Transfer equipment

Abstract

To provide transfer equipment for transferring a medical sheet to a treatment object part of a living body.SOLUTION: Transfer equipment 10 includes: an external cylinder 22 having a tip opening 80; and a first carrier member 18 having a first shaft 24 arranged to be movable along an axial direction inside the external cylinder 22 and a first support part 26 arranged at the tip of the first shaft 24. The tip of the external cylinder 22 is provided with a protrusion 94 protruding in a tip direction more than the tip opening 80, and protruding inward in the radial direction of the external cylinder 22. The protrusion 94 includes a base part 96 arranged in the tip upper part of the external cylinder 22 and a vertical wall part 98 protruding downward from the base part 96.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to a transfer device for transferring a medical sheet to a treatment target part of a living body. [Background technology]

[0002] Patent Document 1 discloses, for example, a transfer device for transferring a medical sheet (cell sheet) used in organ transplantation to a treatment target part of a living body. This transfer device comprises an outer tube, a shaft movable inside the outer tube, and a support part provided at the tip of the shaft and capable of protruding from the tip of the outer tube. The support part has a sheet support for placing the medical sheet. With the transfer device, with the medical sheet placed on the support surface of the sheet support, the shaft is slid relative to the outer tube, thereby drawing the medical sheet together with the sheet support into the outer tube and storing it within the outer tube. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] International Publication No. 2022 / 080459 Summary of the Invention [Problem to be solved by the invention]

[0004] It is desirable to efficiently contain the medical sheet within the barrel. [Means for solving the problem]

[0005] (1) An aspect of the present invention is a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: an outer tube having a tip opening; a shaft extending in the axial direction of the outer tube and disposed inside the outer tube so as to be movable along the axial direction; a carrier member having a sheet-shaped support portion disposed at the tip of the shaft; and a protrusion provided at the tip of the outer tube, protruding further in the tip direction than the tip opening and protruding radially inwardly of the outer tube, the protrusion having a base portion disposed at the upper tip of the outer tube and a vertical wall portion protruding downwardly from the base portion, the support portion including a support surface capable of holding the medical sheet, the width of the support portion in a direction perpendicular to the extension direction of the shaft being greater than the inner peripheral length of the outer tube, and the support portion being accommodated within the outer tube. at a first position where the shaft is moved in a base end direction relative to the outer tube so that the support part is accommodated within the outer tube in a curved and deformed state, and at a second position where the shaft is moved in the distal end direction relative to the outer tube so that the support part protrudes from a distal opening of the outer tube, the support part unfolds by being exposed in the distal direction from the outer tube, and the support part of the transfer device protrudes in the distal direction from the distal end of the outer tube, and when the support part is moved relatively in the base end direction relative to the outer tube with the medical sheet placed on it, the protrusion guides the support part toward the distal opening of the outer tube, and deforms the support part into a curved shape so that both widthwise sides of the support part protrude toward the support surface.

[0006] According to this transfer device, by moving the support part relative to the outer cylinder in the proximal direction from the second position where the support part is deployed in the distal direction of the outer cylinder, the support part can be deformed into a predetermined curved shape by the base part and the vertical wall part of the protrusion. Therefore, it is possible to effectively accommodate the support part having a width larger than the inner circumferential length of the outer cylinder inside the outer cylinder.

[0007] (2) In the transfer device described in (1) above, the vertical wall portion may be formed in a plate shape along the axial direction of the outer tube, and when viewed from the axial direction of the outer tube, may have a partition portion that passes through the central axis of the outer tube and is positioned on a virtual line extending radially of the outer tube.

[0008] With this configuration, the strength of the protrusion can be increased compared to a configuration in which the protrusion is formed in a frame shape. By contacting both sides of the support portion with the partition wall, the support portion can be curved and deformed into a symmetrical shape with the partition wall as the center.

[0009] (3) In the transfer device described in (1) above, the vertical wall portion may have a hollow portion penetrating in a width direction intersecting with a protruding direction of the protrusion portion.

[0010] With this configuration, when the medical sheet is placed on a treatment target part of a living body at the second position, the periphery of the support part can be visually confirmed through the hollow part.

[0011] (4) In the transferring device according to any one of (1) to (3) above, the base portion may be formed to be wider than the vertical wall portion in a width direction perpendicular to a protruding direction of the vertical wall portion.

[0012] With this configuration, the base portion, which is wider than the vertical wall portion, can effectively guide the support portion toward the vertical wall portion, allowing the support portion to be curved and deformed.

[0013] (5) In the transferring device according to any one of (1) to (4) above, the protrusion may have a curved portion that is curved in a convex shape toward the tip.

[0014] With this configuration, the curved portion provided at the tip of the protrusion allows the protrusion to be smoothly inserted when the tip of the outer cylinder is inserted into the living body.

[0015] (6) In the transfer device described in (2) above, the protrusion may have a lumen extending along a protruding direction of the protrusion, through which a medical device is inserted and held.

[0016] With this configuration, the medical device can be held using the lumen of the protrusion of the outer tube, eliminating the need for a holding member for holding the medical device, which reduces manufacturing costs and makes the device smaller and lighter.

[0017] (7) In the transfer device described in (6) above, a tip of the lumen may open into the vertical wall portion of the protrusion, and the medical device may be an endoscope.

[0018] With this configuration, an endoscope can be placed at the tip of the outer tube, so that the treatment target area can be confirmed by the endoscope when the outer tube is inserted into the living body. By placing an endoscope on the vertical wall portion, it is possible to effectively improve the ease of insertion into the treatment target area of ​​the living body.

[0019] (8) In the transfer instrument described in (6) above, a tip of the lumen may open into the base of the protrusion, and the medical instrument may be an endoscope.

[0020] With this configuration, an endoscope can be placed at the tip of the outer tube, so that the treatment target area can be confirmed by the endoscope when the outer tube is inserted into the living body. A wide field of view can be secured when confirming the treatment target area and the support part of the living body with the endoscope.

