Transfer equipment and operation method thereof

Abstract

To transfer a medical sheet to a treatment object part more efficiently in transfer equipment for transferring a medical sheet (cell sheet) to a treatment object part of a living body.SOLUTION: Transfer equipment 10 includes an external cylinder 22 and a first carrier member 18 having a shaft 24, and a sheet-like support part 26. The support part 26 can hold a medical sheet 300 larger than the support part 26 in a width direction orthogonal to an axial direction of the external cylinder 22. In a state that the support part 26 is housed in the external cylinder 22 and is deformed into a curved shape, the support part 26 can hold the medical sheet 300 so that a portion protruding from the support part 26 of the medical sheet 300 comes in contact with other portions of the medical sheet 300.SELECTED DRAWING: Figure 11

Description

[Technical field]

[0001] The present invention relates to a delivery device and a method of operating the same. [Background technology]

[0002] Patent Document 1 discloses a transfer device for transferring a medical sheet (cell sheet) used, for example, in organ transplantation to a treatment target part of a living body. This transfer device comprises an outer tube, a sliding member slidably supported within the outer tube, and a sheet support member provided at the tip of the sliding member. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2009-000511 A Summary of the Invention [Problem to be solved by the invention]

[0004] It is desirable to more efficiently transport medical sheets to the treatment site. [Means for solving the problem]

[0005] (1) A first 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; 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; and a carrier member having a sheet-like support part disposed at the tip of the shaft and including a support surface capable of holding the medical sheet, the support part being capable of holding the medical sheet which is larger than the support part in a width direction perpendicular to the axial direction of the outer tube; and the shaft being moved in a direction perpendicular to the axial direction of the outer tube so that the support part is accommodated within the outer tube. This is a transfer device in which, at a first position where the shaft is moved in a base end direction relative to the outer tube, the support part is contained within the outer tube in a curved and deformed state, and at a second position where the shaft is moved in a distal direction relative to the outer tube so that the support part protrudes from the distal opening of the outer tube, the support part unfolds by being exposed in the distal direction from the outer tube, and when the support part is contained within the outer tube and curved and deformed, the support part is capable of holding the medical sheet such that the portion of the medical sheet protruding from the support part contacts other portions of the medical sheet.

[0006] With this configuration, the support portion can be curved and deformed and housed within the outer tube. This allows the device (transport instrument) to be made thinner and less invasive. In addition, a medical sheet that is wider than the support portion can be housed within the outer tube, making it possible to more effectively reduce the diameter and make the device less invasive. This transport instrument therefore allows the medical sheet to be efficiently transported to the treatment target area. In addition, different parts of the medical sheet come into contact with each other while the medical sheet is housed within the outer tube, making it easier to properly retain moisture in the medical sheet.

[0007] (2) In the transfer device described in (1) above, the support part may be capable of holding the medical sheet such that when the support part is contained within the outer cylinder and curved and deformed, the portions of the medical sheet protruding from both sides of the support part in the width direction are in contact with each other. This configuration makes it possible to more effectively achieve a thinner device and less invasiveness.

[0008] (3) In the transfer device described in (2) above, the support part may be capable of holding the medical sheet such that, when the support part is contained within the outer cylinder and curved and deformed, the portions of the medical sheet protruding from both sides of the support part in the width direction come into contact with the portions of the medical sheet supported by the support surface. This configuration makes it possible to more effectively achieve a thinner device and less invasiveness.

[0009] (4) In the transferring device described in any one of (1) to (3) above, when the support part is in a state where it protrudes from the tip opening of the outer tube and is deployed, the support part may be formed in a corrugated shape in a cross section along the width direction of the support part, and when the support part is contained within the outer tube and is curved and deformed, at least a part of the corrugated shape of the support part may be curved so as to bulge toward the inside of the outer tube. A support part configured in this manner may hold a medical sheet having a larger width.

