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A tissue closing device includes an elongate arrangement device of which a distal end portion can penetrate an opening on a wall of living body cavity and which has a hand-operated portion on the proximal side, and a closure detachably retained at the distal end portion of the arrangement device and

A tissue closing device includes an elongate arrangement device of which a distal end portion can penetrate an opening on a wall of living body cavity and which has a hand-operated portion on the proximal side, and a closure detachably retained at the distal end portion of the arrangement device and operative to close the opening. According to one embodiment, the arrangement device can include a thread for detachably retaining the closure and for pulling the closure in the proximal direction, a cover tube, and a fixed tube. The hand-operated portion has a canceling mechanism for canceling the retained state of the closure. A series of operations from deformation of the closure resulting from pulling the closure by the thread to canceling the retained state of the closure by the canceling mechanism after completion of the deformation are performed continuously by operating the hand-operated portion.

대표청구항 ▼

1. A tissue closing device for closing an opening penetrating living tissue, comprising: a closure for closing the opening, the closure comprising a seal portion positionable on one side of the opening in the living tissue to cover the opening and a periphery of the opening, and a deformable deforma

1. A tissue closing device for closing an opening penetrating living tissue, comprising: a closure for closing the opening, the closure comprising a seal portion positionable on one side of the opening in the living tissue to cover the opening and a periphery of the opening, and a deformable deformation portion positionable on an opposite side of the opening in the living tissue;a body;an elongated tubular member extending distally of the body;a thread extending through the elongated tubular member and connected to the closure;a manually operable operating lever mounted on the body and operatively connected to the thread by a thread holder to move the thread in a proximal direction upon manual operation of the operating lever so that the thread applies a force to the closure which deforms the deformation portion so that the periphery of the opening penetrating the living tissue is positioned between the seal portion and the deformation portion which has been deformed;a release member movably positioned in the body and engageable with the thread holder during manual operation of the operating lever to move the thread holder in a manner which releases the thread and operatively disconnects the thread and the operating lever; andwherein the thread holder is a pin supported in a hole in a thread support portion, the release member engaging the pin during manual operation of the operating lever to move the pin out of the hole of the thread support portion. 2. The tissue closing device as set forth in claim 1, further comprising a cover tube support portion movably positioned in the body and connected to the operating lever so that movement of the operating lever causes movement of the cover tube support portion, the cover tube support portion comprising a plurality of projections that engage the release member during operation of the operating lever to move the release member in a manner causing the pin to move out of the hole of the thread support portion. 3. The tissue closing device as set forth in claim 2, further comprising a spring positioned between the thread support portion and the cover tube support portion so that movement of the cover tube support portion causes movement of the thread support portion by way of the spring. 4. The tissue closing device as set forth in claim 2, wherein the release member comprises a frame shaped lifter provided with a plurality of projections that are engaged by the projections on the cover tube support to lift the lifter and move the pin out of the hole of the thread support portion. 5. The tissue closing device as set forth in claim 1, wherein the operative connection between the operating lever and the thread by way of the thread holder comprises a cover tube support portion and a thread support portion which are movable together as a unit by way of a spring positioned between the cover tube support portion and a thread support portion, the cover tube support portion and the thread support portion also being movable relative to one another through contraction of the spring. 6. The tissue closing device as set forth in claim 5, wherein the cover tube support portion supports a cover tube having a distal end portion that initially covers a distal end portion of the elongated tubular member, initial operation of the operating lever causing the cover tube to move in the proximal direction relative to the elongated tubular member so that the distal end portion of the elongated tubular member is exposed distally beyond the distal end portion of the cover tube. 7. A tissue closing device for closing an opening penetrating living tissue, comprising: a closure for closing the opening, the closure comprising a seal portion adapted to cover the opening and a periphery of the opening from one side of the wall of the living body cavity, and a deformable deformation portion adapted to cover the opening and the periphery of the opening from an opposite side of the wall of the living body cavity;an arrangement device detachably retaining the closure to arrange the closure at a position to close the opening;the arrangement device comprising: lock means for locking at least a part of the closure in a retained state;an operational portion