[0021] (9) In the transfer device described in any one of (1) to (8) above, the base end of the vertical wall portion may be located at the same position as a tip opening of the outer tube in the axial direction or further toward the tip than the tip opening. Effect of the Invention

[0022] According to the present invention, the outer cylinder is provided with a protrusion that protrudes in the distal direction beyond the distal opening of the outer cylinder and protrudes radially inward of the outer cylinder, and the protrusion has a base portion located at the upper tip portion of the outer cylinder and a vertical wall portion protruding downward from the base portion, so that by moving the support portion in the proximal direction from the second position where the support portion is deployed in the distal direction of the outer cylinder to the base end direction, the base portion and the vertical wall portion of the protrusion can deform the support portion into a predetermined curved shape. This makes it possible to effectively accommodate a support portion having a width greater than the inner peripheral length of the outer cylinder inside the outer cylinder. [Brief description of the drawings]

[0023] [Figure 1] FIG. 1 is a perspective view of a delivery device according to an embodiment of the present invention. [Diagram 2] FIG. 2 is an exploded perspective view of the delivery device of FIG. [Diagram 3] FIG. 3 is a plan view of the tip of the delivery device of FIG. [Figure 4] FIG. 4 is a vertical cross-sectional view taken along line IV-IV in FIG. [Diagram 5] FIG. 5 is a cross-sectional view taken along line VV in FIG. [Figure 6] Fig. 6A is an enlarged perspective view showing the tip of the outer cylinder, and Fig. 6B is a cross-sectional view taken along line VIB-VIB in Fig. 6A. [Figure 7] Fig. 7A is an enlarged side view of the tip portion of the outer cylinder shown in Fig. 6A, and Fig. 7B is a front view of the tip portion of the outer cylinder shown in Fig. 6A. [Figure 8] FIG. 8 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 9] FIG. 9 is a first explanatory view of the sheet placing step. [Figure 10] FIG. 10 is a second explanatory view of the sheet placing step. [Figure 11] FIG. 11 is a first explanatory view of the accommodation step. [Figure 12] FIG. 12 is a cross-sectional view taken along line XII-XII in FIG. [Figure 13] FIG. 13 is a second explanatory view of the accommodation step. [Figure 14] FIG. 14 is a cross-sectional view taken along line XIV-XIV in FIG. [Figure 15] FIG. 15 is an explanatory diagram of the arrangement process. [Figure 16] FIG. 16 is an explanatory diagram of the development process. [Figure 17] FIG. 17 is an explanatory diagram of the movement process. [Figure 18] FIG. 18 is an explanatory diagram of the removal step. [Figure 19]Fig. 19A is an enlarged perspective view showing a tip portion of an outer cylinder having a protrusion according to a first modified example, and Fig. 19B is a front view of the tip portion of the outer cylinder shown in Fig. 19A. [Figure 20] Fig. 20A is an enlarged perspective view showing a tip portion of an outer tube having a protrusion according to a second modified example, Fig. 20B is an enlarged side view of the tip portion of the outer tube shown in Fig. 20A, and Fig. 20C is a front view of the tip portion of the outer tube shown in Fig. 20A. [Figure 21] Fig. 21A is an enlarged perspective view showing a tip portion of an outer tube having a protrusion according to a third modified example, Fig. 21B is an enlarged side view of the tip portion of the outer tube shown in Fig. 21A, and Fig. 21C is a front view of the tip portion of the outer tube shown in Fig. 21A. [Figure 22] Fig. 22A is an enlarged perspective view showing a tip portion of an outer tube having a protrusion according to a fourth modified example, Fig. 22B is a side view of the tip portion of the outer tube shown in Fig. 22A, and Fig. 22C is a front view of the tip portion of the outer tube shown in Fig. 22A. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0024] As shown in Fig. 1, the transfer device 10 according to this embodiment is a medical device for transferring a medical sheet 300 to a treatment target part of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure caused by ischemic heart disease. In this case, the medical sheet 300 is transplanted to a transplant target part 402 of a heart 400 (a treatment target part of a living body) (see Figs. 15 to 18). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

[0025] Such medical sheet 300 includes pharmaceuticals for medical use, regenerative medicine products, medical devices, etc. The medical sheet 300 is formed in a sheet shape such as a film or membrane (gel-like substance). The medical sheet 300 may be reinforced by applying fibrin or the like. Regenerative medicine products containing cells include, for example, cell sheets (sheet-shaped cell cultures), spheroids, etc. The cell sheet can be formed by culturing autologous cells or allogeneic cells. The cells constituting the cell sheet include, for example, somatic stem cells (adult stem cells), mesenchymal stem cells, or cardiomyocytes derived from iPS cells (induced pluripotent stem cells). The somatic stem cells preferably include skeletal myoblasts (myoblast cells).

[0026] The medical sheet 300 may contain a tissue adhesive, a local anesthetic, etc. The thickness of the medical sheet 300 is, for example, about 100 μm, and the diameter of the medical sheet 300 is, for example, about 60 mm. However, the thickness and diameter (size) of the medical sheet 300 can be set appropriately.

[0027] The medical sheet 300 may be a sheet to be transplanted into an organ (such as the lung, liver, pancreas, kidney, small intestine, or esophagus) other than the heart 400. Furthermore, the medical sheet 300 may be a sheet for preventing adhesions, for example, so long as it is for medical use.

[0028] 1 and 2, the transportation instrument 10 includes an instrument body 12, an endoscope 14, and a fixing member 16. The instrument body 12 includes a first carrier member 18, a second carrier member 20, and an outer cylinder 22. Note that the transportation instrument 10 is not limited to including the endoscope 14.

[0029] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0030] The first shaft 24 is a tubular body (a circular tube member in this embodiment) having a first lumen 28. The first lumen 28 opens at the tip (the end in the direction of the arrow X1) of the first shaft 24 and at the base end (the end in the direction of the arrow X2) of the first shaft 24. An airtight valve body 55 that is in close contact with the outer circumferential surface of the second shaft 48 is provided at the base end of the first shaft 24. A marker 551 is provided on the outer circumferential surface of the valve body 55. When using the transfer device 10, the user can see the marker 551. Note that the first shaft 24 is not limited to a tubular body, and may not be a tubular body.

[0031] The first shaft 24 extends in the axial direction of the outer cylinder 22 and is disposed inside the outer cylinder 22 so as to be movable along the axial direction. The first shaft 24 is made of, for example, a resin material. The constituent material of the first shaft 24 is not particularly limited, but examples thereof include polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyether ether ketone, polyvinyl chloride, ABS resin, polyamide elastomer, and polyester elastomer. The first shaft 24 may be made of a metal material.

[0032] The first shaft 24 may be flexible. The first shaft 24 may have a flexible tube portion capable of retaining a bent shape. In this case, the first shaft 24 can be bent into an appropriate shape within the body cavity and can retain the bent shape.

[0033] As shown in Figs. 2 to 4, the first support part 26 is attached to the tip of the first shaft 24. The first support part 26 is made of, for example, a resin material. The first support part 26 is capable of holding a medical sheet 300. The first support part 26 is formed by folding a flexible resin sheet material (film material) into a predetermined shape. The first support part 26 is formed, for example, by forming the sheet material into a predetermined shape using a sheet forming die. The thickness of the sheet material is not particularly limited, but is preferably set to, for example, 100 µm or more and 200 µm or less. The first support part 26 has a first joint part 30 and a first support body 32.