[0010] (5) A second aspect of the present invention is a method for operating a transfer instrument for transferring a medical sheet to a treatment target part of a living body, the transfer instrument comprising: an outer tube; a shaft extending in the axial direction of the outer tube and disposed inside the outer tube movably along the axial direction; and a carrier member having a sheet-like support portion disposed at the tip of the shaft and including a support surface capable of holding the medical sheet, the support portion being capable of holding the medical sheet which is larger than the support portion in a width direction perpendicular to the axial direction of the outer tube; and at a first position where the shaft is moved in a base end direction relative to the outer tube so that the support portion is contained within the outer tube, the support portion is contained within the outer tube in a curved and deformed state, and the support portion is disposed at a first position where the shaft is moved in a base end direction relative to the outer tube so that the support portion is contained within the outer tube. At a second position where the shaft has been moved in a distal direction relative to the outer tube so that the holding portion protrudes from the distal opening of the outer tube, the support portion unfolds by being exposed in the distal direction from the outer tube, and the operating method includes a loading step of placing the medical sheet on the support surface with the support portion positioned at the second position, and a accommodating step of accommodating the support portion within the outer tube by moving the support portion from the second position to the first position relative to the outer tube with the medical sheet placed on the support surface, wherein when the support portion is accommodated within the outer tube and curved and deformed, the portion of the medical sheet protruding from the support portion is in contact with other portions of the medical sheet. Effect of the Invention

[0011] According to the present invention, the support part can be curved and deformed and housed inside the outer cylinder. This allows the device (transport instrument) to be made thinner and less invasive. In addition, a medical sheet that is wider than the support part can be housed inside the outer cylinder, which makes it possible to more effectively achieve a thinner device and less invasiveness. Thus, the transport instrument allows the medical sheet to be efficiently transported to the treatment target area. In addition, different parts of the medical sheet come into contact with each other while the medical sheet is housed inside the outer cylinder, which makes it easier to properly retain moisture in the medical sheet. [Brief description of the drawings]

[0012] [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. 6 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 7] FIG. 7 is an explanatory diagram of the sheet placing step. [Figure 8] FIG. 8 is an explanatory diagram of the accommodation step. [Figure 9] FIG. 9 is a cross-sectional view taken along line IX-IX in FIG. [Figure 10] FIG. 10 is an explanatory diagram of the placement process. [Figure 11] FIG. 11 is an explanatory diagram of the development process. [Figure 12] FIG. 12 is an explanatory diagram of the movement process. [Figure 13] FIG. 13 is an explanatory diagram of the removal step. [Figure 14] Fig. 14A is a plan view of a first support part according to a modified example, and Fig. 14B is a cross-sectional view taken along the width direction of the first support part. [Figure 15] FIG. 15 is a cross-sectional view of a state in which a first support part according to a modified example is housed in an outer cylinder together with a second support part and a medical sheet. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] 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 Fig. 12). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

[0014] 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).

[0015] 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.

[0016] 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.

[0017] 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.

[0018] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0019] 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.

[0020] 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.

[0021] 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 in the body cavity and can retain the bent shape. As shown in Figs. 2 to 4, the first support portion 26 is attached to the tip portion of the first shaft 24. The first support portion 26 is made of, for example, a resin material. The first support portion 26 can hold a medical sheet 300. The first support portion 26 is formed by folding a flexible resin sheet material (film material) into a predetermined shape. The first support portion 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 portion 26 has a first joint portion 30 and a first support body 32.

[0022] 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.

[0023] 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.

[0024] 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.

[0025] As shown in Fig. 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 (see Fig. 2). 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).

[0026] 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.

[0027] 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).

[0028] 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.

[0029] 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.

[0030] 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).

[0031] 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.

[0032] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0033] 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.

[0034] 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.

[0035] 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.

[0036] 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.

[0037] 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. 12).

[0038] 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.

[0039] 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.

[0040] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0041] 1 and 2, the outer tube 22 is a cylindrical member having a cavity 78. The cavity 78 has a tip opening 80 that opens at the tip (end in the direction of arrow X1) of the outer tube 22. The cavity 78 opens at the base end (end in the direction of arrow X2) of the outer tube 22. The outer tube 22 is flexible. The outer tube 22 may be made of the same material as the first shaft 24 described above. The first shaft 24 is inserted into the cavity 78 of the outer tube 22. The length of the outer tube 22 in the axial direction is shorter than the length of the first shaft 24 in the axial direction. The base end of the outer tube 22 is provided with an airtight valve body 84 that is in close contact with the outer circumferential surface of the first shaft 24.

[0042] 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.

[0043] 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.

[0044] 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.

[0045] 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. 9). 9, 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. As shown in FIG. 1, the first support part 26 is capable of holding a medical sheet 300 that is larger than the first support part 26 in the width direction (W direction) perpendicular to the axial direction of the outer cylinder 22. The width W2 of the medical sheet 300 shown in this embodiment is larger than the width W1 of the first support part 26. When the medical sheet 300 is circular, the width W2 is the diameter of the medical sheet 300.