provided on a proximal side of the lock means;canceling means for canceling the retained state of the closure; and,the operational portion being operable to effect in a continuous operation relative movement between the closure and the lock means under a condition in which the closure is locked by the lock means to deform the deformation portion of the closure, and after completion of the deformation, to cancel the retained state of the closure by the canceling means;retaining means for detachably retaining the closure at a distal end portion of the lock means;wherein the closure comprises a fixing portion for retaining a condition where the deformation portion has been put into a predetermined form;wherein:the fixing portion is a thread-like member comprising a movable knot; andwhen the closure is pulled by the retaining means upon operation of the operational portion, the knot is moved on the thread-like member of the fixing portion with the deformation portion being deformed into the predetermined form and retained in the predetermined form by the knot;the thread-like member is a first thread-like member, and the retaining means is a second thread-like member different from the first thread-like member, the second thread-like member possessing one end portion and an other end portion, the one end portion of the second thread-like member being detachably connected to a part of the arrangement device, the other end portion of the second thread-like member being un-detachably fixed, the second thread-like member retaining the closure by passing through the closure and being turned back at a distal end portion of the arrangement device; andthe one end portion of the second thread-like member includes a loop through which passes a connecting means which is movable from one position in which the connecting means prevents release of the loop to an other position in which the connecting means permits release of the loop. 8. The tissue closing device as set forth in claim 7, wherein the knot is a clinch knot. 9. The tissue closing device as set forth in claim 7, wherein the second thread-like member is connected to the first thread-like member. 10. The tissue closing device as set forth in claim 7, wherein the second thread-like member is connected to the first thread-like member by way of a ring. 11. The tissue closing device as set forth in claim 7, wherein the other end portion of the second thread-like member is fixed to a part of the arrangement device. 12. The tissue closing device as set forth in claim 7, wherein the thread-like member comprises two ends tied together to form the movable knot which is movable relative to the thread-like member to tighten the thread-like member. 13. A tissue closing device for closing an opening penetrating living tissue, comprising: a closure for closing the opening, the closure comprising a seal portion adapted to cover the opening and a periphery of the opening from one side of the wall of the living body cavity, and a deformable deformation portion adapted to cover the opening and the periphery of the opening from an opposite side of the wall of the living body cavity; andan arrangement device detachably retaining the closure to arrange the closure at a position to close the opening;the arrangement device comprising: lock means for locking at least a part of the closure in a retained state;an operational portion provided on a proximal side of the lock means;canceling means for canceling the retained state of the closure; andthe operational portion being operable to effect in a continuous operation relative movement between the closure and the lock means under a condition in which the closure is locked by the lock means to deform the deformation portion of the closure, and after completion of the deformation, to cancel the retained state of the closure by the canceling means;retaining means for detachably retaining the closure at a distal end portion of the lock means;wherein the operational portion comprises: an operational portion body;a retaining means support portion supporting the retaining means and movable relative to the operational portion body, andthe retaining means support portion being moved in the proximal direction by operation of the operational portion to cause the retaining means to move in the proximal direction and move the closure;wherein the operational portion comprises connecting means for detachably connecting the retaining means to the retaining means support portion;after the deformation of the deformation portion of the closure is completed by operation of the operational portion, the connection between the retaining means and the retaining means support portion by the connecting means is released by the canceling means to release the retained state of the closure by the retaining means;wherein the retaining means is a thread-like member possessing one end portion and an other end portion, the one end portion of the thread-like member being detachably connected to the retaining means support portion by the connecting means, the other end portion of the thread-like member being undetachably fixed, the thread-like member retaining the closure by passing through the closure and being turned back at a distal end portion of the arrangement device;wherein the canceling means comprises a connecting means support portion supporting the connection means and displaceable relative to the operational portion body;a displacing portion provided at the cover member support portion and operative to displace the connecting means support portion; andoperation of the operational portion causing the cover member support portion to move in the proximal direction to displace the connecting means support portion by the displacing portion to release the connection means providing connection between the retaining means and the retaining means support portion. 