[0034] The constituent material of the first support section 26 is not particularly limited, but is preferably transparent, and examples of the constituent material include polyethylene, polycarbonate, polyamide, polystyrene, polypropylene, polyacetal resin, polyimide, polyetherimide, polyether ether ketone, polyethylene terephthalate, fluororesin, etc. The first support section 26 may be in a mesh shape.

[0035] In Fig. 4, the first joint part 30 is bonded to the inner circumferential surface of the tip part of the first shaft 24 by an adhesive. The adhesive is not particularly limited, but examples thereof include a UV adhesive, a hot melt adhesive, and an instant adhesive (e.g., a cyanoacrylate instant adhesive). The first joint part 30 may be heat fused to the inner circumferential surface of the first shaft 24. The first support part 26 may be detachable from the tip part of the first shaft 24.

[0036] As shown in FIG. 2, the first support body 32 extends from the first joint portion 30 in the distal direction. The first support body 32 has a base end support portion 34, an intermediate support portion 36, a pair of first protrusions 38, a pair of second protrusions 40, and a distal support portion 42. The first support body 32 has a first support surface 261. The marker 551 is arranged so that the marker 551 of the first shaft 24 faces upward when the first support surface 261 faces upward. That is, the marker 551 allows the user to confirm the direction of the first support surface 261 in the first support portion 26.

[0037] 3, the base end support part 34 is formed to be wider in the extension direction. In other words, both sides in the width direction of the base end support part 34 are tapered toward the first joint part 30. The intermediate support part 36 is formed to be tapered so that the width gradually decreases from the tip toward the base end (arrow X2 direction).

[0038] The tip support portion 42 is connected to the tip of the intermediate support portion 36 and the tips of the pair of second protrusions 40. The tip support portion 42 protrudes in an arc shape toward the tip direction (arrow X1 direction). That is, when viewed from a direction perpendicular to the first support surface 261 shown in FIG. 3, the tip support portion 42 of the first support portion 26 is in the shape of an arc connecting the pair of second protrusions 40.

[0039] 4, the base end support portion 34 extends from the tip of the first joint portion 30 toward the tip direction (arrow X1 direction) so as to generally follow the axis Ax of the first shaft 24. The intermediate support portion 36 extends from the tip of the base end support portion 34 toward the tip direction (arrow X1 direction) to intersect with the axis Ax of the first shaft 24 and toward the tip direction of the first support portion 26 (arrow X1 direction).

[0040] 2 and 3, the pair of first protrusions 38 protrude upward (in the direction of arrow Y) and inward in the width direction of the intermediate support part 36 from both sides in the width direction of the intermediate support part 36 perpendicular to the moving direction of the first shaft 24. The pair of first protrusions 38 are connected to the base end support part 34. The first protrusions 38 are arc-shaped and bulge outward in a convex manner in a direction away from the first support surface 261.

[0041] 3, the pair of second protrusions 40 are respectively connected to the tips of the pair of first protrusions 38. The pair of second protrusions 40 protrude upward and outward in the width direction from both sides of the intermediate support part 36. The second protrusions 40 are formed with a smaller curvature than the first protrusions 38. The second protrusions 40 protrude lower from the first support surface 261 than the first protrusions 38.

[0042] As shown in FIG. 3, hereinafter, the combined portion of the first protrusion 38 and the second protrusion 40 of the first support portion 26 is referred to as the "protrusion 37". Therefore, a pair of protrusions 37 is provided on both sides of the width direction of the first support portion 26. In FIG. 3, the direction perpendicular to the axial direction of the first shaft 24 (W direction) is the width direction of the first support portion 26. The W direction is also the width direction of other components (such as the outer tube 22). In this embodiment, the first support portion 26 has a pair of protrusions 37, and W1 in FIG. 3 is the width of the portion where the width of the first support portion 26 is maximum when the first support portion 26 is developed in a planar state. That is, the width W1 of the first support portion 26 is the maximum width of the first support portion 26P in a planar state before the pair of protrusions 37 are formed (before bending). The width W1 of the first support portion 26 is greater than the inner circumferential length L of the outer tube 22 (see FIG. 14). 14, the inner peripheral length L of the outer cylinder 22 is the length of the inner peripheral surface along the circumferential direction of the outer cylinder 22 (L=2πR). R is the radius of the inner cavity 78 of the outer cylinder 22.

[0043] Each of the pair of first protruding portions 38 has a pair of bent portions 444. Each of the pair of bent portions 444 bends the pair of first protruding portions 38 toward the first supporting surface 261 (middle supporting portion 36) of the first supporting portion 26 (see FIG. 5).

[0044] The first support body 32 has a front surface 461 that faces upward (in the direction of arrow Y) and includes the first support surface 261, and a back surface 462 that is the opposite surface to the front surface 461. The first support surface 261 is a flat surface that is continuous with the upper surface of the base end support part 34, the intermediate support part 36, and the upper surfaces of the tip support part 42. A lubricant may be applied to the first support surface 261 so that a second support part 50 of the second carrier member 20, which will be described later, can slide smoothly on the first support surface 261.

[0045] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0046] The second shaft 48 is a tubular body (a circular tube member in this embodiment) having a second lumen 57. The length of the second shaft 48 along the axial direction is longer than the length of the first shaft 24 along the axial direction. The second shaft 48 is inserted into the first lumen 28 of the first shaft 24 (see Figs. 1 and 4). In other words, the distal end of the second shaft 48 protrudes in the distal direction (arrow X1 direction) from the distal end opening of the first shaft 24. The proximal end of the second shaft 48 protrudes in the proximal direction (arrow X2 direction) from the proximal end opening of the first shaft 24 (see Fig. 1). The second shaft 48 extends along the first shaft 24 and is provided movably along the first shaft 24. The second shaft 48 is not limited to a tubular body and may not be a tubular body.

[0047] The second shaft 48 is configured so as to be able to follow the shape of the first support portion 26. As the constituent material of the second shaft 48, for example, a material that is more flexible than the constituent material of the first shaft 24 is selected. Specifically, as the constituent material of the second shaft 48, for example, polyamide elastomer, polyester elastomer, polyurethane elastomer, polyvinyl chloride, polybutadiene, silicone rubber, metal coil (including composite with resin), etc. can be mentioned. The second shaft 48 is flexible.

[0048] 4, the second shaft 48 has a carrier holding portion 54 and a pressing portion 56 formed by the tip portion of the second shaft 48. The pressing portion 56 is formed from an elastic body such as an elastomer material. The pressing portion 56 presses the first support portion 26 against the inner surface of the outer tube 22 in a state in which the first support portion 26 is housed inside the outer tube 22.

[0049] The tip of the carrier holding part 54 has a pressing surface 58. The carrier holding part 54 is capable of pressing the outer peripheral end surface of the medical sheet 300 supported by the first support part 26 in the tip direction (arrow X1 direction) with the pressing surface 58. In this embodiment, the pressing part 56 is provided with the carrier holding part 54 that supports the second support part 50. The carrier holding part 54 has a pressing surface 58 and an attachment hole 60.