[0046] 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. 10 to Fig. 13, 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. 6, 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.

[0047] 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 shaft 24 and the second shaft 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.

[0048] Next, in the sheet placement step (step S2), as shown in Fig. 7, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. When placed on the second support surface 74, the medical sheet 300 overhangs outward from the second support part 50. The first support surface 261 supports the overhanging part 302 of the medical sheet 300 that overhangs outward from the second support part 50. Since the width W2 of the medical sheet 300 is greater than the width W1 of the first support part 26 (see Fig. 1), as shown in Fig. 7, when the medical sheet 300 is placed on the first support part 26, both ends in the width direction of the medical sheet 300 overhang both ends of the first support part 26.

[0049] Thereafter, in the accommodation step (step S3 in FIG. 6), the medical sheet 300 is accommodated in the outer cylinder 22 together with the first support part 26 and the second support part 50 to a accommodated position (first position) as shown in FIG. 8. 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.

[0050] Then, the base end support portion 34 (see FIG. 2) of the first support portion 26 is drawn in the base end direction from the tip opening 80 of the outer tube 22. At this time, the tapered both sides of the base end support portion 34 come into contact with the tip opening 80 of the outer tube 22, so that a force acts on the base end support portion 34 to curl the base end support portion 34 along the circumferential direction of the outer tube 22. Therefore, the base end support portion 34 is smoothly drawn into the outer tube 22 while curling. At this time, the first support portion 26 is accommodated in the outer tube 22 while curling into a cone shape such that the tip side has a large diameter and the base end support portion 34 has a small diameter.

[0051] When the base end support portion 34 of the first support portion 26 is deformed, a force acts on the middle support portion 36 of the first support portion 26 to curl up along the circumferential direction of the outer tube 22, so that the middle support portion 36 (see FIG. 2) is drawn into the outer tube 22 while curling up. At this time, the middle support portion 36 is deformed into a cylindrical shape along the inner surface of the outer tube 22. 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. As shown in FIG. 9, the back surfaces 462 on both sides in the width direction of the first support portion 26 come into contact with each other on a virtual line L2 extending perpendicular to the central axis of the outer tube 22. One first protrusion 38 and the other first protrusion 38 come into contact with each other and are accommodated downward (first support surface 261, surface 461).

[0052] As a result, the back surface 462 of the first support portion 26 is curved in intimate contact with the inner surface of the outer tube 22, and each of the first protrusions 38 is further curved so as to be folded back toward the center of the outer tube 22, and the free end of each of the first protrusions 38 is disposed below the central axis of the outer tube 22. In other words, the first support portion 26 is curved into a heart shape that follows the inner surface of the outer tube 22.

[0053] 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. 9).

[0054] As the first support part 26 is curved and deformed, the second support part 50 is also curved and deformed along the first support part 26 on the inside (surface 461 side) of the first support part 26. As the first support part 26 and the second support part 50 are curved and deformed, the medical sheet 300 is deformed into a shape corresponding to the shapes of the first support body 32 and the second support body 72, and the medical sheet 300 is contained within the outer cylinder 22.

[0055] As shown in Fig. 9, when the first support part 26 is contained within the outer cylinder 22 and curved, the portions of the medical sheet 300 protruding from the first support part 26 come into contact with other portions of the medical sheet 300. In the example shown in Fig. 9, the medical sheet 300 has portions protruding from both sides in the width direction of the first support part 26 (hereinafter also referred to as "protruding parts 304"), and the protruding parts 304 come into contact with each other. In addition, the pair of protruding parts 304 come into contact with a portion of the medical sheet 300 supported by the first support surface 261 (hereinafter also referred to as "sheet middle part 306").

[0056] When the medical sheet 300 is placed on the first support part 26, the widthwise center of the first support part 26 does not have to coincide with the widthwise center of the medical sheet 300. That is, the widthwise center of the medical sheet 300 may be shifted in the width direction (left and right direction) from the widthwise center of the first support part 26. Only one of the protruding parts 304 of the medical sheet 300 may be in contact with the sheet intermediate part 306. Both of the pair of protruding parts 304 of the medical sheet 300 may not be in contact with the sheet intermediate part 306.

[0057] A partition (not shown) protruding downward from the upper inner surface of the outer cylinder 22 may be provided inside the tip of the outer cylinder 22. The rear surfaces 462 of the pair of first protrusions 38 of the first support part 26 may contact the partition. When the first support part 26 and the medical sheet 300 are stored inside the outer cylinder 22, the partition may function as a guide part for curving and deforming the first support part 26 into a heart shape.

