10: 1st part 11, 11 '': 1st ring member 11 ′: Gapped ring member 12: Second ring member 13: Gap 14A: First end 14B: Second end 20: Second portion 21: Second ring member 21 ′, 21 ″: Gapped ring member 23: Gap 24A: first end 24B: second end 30: third portion 31: annular portion 32: top portion 33: bottom portion 34A: first connecting portion 34B: second connecting portion 35: elongated member 36, 36B: engaging portion 40 : First connecting part 40A, 40B: connecting part 41: first bent part 42: second bent part 50: second connecting part 50A, 50B: connecting part 51: first bent part 52: second bent part 70: cylinder Sheet bodies 70-1, 70′-1: first end side Region 70-2: Second end side region 70-3: Region 80: Fourth portion 80A: First arc member 80B: Second arc member 81A: Second engagement portion 81B: Second engagement portion 200: Correction tool 310: Waveform circumferential portions 311, 311 ′: Closed loop T1: Virtual straight line

Claims (9)

An anastomosis connector for joining a side portion of a first tubular body extending in a first direction and an end portion of a second tubular body extending in a second direction,
A first portion disposed on one side of a hole provided in the first tubular body;
A second portion disposed on the other side of the hole provided in the first tubular body;
A third portion connected to the first portion by a first connection portion and connected to the second portion by a second connection portion;
The first portion includes a first ring member or a first gap ring member configured to be engageable with an inner surface of the first tubular body,
The second portion includes a second ring member or a second gap ring member configured to be engageable with an inner surface of the first tubular body,
The third portion includes an annular portion configured to be engageable with an inner surface of the second tubular body,
The annular portion includes a corrugated circumferential portion having a plurality of top portions and a plurality of bottom portions alternately. The anastomotic connector according to claim 1,
The number of the said waveform circumference part with which the said annular part is provided is one zygote for anastomosis. The zygote for anastomosis according to claim 1 or 2,
The annular portion does not include a closed loop disposed so as to surround a virtual straight line parallel to the radial direction of the third portion. In the zygote for anastomosis according to any one of claims 1 to 3,
An anastomotic connector further comprising an arcuate member that is cantilevered by at least one bottom of the plurality of bottoms. In the zygote for anastomosis according to any one of claims 1 to 4,
The third portion includes an elongated member that is cantilevered by at least one top of the plurality of tops and extends in parallel with the second direction. In the anastomotic connector according to any one of claims 1 to 5,
The shape constituted by the first portion, the second portion, and the third portion is a shape that can be produced from one member cut out from one cylindrical sheet body. An anastomosis connector for joining the side of the first tubular body and the end of the second tubular body,
A first portion having a central axis parallel to the first direction;
A second portion having a central axis parallel to the first direction;
A third portion connected to the first portion by a first connecting portion, connected to the second portion by a second connecting portion, and having a central axis parallel to a second direction different from the first direction; Comprising
The first portion comprises a first ring member or a first gap ring member,
The second portion comprises a second ring member or a second gap ring member,
The third portion comprises an annular portion;
The annular portion includes a corrugated circumferential portion having a plurality of top portions and a plurality of bottom portions alternately. A method for producing an anastomotic connector, comprising:
From one cylindrical sheet body, a third portion having a central axis parallel to the central axis of the cylindrical sheet body, a first portion connected to the third portion by a first connection portion, and the third portion Cutting out the second part connected by the second connection part;
Bending the first portion relative to the third portion in the first connection portion;
Bending the second part relative to the third part in the second connection part, and
Immediately after the cutting step,
The first portion comprises a first ring member or a first gap ring member,
The second portion comprises a second ring member or a second gap ring member,
The third portion includes a corrugated circumferential portion including a plurality of top portions and a plurality of bottom portions alternately. In the manufacturing method of the zygote for anastomosis according to claim 8,
The first portion is formed using a first end side region of the cylindrical sheet body,
The second part is formed using the first end side region of the cylindrical sheet body,
The third portion is formed by using a second end side region of the cylindrical sheet body.

Images