[0050] In Fig. 4, the pressing surface 58 is provided on the tip surface of the carrier holding part 54. An attachment hole 60 opens in the pressing surface 58. The second support part 50 is attached to the pressing surface 58. The pressing surface 58 presses the outer peripheral end surface of the medical sheet 300 in the tip direction (the direction of the arrow X1) (see Fig. 17).

[0051] 2 to 4, the second support part 50 is configured in a flexible sheet shape. The second support part 50 has a second joint part 70 and a second support body 72. The second joint part 70 is provided at the base end of the second support part 50. The second joint part 70 is provided at the base end of the second support body 72. The second joint part 70 is inserted into the mounting hole 60 of the carrier holding part 54 and is, for example, bonded. The second joint part 70 may be bonded to the mounting hole 60 of the carrier holding part 54 by an appropriate bonding method other than bonding. Furthermore, the second support part 50 may be molded integrally with the carrier holding part 54.

[0052] The second support body 72 extends from the second joint 70 in the tip direction (the direction of arrow X1). The length of the second support body 72 in the extending direction from the second joint 70 is shorter than the length of the first support body 32 in the extending direction from the first joint 30. A second support surface 74 for placing the medical sheet 300 on is provided on the upper surface of the second support body 72. The second support surface 74 is a flat surface. The second support body 72 is smaller than the first support body 32. In other words, the area of ​​the second support surface 74 is smaller than the area of ​​the first support surface 261.

[0053] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0054] 1 and 2, the outer cylinder 22 is a cylindrical member having a lumen 78. The lumen 78 has a distal end opening 80 that opens at the distal end (end in the direction of arrow X1) of the outer cylinder 22. The lumen 78 opens at the proximal end (end in the direction of arrow X2) of the outer cylinder 22. The outer cylinder 22 is flexible. Examples of materials constituting the outer cylinder 22 include the same materials as those constituting the first shaft 24 described above.

[0055] The first shaft 24 is inserted into the inner cavity 78 of the outer cylinder 22. The length along the axial direction of the outer cylinder 22 is shorter than the length along the axial direction of the first shaft 24. An airtight valve body 84 that comes into close contact with the outer circumferential surface of the first shaft 24 is provided at the base end of the outer cylinder 22.

[0056] 2 and 4, the tip surface of the outer cylinder 22 extends along a direction perpendicular to the axial direction of the outer cylinder 22. In FIG.

[0057] As shown in Fig. 2, the endoscope 14 has a long endoscope body 86. The tip of the endoscope body 86 is fixed to the outer peripheral surface of the outer tube 22 by a fixing member 16 (see Fig. 1). An objective lens 88 provided on the tip surface of the endoscope body 86 faces the tip direction of the outer tube 22 (the direction of the arrow X1). The tip of the endoscope body 86 is fixed to a middle part of the outer tube 22 in the axial direction. However, the tip of the endoscope body 86 may be fixed to the tip of the outer tube 22.

[0058] The fixing member 16 includes, for example, a fixed cylinder 90 and a fixed tube 92. The fixed cylinder 90 is made of, for example, a hard resin material. The endoscope main body 86 can be inserted into the inner cavity of the fixed cylinder 90. The fixed cylinder 90 is arranged along the longitudinal direction of the outer cylinder 22. The fixed tube 92 is a tube for fixing the fixed cylinder 90 to a predetermined position of the outer cylinder 22. The fixed tube 92 is, for example, a heat shrink tube. The method of fixing the tip portion of the endoscope main body 86 to the outer cylinder 22 can be set appropriately.

[0059] 6A, the tip end of the outer cylinder 22 includes a protrusion 94. The protrusion 94 protrudes in the tip direction (arrow X1 direction) beyond the tip opening 80 of the outer cylinder 22. As shown in FIG. 7A, the protrusion 94 protrudes radially inward from the tip end of the outer cylinder 22. The protrusion 94 is formed integrally with the outer cylinder 22.

[0060] As shown in FIG. 7B, when viewed from the axial direction of the outer tube 22, the protrusion 94 faces the distal end opening 80 of the outer tube 22. In the plan view of the outer tube 22 shown in FIG. 3, the protrusion 94 and the first support portion 26 (base end support portion 34) face each other at a position (second position) where the first support portion 26 is exposed from the tip of the outer tube 22 in the distal direction. The first support portion 26 and the protrusion 94 are arranged to face each other about the axis of the outer tube 22 (see FIG. 4). Note that the protrusion 94 may protrude only in the distal direction from the tip of the outer tube 22, or a part of the protrusion 94 may extend from the tip of the outer tube 22 in the proximal direction and be arranged in the lumen 78.

[0061] As shown in FIG. 6A, the protrusion 94 includes a base 96 and a vertical wall 98. As shown in FIG. 7A, the base 96 is provided on the upper part of the protrusion 94. As shown in FIG. 7B, the base 96 is disposed on the upper part of the tip of the outer tube 22. The base 96 extends in a width direction perpendicular to the protruding direction of the protrusion 94. The base 96 has a curved shape along the peripheral wall 22A of the outer tube 22. For example, the base 96 is formed with the same radius as the peripheral wall 22A of the outer tube 22. The base 96 may be formed with a radius different from that of the peripheral wall 22A of the outer tube 22. As shown in FIG. 3, the tip of the base 96 has a first curved portion 100. The first curved portion 100 is formed in a circular arc shape that is convex toward the tip.

[0062] As shown in FIG. 7B, the vertical wall portion 98 protrudes downward relative to the base portion 96. In the width direction of the protrusion portion 94, the vertical wall portion 98 is provided at the center of the base portion 96. That is, the vertical wall portion 98 protrudes radially inward from the inner surface of the center of the width direction of the base portion 96. As shown in FIG. 7A, the vertical wall portion 98 extends linearly along the axial direction of the outer tube 22. The vertical wall portion 98 is a plate-like portion extending in the protruding direction of the protrusion portion 94. In the axial direction of the outer tube 22, the base end 98A of the vertical wall portion 98 is disposed at the same position as the tip opening 80 of the outer tube 22. As shown in FIG. 6B, the base end 98A of the vertical wall portion 98 is formed in a tapered shape toward the base end direction (arrow X2 direction). Note that the base end 98A of the vertical wall portion 98 is not limited to being disposed at the same position as the tip opening 80 of the outer tube 22. It is sufficient that the base end 98A of the vertical wall portion 98 is disposed on the distal end side of the distal end opening 80 of the outer cylinder 22.