[0058] 8, the accommodating step is completed when the entire first support part 26 is completely inserted into the outer tube 22. When the accommodating step is completed, a part of the first support part 26 may protrude from the tip opening 80 of the outer tube 22. In this case, the state in which a part of the first support part 26 protrudes from the tip opening 80 of the outer tube 22 is the first position of the first support part 26.

[0059] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 10, 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).

[0060] Next, in the unfolding step (step S5 in FIG. 6), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 11. 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 spreads out into a planar shape.

[0061] 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.

[0062] 12, 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.

[0063] 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 distal end surface of the carrier holding part 54 (pressing part 56) presses the outer peripheral end surface of the medical sheet 300 in the distal direction, the entire medical sheet 300 is positioned in the distal direction further 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.

[0064] Then, in the removal step (step S7 in FIG. 6), as shown in FIG. 13, 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. Then, the entire medical sheet 300 comes 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.

[0065] This embodiment provides the following advantages.

[0066] Since the transfer instrument 10 includes the second carrier member 20 that is movable in the axial direction relative to the first carrier member 18, the medical sheet 300 can be transferred from the first support portion 26 to the transplantation target portion 402 of the living body by utilizing the second carrier member 20 without using any other device (forceps, etc.). Therefore, the medical sheet 300 can be efficiently transferred to the transplantation target portion 402.

[0067] 1, a sheet-like second support part 50 including a second support surface 74 capable of holding a medical sheet 300 is provided at the tip of the second shaft 48. The second support part 50 is movable relative to the first support part 26 between a retracted position where it overlaps with the first support surface 261 and an advanced position where it is positioned further distally (in the direction of arrow X1) than the first support surface 261. With this configuration, the medical sheet 300 can be moved along the first support surface 261 of the first support part 26 by the second support part 50 having the second support surface 74.

[0068] 9, in the accommodated position (first position), the second support part 50 is curved and deformed together with the first support part 26 and accommodated inside the outer tube 22. With this configuration, even if the second support part 50 has a width dimension larger than the width (thickness) of the second shaft 48, the second support part 50 can be suitably accommodated together with the first support part 26 inside the outer tube 22 in the accommodating step.

[0069] The first support part 26 is formed of a flexible sheet having a surface 461 and a back surface 462. The first support part 26 has a pair of first protrusions 38 that protrude upward from both sides in the width direction of the first support surface 261 perpendicular to the moving direction of the first shaft 24. With this configuration, when the first support part 26 is accommodated in the outer tube 22, the back surfaces 462 of the first protrusions 38 that are curved and deformed into a convex shape come into contact with each other. The pair of first protrusions 38 are displaced toward the first support surface 261, and the first support part 26 is curved and deformed into a heart shape. As a result, the first support part 26 can be accommodated in the outer tube 22 in a heart shape, and therefore damage to the medical sheet 300 held by the first support part 26 can be effectively suppressed compared to a case in which the first support part 26 is deformed into a shape other than a heart shape. Furthermore, because the first support portion 26 can be smoothly and compactly housed within the outer cylinder 22, the diameter of the outer cylinder 22 can be made smaller than in a configuration in which the first support portion 26 is not curved and deformed into a heart shape.

[0070] The first support part 26 can hold the medical sheet 300 such that the part of the medical sheet 300 protruding from the first support part 26 (protruding part 304) contacts other parts of the medical sheet 300 when the first support part 26 is accommodated in the outer tube 22 and curved. With this configuration, the first support part 26 can be curved and accommodated in the outer tube 22. This allows the device (transfer instrument 10) to be narrower and less invasive. In addition, the medical sheet 300, which is wider than the first support part 26, can be accommodated in the outer tube 22, so that the device can be made narrower and less invasive more effectively. Therefore, the transfer instrument 10 allows the medical sheet 300 to be efficiently transferred to the transplantation target part 402 (treatment target part). In addition, since different parts of the medical sheet 300 contact each other when the medical sheet 300 is accommodated in the outer tube 22, the moisture of the medical sheet 300 is easily retained appropriately.

[0071] When the first support part 26 is accommodated in the outer tube 22 and curved, the first support part 26 can hold the medical sheet 300 so that the parts of the medical sheet 300 protruding from both sides in the width direction of the first support part 26 (protruding parts 304) come into contact with each other. With this configuration, it is possible to more effectively achieve a thinner device and less invasiveness.