14. The tissue closing device as set forth in claim 13, wherein the arrangement device further comprises: a cover member covering an outside surface of the lock means and possessing a distal end portion covering at least a part of the closure during positioning of the closure; andthe operation of the operational portion causing the cover member to move in a proximal direction exposing the deformation portion of the closure distally beyond the distal end portion of the cover member before the deformation of the deformation portion. 15. The tissue closing device as set forth in claim 13, wherein during the operation of the operational portion, the retaining means moves the deformation portion of the closure into contact with the distal end portion of the lock means, with further operation of the operational member causing the retaining means to apply a force to the closure locked by the lock means which deforms the deformation portion. 16. The tissue closing device as set forth in claim 13, wherein the lock means is a tubular member having a longitudinally extending passage, and the retaining means passes through the longitudinally extending passage. 17. The tissue closing device as set forth in claim 13, wherein: the arrangement device further comprises a cover member covering an outside surface of the lock means and possessing a distal end portion covering at least a part of the closure during positioning of the closure;the operational portion comprising a cover member support portion supporting the cover member and movable together with the cover member, the cover member support portion being movable relative to the operational portion body; andthe operation of the operational portion causing the cover member to move in a proximal direction exposing the deformation portion of the closure distally beyond the distal end portion of the cover member before the deformation of the deformation portion. 18. The tissue closing device as set forth in claim 17, further comprising an elastic member positioned between the cover member support portion and the retaining means support portion, the elastic member being adapted to be contracted along a moving direction of the cover member support portion and the retaining means support portion; andthe movement of the cover member support portion in the proximal direction causing movement of the retaining means support portion in the proximal direction through the elastic member, the movement of the retaining means support portion in response to operation of the operational portion being stopped upon completion of the deformation of the deformation portion of the closure, the elastic member being contracted after deformation of the deformation portion is completed and movement of the retaining means support portion is stopped to permit movement of the cover member support portion relative to the retaining means support portion. 19. The tissue closing device as set forth in claim 13, wherein the canceling means is so configured that connection between the retaining means and the retaining means support portion by the connecting means is canceled by a movement of the cover member support portion in the proximal direction. 20. The tissue closing device as set forth in claim 13, wherein the one end portion of the thread-like includes a loop through which passes the connecting means, the connecting means being movable relative to the retaining means support portion from one position in which the connecting means prevents release of the loop to maintain the retained state of the closure to an other position in which the connecting means permits release of the loop to release the retained state of the closure. 21. The tissue closing device as set forth in claim 13, wherein the closure comprises a fixing portion for retaining a condition where the deformation portion has been put into a predetermined form. 22. The tissue closing device as set forth in claim 21, wherein the retaining means retains the fixing portion of the closure. 23. The tissue closing device as set forth in claim 13, wherein: the seal portion is substantially plate-shaped; andthe deformation portion is in the shape of a frame which is deformable between a first form in which the frame is expanded in a direction substantially perpendicular to the seal portion and is contracted in a direction substantially parallel to the seal portion and a second form in which the frame is contracted in the direction substantially perpendicular to the seal portion and is expanded in the direction substantially parallel to the seal portion. 24. The tissue closing device as set forth in claim 13, wherein the connecting means is movable relative to the retaining means support portion from one position in which the connecting means prevents release of the one end portion of the thread-like member to maintain the retained state of the closure to an other position in which the connecting means permits release of the one end portion of the thread-like member to release the retained state of the closure. 25. The tissue closing device as set forth in claim 13, wherein the other end portion of the thread-like member is fixed to the retaining means support portion. 26. The tissue closing device as set forth in claim 13, wherein the other end portion of the thread-like member is fixed to a part of the arrangement device. 27. The tissue closing device as set forth in claim 13, wherein the lock means is a tube possessing a distal end and a proximal end, the closure being positioned distally of the distal end of the tube, the thread-like member comprising two different portions each positioned in the tube and extending out the proximal end of the tube.