[0063] The vertical wall portion 98 has a partition portion 102. As shown in Fig. 7B, the vertical wall portion 98 is disposed on an imaginary line D1 that passes through the central axis of the outer cylinder 22 and extends radially outward. The vertical wall portion 98 has a fixed end 104 that is connected to the inner surface of the base portion 96, and a free end 106 that is an end portion spaced radially inward from the inner surface.

[0064] When viewed from the axial direction of the outer tube 22, the fixed end 104 of the vertical wall portion 98 and the inner surface of the base portion 96 are connected by a pair of curved portions 108. The curved portions 108 are arc-shaped and concavely recessed radially outward. When viewed from the axial direction of the outer tube 22, the base portion 96 and the vertical wall portions 98 form a protrusion portion 94 in a substantially T-shape. In the width direction (W direction) perpendicular to the protruding direction of the protrusion portion 94, the base portion 96 is formed wider than the vertical wall portions 98.

[0065] The vertical wall portion 98 is disposed radially outward of the first shaft 24 which is inserted into the inner cavity 78 of the outer cylinder 22. Specifically, a free end 106 of the vertical wall portion 98 is disposed closer to the radial center of the outer cylinder 22 than the outer circumferential surface of the first shaft 24.

[0066] As shown in FIG. 7A, in the protruding direction of the protrusion 94, the tip of the vertical wall 98 and the tip of the base 96 are at the same position. The tip of the vertical wall 98 has a second curved portion 110. The second curved portion 110 is connected to the tip of the first curved portion 100 and curves radially inward toward the base end direction (arrow X2 direction). The second curved portion 110 is formed in a substantially arc shape that is convex toward the tip direction. That is, the vertical wall 98 has an upper end (fixed end 104) connected to the base 96 disposed at the most distal end direction (arrow X1 direction). The base end 98A of the vertical wall 98 is disposed at the same position as the tip opening 80 of the outer tube 22. Note that, as shown by the virtual line in FIG. 7A, the vertical wall 98 may extend to the inner cavity 78 of the outer tube 22, and the base end 98A of the vertical wall 98 may be disposed in the inner cavity 78. A base end 98A of the vertical wall portion 98 may be in contact with the inner peripheral surface of the outer cylinder 22, or may be spaced apart from the inner peripheral surface of the outer cylinder 22.

[0067] The first and second curved portions 100, 110 are not limited to a curved shape that is convex toward the distal end, but may be formed in a tapered shape toward the distal end.

[0068] Next, a method for transferring the medical sheet 300 to a treatment target part of a living body will be described. Specifically, as shown in Fig. 15 to Fig. 18, a method for transferring the medical sheet 300 to a transplant target part 402 of a heart 400 (treatment target part of a living body) by thoracoscopic surgery will be described. As shown in Fig. 8, the transfer method according to this embodiment includes a preparation step, a sheet placement step, a storage step, a positioning step, a deployment step, a movement step, and a removal step.

[0069] First, in a preparation step (step S1), the transfer device 10 according to the present embodiment described above is prepared. In the following, the state shown in FIG. 1 will be described as the initial state of the transfer device 10. In the initial state, the first and second shafts 24, 48 are moved in the distal direction (arrow X1 direction) relative to the outer tube 22, and the first support portion 26 and the second support portion 50 are in a protruding position (second position) protruding in the distal direction from the distal opening 80 of the outer tube 22. Each of the first and second support portions 26, 50 is exposed in the distal direction from the outer tube 22 and deployed, and the second support portion 50 is disposed on the first support surface 261 of the first support portion 26. That is, the second support portion 50 is disposed in a retracted position overlapping the first support surface 261 of the first support portion 26. At this time, the base end portion of the carrier holding portion 54 is inserted into the first inner cavity 28 of the first shaft 24.

[0070] Next, in the sheet placement step (step S2), as shown in Fig. 9, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. Note that, as shown in Fig. 10, the medical sheet 300 protrudes outward from the second support part 50 when placed on the second support surface 74. The first support surface 261 supports the protruding part 302 of the medical sheet 300 that protrudes outward from the second support part 50. The pair of second protrusions 40 suppress movement (displacement) of the medical sheet 300 in the width direction of the intermediate support part 36 when the medical sheet 300 is placed on the second support surface 74.

[0071] Thereafter, in a storage step (step S3 in FIG. 8), the medical sheet 300 is placed in a storage position (first position) together with the first support part 26 and the second support part 50 in the outer cylinder 22. Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the base end direction (the direction of the arrow X2) relative to the outer cylinder 22.

[0072] As shown in FIG. 11, with the relative movement of the first and second carrier members 18, 20 relative to the outer tube 22 in the proximal direction, the base end support portion 34 of the first support portion 26 is drawn in the proximal direction from the tip opening 80 of the outer tube 22. At this time, both sides of the base end support portion 34 come into contact with the inner surface of the base portion 96 of the protruding portion 94, so that a force acts on the base end support portion 34 to curl the base end support portion 34 from the base portion 96 through the curved surface portion 108 toward the vertical wall portion 98. Therefore, the base end support portion 34 is smoothly drawn from the tip opening 80 of the outer tube 22 into the inner cavity 78 while gradually curling along the base portion 96 and the inner surface of the curved surface portion 108 and the vertical wall portion 98 in the proximal direction. At this time, the first support portion 26 is accommodated in the inner cavity 78 of the outer tube 22 from the inside of the protruding portion 94 while curling in a conical shape so that the tip side has a large diameter and the base end support portion 34 has a small diameter.

[0073] When the base end support portion 34 is deformed, a force acts on the intermediate support portion 36 to curl up along the circumferential direction of the outer tube 22, so that the intermediate support portion 36 is deformed into a cylindrical shape while being curled up along the inner surface of the outer tube 22, the base portion 96 of the protrusion portion 94, and the inner surface of the curved surface portion 108. At this time, each of the pair of first protrusions 38 is curved so that the surface 461 of the first support portion 26 is on the inside and the back surface 462 of the first support portion 26 is on the outside, so that the pair of first protrusions 38 is rolled up inward by the central vertical wall portion 98 of the protrusion portion 94 (see FIG. 12). As shown in FIG. 12, the back surfaces 462 of the intermediate portions 443 that bulge outward in a convex shape in the radial direction face each other across the vertical wall portion 98, centered on the imaginary line D2 extending in a direction perpendicular to the central axis of the outer tube 22.

[0074] As a result, the back surface 462 of the first support portion 26 is curved in close contact with the inner surface of the outer tube 22 and the inner surface of the protrusion 94, and each of the first protrusions 38 is further curved so as to fold back toward the center of the outer tube 22, and the outer edge is disposed below the free end 106 of the vertical wall portion 98. At this time, since the vertical wall portion 98 of the protrusion 94 is disposed to face the center in the width direction of the first support portion 26, the first support portion 26 is folded symmetrically across the vertical wall portion 98 and curved into a heart shape along the inner surface. As the first support portion 26 is curved and deformed, the second support portion 50 is also curved and deformed along the first support portion 26 on the inside (surface 461 side) of the first support portion 26. As the first and second support portions 26, 50 are curved and deformed, the medical sheet 300 is deformed into a shape corresponding to the shapes of the first and second support bodies 32, 72.