[0072] When the first support part 26 is contained within the outer tube 22 and curved, the first support part 26 can hold the medical sheet 300 such that the parts of the medical sheet 300 protruding from both sides in the width direction of the support part (protruding parts 304) come into contact with the part of the medical sheet 300 supported by the first support surface 261 (sheet middle part 306). With this configuration, it is possible to more effectively achieve a thinner device and less invasiveness.

[0073] Instead of the above-mentioned first support portion 26, a first support portion 26A shown in Fig. 14A and Fig. 14B may be adopted. When the first support portion 26A is projected from the tip opening 80 (see Fig. 1) of the outer tube 22 and deployed, the first support portion 26A is formed in a wave shape in a cross section along the width direction (W direction) of the first support portion 26A. Note that in Fig. 14A, the second support portion 50 and the medical sheet 300 are omitted from illustration. As shown in Fig. 14B, the first support portion 26A has a downward curved convex portion 264 that is curved to be convex downward at the center in the width direction, and a pair of upward curved convex portions 266 that are curved to be convex upward on both sides of the downward curved convex portion 264. A pair of first protrusions 38 are provided on the outer side in the width direction of the pair of upward curved convex portions 266.

[0074] As shown in Fig. 15, when the first support portion 26A is accommodated in the outer tube 22 and curved and deformed, at least a part of the corrugated shape of the first support portion 26A curves so as to bulge toward the inside of the outer tube 22. In the example shown in Fig. 15, a pair of upward curved convex portions 266 curve so as to bulge toward the inside of the outer tube 22 (the space between the first protruding portion 38 and a portion 268 of the first support portion 26A that curves along the inner surface of the outer tube 22). The medical sheet 300 and the second support portion 50 are also curved along the curved shape of the first support portion 26A. The sheet middle portion 306 of the medical sheet 300 is supported by the downward curved convex portions 264 of the first support portion 26A and contacts a pair of protruding portions 304 of the medical sheet 300.

[0075] The first support portion 26A configured as described above is formed in a corrugated shape, and is therefore capable of holding a medical sheet 300 having a larger width.

[0076] 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]

[0077] 10…Transfer device 18...First carrier member 20...Second carrier member 22…Outer cylinder 24…First shaft 26, 26A...1st support part 48…Second shaft 261...1st support surface 300…Medical sheets 304…Protruding part 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, 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-like support portion disposed at a tip of the shaft and including a support surface capable of holding the medical sheet; Equipped with the support portion is capable of holding the medical sheet which is larger than the support portion in a width direction perpendicular to the axial direction of the outer cylinder, 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 a 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 part is capable of holding the medical sheet such that when the support part is contained within the outer tube and curved and deformed, the portion of the medical sheet that protrudes from the support part contacts other portions of the medical sheet.

2. 2. The transfer device of claim 1, A transfer device in which, when the support part is contained within the outer tube and curved and deformed, the support part is capable of holding the medical sheet such that portions of the medical sheet protruding from both sides of the support part in the width direction are in contact with each other.

3. 3. The transfer device of claim 2, A transfer device in which, when the support part is contained within the outer tube and curved and deformed, the support part is capable of holding the medical sheet such that the portions of the medical sheet extending beyond both sides of the support part in the width direction contact the portions of the medical sheet supported by the support surface.

4. 2. The transfer device of claim 1, When the support portion is extended and protrudes from the tip opening of the outer cylinder, the support portion is formed in a wave shape in a cross section along a width direction of the support portion, A transfer device in which, when the support portion is contained within the outer tube and curved and deformed, at least a portion of the wavy shape of the support portion curves so as to bulge toward the inside of the outer tube.

5. A method for operating a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: The transfer device includes: An outer cylinder, 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-like support portion disposed at a tip of the shaft and including a support surface capable of holding the medical sheet; Equipped with the support portion is capable of holding the medical sheet which is larger than the support portion in a width direction perpendicular to the axial direction of the outer cylinder, 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 a 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, The method of operation includes: a sheet placing step of placing the medical sheet on the support surface with the support portion positioned at the second position; and an accommodating step of accommodating the support part in the outer cylinder by moving the support part from the second position to the first position with respect to the outer cylinder with the medical sheet placed on the support surface, A method of operating a transfer device, in which the support part is contained within the outer tube and curved and deformed, and a portion of the medical sheet protruding from the support part is in contact with other portions of the medical sheet.

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