[0075] The heart shape refers to a generally circular shape consisting of a convexly curved shape on one side and two convexly curved shapes on the other side opposite to the one side. When a heart shape is formed in the lumen 78 of the tubular body (outer cylinder 22), the two convexly curved shapes protruding to the other side along the inner surface of the tubular body approach each other and part of the circumferential surface comes into contact with each other, so that the overall outline becomes a generally circular shape along the inner surface of the tubular body (see the shape of the first support part 26 in FIG. 12).

[0076] 11, the first and second carrier members 18, 20 are moved toward the base end relative to the outer tube 22, whereby the first support part 26, which has been curved and deformed into a heart shape at the tip of the outer tube 22, is drawn into and accommodated in the inner cavity 78 of the outer tube 22 (see FIG. 13). In the inner cavity 78 of the outer tube 22, the first support part 26 comes into contact with the inner surface of the inner cavity 78, and is accommodated in a state in which the heart shape of the first support part 26 is maintained along the inner surface.

[0077] 13, the accommodating step is completed when the entire first support part 26 is completely accommodated in the outer tube 22. The accommodated position is a position where the first shaft 24 is moved in the proximal direction (the direction of the arrow X2) relative to the outer tube 22 so that the first support part 26 is accommodated in the inner cavity 78 of the outer tube 22, and the first support part 26 is accommodated in the inner cavity 78 of the outer tube 22 in a curved and deformed state. When the accommodating step is completed, a part of the first support part 26 may protrude from the distal end opening 80 of the outer tube 22. In this case, the state where a part of the first support part 26 protrudes from the distal end opening 80 of the outer tube 22 is the first position of the first support part 26.

[0078] When the first support part 26, the second support part 50 and the medical sheet 300 are housed within the outer tube 22, the pair of first protrusions 38 are positioned further towards the tip (in the direction of arrow X1) than the pressing surface 58 of the pressing part 56 (see Figure 13) with their back surfaces 462 in contact with each other (see Figure 14).

[0079] Thereafter, in a placement step (step S4 in FIG. 8), as shown in FIG. 15, the transfer instrument 10 is inserted into the thoracic cavity 410 through the incision 409 in the chest 408. At this time, the tip of the transfer instrument 10 is positioned near the transplant target portion 402 in the heart 400, and the tip of the endoscope 14 is positioned inside the thoracic cavity 410. Note that before inserting the transfer instrument 10 into the thoracic cavity 410, a liquid supply instrument (not shown) may be connected to the connection port of the hub 52 to introduce liquid (e.g., physiological saline).

[0080] Next, in the unfolding step (step S5 in FIG. 8), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 16. Specifically, in the unfolding step, the first shaft 24 is grasped and moved toward the tip (arrow X1 direction) relative to the outer tube 22. As a result, the valve body 55 of the first shaft 24 moves the second shaft 48 together with the first shaft 24 toward the tip (arrow X1 direction). Then, the first support part 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. In the second position where the first support part 26 is unfolded, the second support part 50 and the medical sheet 300 spread out into a planar shape.

[0081] In the unfolding step, the second carrier member 20 has the second support surface 74, on which the medical sheet 300 is placed, positioned entirely above the first support surface 261. At this time, the medical sheet 300 is supported by the first support surface 261 and the second support surface 74. This makes it possible to prevent wrinkles from forming in the protruding portion 302 of the medical sheet 300 before the medical sheet 300 is transferred to the transplantation target portion 402 of the heart 400.

[0082] 17, by moving the second carrier member 20 in the distal direction (arrow X1 direction) relative to the first carrier member 18, the second support part 50 on which the medical sheet 300 is placed moves from the retracted position to the advanced position, and the second support part 50 protrudes in the distal direction (arrow X1 direction) beyond the tip of the first support part 26. Specifically, in the moving step, the second shaft 48 is moved in the distal direction relative to the first shaft 24.

[0083] As a result, the second support part 50 moves in the distal direction (direction of arrow X1) relative to the first support part 26. At this time, when the pressing surface 58 of the carrier holding part 54 (pressing part 56) presses the outer peripheral end face of the medical sheet 300 in the distal direction, the entire medical sheet 300 is positioned further distally than the first support part 26. In this moving step, the medical sheet 300 is moved above the transplant target part 402 of the heart 400, and the overhanging part 302 of the medical sheet 300 is brought into contact with the transplant target part 402.

[0084] Then, in the removal step (step S7 in FIG. 8), as shown in FIG. 18, the second carrier member 20 is moved from the second position to the first position to remove the second support part 50 from between the transplantation target part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation target part 402. This completes the transfer of the medical sheet 300 to the transplantation target part 402. Thereafter, the transferring instrument 10 is removed from the chest 408 with the first support part 26 and the second support part 50 housed within the outer cylinder 22.

[0085] This embodiment provides the following advantages.

[0086] As shown in FIG. 6A, the tip of the outer tube 22 in the transfer device 10 is provided with a protrusion 94 that protrudes in the tip direction beyond the tip opening 80 of the outer tube 22 and protrudes radially inward of the outer tube 22. The protrusion 94 has a base 96 disposed at the top of the tip of the outer tube 22 and a vertical wall 98 that protrudes downward from the base 96. As a result, as shown in FIG. 1, by moving the first support part 26 relative to the outer tube 22 in the base direction from the second position in which the first support part 26 is exposed and deployed in the tip direction of the outer tube 22, the base 96 and the vertical wall 98 of the protrusion 94 can deform the first support part 26 into a predetermined curved shape. Therefore, the first support part 26 having a width W1 larger than the inner circumferential length L of the outer tube 22 can be effectively accommodated in the inner cavity 78 of the outer tube 22.

[0087] As shown in Fig. 7A, the vertical wall portion 98 is formed in a plate shape along the axial direction of the outer tube 22, and as shown in Fig. 7B, when viewed from the axial direction of the outer tube 22, has a partition portion 102 that passes through the central axis of the outer tube 22 and is disposed on a virtual line D1 extending in the radial direction of the outer tube 22. This makes it possible to increase the strength of the protrusion portion 94 compared to a configuration in which the protrusion portion 94 is formed in a frame shape, for example. The first support portion 26 comes into contact with the partition portion 102 from both sides in the width direction, and thus the first support portion 26 can be curved and deformed into a symmetrical shape centered on the partition portion 102.

[0088] The base 96 is formed to be wider than the vertical wall 98 in a width direction perpendicular to the protruding direction of the vertical wall 98. As a result, when the first support 26 is accommodated within the outer tube 22 from the second position in which the first support 26 protrudes from the outer tube 22 in the distal direction and is deployed, the wide base 96 can effectively guide the first support 26 toward the vertical wall 98 to cause it to bend and deform.

[0089] As shown in FIG. 6A, the protrusion 94 has first and second curved portions 100, 110 that are convexly curved toward the tip, so that when the tip of the outer tube 22 is inserted into the living body (the incision 409 in the chest 408) during the placement process, the protrusion 94 can be smoothly inserted into the living body.

[0090] Protrusion 94 is not limited to a configuration including arc-shaped base 96 along peripheral wall 22A of outer cylinder 22. For example, protrusion 94 may be configured to include base 961 having a pair of arc portions 951A, 951B, like protrusion 941 of conveying device 10A according to a first modified example shown in FIG 19A.

[0091] The protrusion 941 includes a base 961 and a vertical wall 981. The base 961 is connected to the upper tip of the outer tube 22. The base 961 includes a pair of arcuate portions 951A and 951B. As shown in FIG. 19B, when viewed from the axial direction of the outer tube 22, the pair of arcuate portions 951A and 951B are arranged symmetrically in the width direction with the vertical wall 981 as the center. Each of the pair of arcuate portions 951A and 951B is connected to the fixed end 104 of the vertical wall 981. The base 961 extends in the circumferential direction and width direction (W direction) of the outer tube 22 relative to the fixed end 104 of the vertical wall 981. Each of the pair of arcuate portions 951A and 951B is an arcuate shape that is convex toward the radially outward direction of the outer tube 22. When viewed from the axial direction of the outer tube 22, the protrusion 941 is substantially T-shaped.

[0092] The first modified example provides the following effects.

[0093] When the first and second carrier members 18, 20 are moved in the base direction from the second position in which the first support portion 26 is exposed in the distal direction from the distal end of the outer tube 22 and deployed, the back surface 462 of the first support portion 26 comes into contact with the inner surfaces of each of the arc portions 951A, 951B of the base portion 961. Both widthwise sides of the first support portion 26 come into contact with the inner surfaces of the arc portions 951A, 951B, so that the first support portion 26 can be smoothly deformed into a curved shape along the inner surfaces.

[0094] 20A shows a conveying device 10B according to a second modified example, which has a protrusion 942 at the tip of outer cylinder 22. Protrusion 942 protrudes in the tip direction (arrow X1 direction) from the tip of outer cylinder 22. Protrusion 942 includes a base 962 and a vertical wall portion 982 having a hollow portion 122.

[0095] As shown in Fig. 20B, the base 962 is connected to an upper tip portion of the outer tube 22 and extends in the tip direction. The vertical wall portion 982 protrudes downward from the base 962 (see Fig. 20C). The vertical wall portion 982 includes a fixed end 1042 connected to the base 962, a free end 1062 that is an end portion spaced radially inward from the fixed end 1042, a curved portion 120 that connects the fixed end 1042 and the free end 1062, and a hollow portion 122.

[0096] The fixed end 1042 extends in a distal direction from the base portion 962. The free end 1062 is disposed substantially parallel to the fixed end 1042. The free end 1062 faces the distal opening 80 of the outer cylinder 22 and points in the proximal direction.

[0097] The curved portion 120 is disposed in the distal direction (arrow X1 direction) relative to the fixed end 1042 and the free end 1062, and has a curved shape that is convex toward the distal direction. The hollow portion 122 is surrounded by the fixed end 1042, the free end 1062, and the curved portion 120. The hollow portion 122 is a space that penetrates in the width direction intersecting with the protruding direction of the protruding portion 942. The hollow portion 122 faces the distal opening 80 of the outer tube 22 at the protruding portion 942. That is, when viewed from the penetrating direction of the hollow portion 122, the protruding portion 942 is formed in a C-shaped arm shape that is open toward the base end direction.

[0098] The second modified example provides the following effects.

[0099] As shown in Figure 20B, the vertical wall portion 982 of the protrusion portion 942 has a hollow portion 122 that penetrates in a width direction that intersects with the protruding direction of the protrusion portion 942.Therefore, when the medical sheet 300 is placed on a transplant target portion 402 of a living body in the second position in which the first support portion 26 on which the medical sheet 300 is placed is exposed in the tip direction from the tip of the outer tube 22, the user can effectively view the surroundings of the transplant target portion 402 through the hollow portion 122.

[0100] A transferring device 10C according to a third modified example shown in Fig. 21A has a protrusion 943 at the tip of an outer cylinder 22. As shown in Fig. 21B, the protrusion 943 includes a base 963, a vertical wall 983, and a lumen 130 through which a medical device P can be inserted. The vertical wall 983 has a triangular shape protruding from the base 963 toward the tip. The vertical wall 983 is provided on the axis of the outer cylinder 22 and has a leading end 983A that protrudes most toward the tip.

[0101] As shown in FIG. 21C, when viewed from the axial direction of the outer tube 22, for example, the lumen 130 has a circular cross section. The cross section of the lumen 130 is not limited to a circular cross section. The cross section of the lumen 130 may have any shape that corresponds to the shape of the medical device P inserted into the lumen 130. The lumen 130 is formed along the protruding direction of the protruding portion 943. The extending direction of the lumen 130 and the axial direction of the outer tube 22 are approximately parallel. The medical device P is, for example, an endoscope 14 for checking the transplantation target portion 402 of a living body, forceps for performing a treatment on the transplantation target portion 402, a liquid supply tube for supplying liquid (physiological saline) to the transplantation target portion 402, etc. A case where the endoscope 14 is used as the medical device P will be described below.

[0102] The lumen 130 includes a first opening 1301 that opens at the most distal end 983A of the vertical wall portion 983, and a second opening 1302 that opens at the base end of the vertical wall portion 983. As shown in FIG. 21C, the first opening 1301 is disposed, for example, on the central axis of the outer tube 22. Note that the first opening 1301 is not limited to being disposed on the central axis of the outer tube 22. The first opening 1301 may be disposed at a position radially spaced from the central axis of the outer tube 22.

[0103] As shown in FIG. 21A, when the endoscope 14 is inserted into the lumen 130, the tip of the endoscope 14 having the objective lens 88 is disposed in the first opening 1301. The tip of the endoscope 14 is exposed in the tip direction of the outer tube 22 through the first opening 1301. The tip of the endoscope 14 and the forefront 983A of the vertical wall portion 983 are disposed in the same position (see FIG. 21B). Note that the present invention is not limited to the case where the tip of the endoscope 14 and the forefront 983A of the vertical wall portion 983 are disposed in the same position. For example, the tip of the endoscope 14 may be disposed in the tip direction relative to the forefront 983A of the vertical wall portion 983, and the endoscope 14 may protrude in the tip direction beyond the vertical wall portion 983.

[0104] The endoscope body 86 of the endoscope 14 is exposed to the outside of the sheath tube 22 through the second opening 1302, the inner cavity 78 of the sheath tube 22, and the side hole 132 of the sheath tube 22. The endoscope body 86 is fixed to the sheath tube 22 by a fixing member (not shown) on the outside of the sheath tube 22. Note that the endoscope 14 is not limited to a configuration in which the endoscope body 86 is exposed to the outside through the side hole 132 of the sheath tube 22. For example, the endoscope body 86 may be inserted along the inner cavity 78 of the sheath tube 22 to the base end of the sheath tube 22 and held there.

[0105] The third modified example has the following effects.

[0106] 21A, the protrusion 943 has a lumen 130 extending along the protruding direction of the protrusion 943, through which the endoscope 14 (medical device P) is inserted and held. This makes it possible to hold the medical device P by utilizing the lumen 130 of the protrusion 943 of the outer tube 22, thereby eliminating the need for a holding member for holding the medical device P, thereby reducing the manufacturing cost of the transfer device 10C and making it smaller and lighter.

[0107] 21B, the tip of the lumen 130 opens at the most distal end 983A of the vertical wall portion 983 of the protrusion 943, and since the medical device P is the endoscope 14, the insertability of the tip of the outer tube 22 can be effectively improved when inserting the transportation instrument 10C into the living body (inside the thoracic cavity 410 of the chest 408) in the placement step. When the medical sheet 300 is placed on the transplantation target portion 402 of the living body, the periphery of the transplantation target portion 402 can be effectively confirmed by the endoscope 14.

[0108] A delivery device 10D according to a fourth modified example shown in FIG. 22A has a protrusion 944 at the tip of the outer tube 22. The protrusion 944 includes a base 964, a vertical wall 984, and a lumen 130. The vertical wall 984 has an arc-shaped curved shape protruding from the peripheral wall 22A of the outer tube 22 toward the axis of the outer tube 22 in the tip direction (see FIG. 22B). As shown in FIG. 22B, the lumen 130 includes a first opening 1301 that opens at the base 964 and a second opening 1302 that opens at the base end of the base 964. The first opening 1301 is spaced radially outward from the central axis of the outer tube 22 (see FIG. 22C).

[0109] 22A, when the endoscope 14 is inserted into the lumen 130, the tip of the endoscope 14 is disposed in the first opening 1301. The tip of the endoscope 14 is exposed in the tip direction of the outer tube 22 through the first opening 1301. The tip of the endoscope 14 is disposed in the tip direction relative to the base 964. The tip of the endoscope 14 protrudes in the tip direction from the base 964. Note that this is not limited to the case where the tip of the endoscope 14 is disposed in the tip direction from the base 964. For example, the first opening 1301 of the base 964 and the tip of the endoscope 14 may be disposed at the same position.

[0110] The fourth modified example has the following effects.

[0111] 22A, the tip of the lumen 130 has a first opening 1301 that opens into the base 964 of the protrusion 944, and by using the endoscope 14 as the medical device P, the endoscope 14 can be disposed at the tip of the outer tube 22. Therefore, when the outer tube 22 is inserted into a living body, the transplant target part 402 can be effectively confirmed by the endoscope 14. A wide field of view can be secured when the transplant target part 402 and the first support part 26 of the living body are confirmed by the endoscope 14.

[0112] The present invention is not limited to the above disclosure, and various configurations can be adopted without departing from the gist of the present invention. [Explanation of symbols]

[0113] 10, 10A, 10B, 10C, 10D…transfer equipment 18...First carrier member 22…Outer cylinder 24…First shaft 26…First support part 80…Tip opening 94, 941, 942, 943, 944...Protrusion 96, 961, 962, 963, 964...Base 98, 981, 982, 983, 984...Vertical wall part 300…Medical sheets 402…Transplant target area

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, An outer cylinder having a tip opening; a carrier member including a shaft extending in an axial direction of the outer cylinder and disposed inside the outer cylinder so as to be movable along the axial direction, and a sheet-shaped support portion disposed at a tip end of the shaft; a protrusion provided at a tip end of the outer cylinder, protruding in a tip direction beyond the tip opening and protruding radially inward of the outer cylinder; Equipped with The protrusion has a base portion disposed on an upper tip portion of the outer cylinder, A vertical wall portion protruding downward from the base portion; having the support portion includes a support surface capable of holding the medical sheet, and a width of the support portion in a direction perpendicular to an extension direction of the shaft is greater than an inner peripheral length of the outer tube, At a first position where the shaft is moved in a proximal direction relative to the outer cylinder so that the support portion is accommodated in the outer cylinder, the support portion is accommodated in the outer cylinder in a curved and deformed state, At a second position where the shaft is moved in the distal direction relative to the outer tube so that the support portion protrudes from a distal opening of the outer tube, the support portion is exposed in the distal direction from the outer tube and deployed, a transfer device in which the support portion of the transfer device protrudes in the tip direction from the tip portion of the outer tube, and when the support portion is moved relative to the outer tube in the base end direction with the medical sheet placed on the support portion, the protrusion portion guides the support portion toward the tip opening of the outer tube and deforms the support portion into a curved shape so that both widthwise sides of the support portion protrude toward the support surface.

2. 2. The transfer device of claim 1, A transfer device having a partition portion formed in a plate shape along the axial direction of the outer tube, and when viewed from the axial direction of the outer tube, which partition portion passes through the central axis of the outer tube and is positioned on an imaginary line extending radially of the outer tube.

3. 2. The transfer device of claim 1, A transfer device, wherein the vertical wall portion has a hollow portion penetrating in a width direction intersecting with a protruding direction of the protrusion portion.

4. 4. The transfer device according to claim 2 or 3, A transfer device, wherein the base portion is formed wider than the vertical wall portion in a width direction perpendicular to a protruding direction of the vertical wall portion.

5. 4. The transfer device according to claim 2 or 3, A delivery device, wherein the protrusion has a curved portion that is convexly curved toward a tip end.

6. 3. The transfer device of claim 2, The protrusion has a lumen extending along a protruding direction of the protrusion and through which a medical device is inserted and held.

7. 7. The transfer device of claim 6, A delivery instrument, wherein a tip of the lumen opens into the vertical wall portion of the protrusion, and the medical instrument is an endoscope.

8. 7. The transfer device of claim 6, A delivery instrument, wherein a distal end of the lumen opens into the base of the projection, and the medical instrument is an endoscope.

9. 2. The transfer device of claim 1, A transfer device, wherein a base end of the vertical wall portion is provided at the same position as a tip opening of the outer tube in the axial direction or further distal than the tip opening.

Images