Transfer equipment

Abstract

To provide transfer equipment for transferring a medical sheet to a treatment object part of a living body more efficiently.SOLUTION: In transfer equipment 10, a reflection part 100 capable of irregularly reflecting light is provided on a second support surface 74 of a second support part 50. The reflection part 100 irregularly reflects light when a medical sheet 300 is not supported on the second support surface 74. The reflection part 100 suppresses irregular reflection of light when the medical sheet 300 is supported on the second support surface 74 and a moisture 110 invades into a gap between the medical sheet 300 and the second support surface 74.SELECTED DRAWING: Figure 8

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 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) 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: a first carrier member including a first shaft and a first support part provided at a tip of the first shaft and having a first support surface; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a second support part provided at a tip of the second shaft and having a second support surface smaller than the first support surface; and the medical sheet, the first support part, and the second support part are transmissible to light from outside. the first support surface is a surface of the first support part facing the second support part, the second support surface is a surface of the second support part opposite to the surface facing the first support surface, the second support surface is provided with a reflecting portion capable of diffusely reflecting the light, and the reflecting portion diffusely reflects the light when the medical sheet is not supported on the second support surface, and suppresses the diffuse reflection of the light when the medical sheet is supported on the second support surface and moisture has penetrated into the gap between the medical sheet and the second support surface.

[0006] With this configuration, by moving the second shaft along the first shaft while the medical sheet is supported on the second support surface, the medical sheet can be efficiently transported to the area to be treated.

[0007] Furthermore, with this configuration, when the medical sheet is not supported on the second support surface, the reflecting portion diffuses light irradiated onto the second support surface from the outside. By visually checking the light diffusely reflected by the reflecting portion, the user can easily determine that the medical sheet is erroneously supported between the first support portion and the second support portion.

[0008] Furthermore, when the medical sheet is supported on the second support surface and moisture has entered the gap between the medical sheet and the second support surface, the reflecting portion suppresses diffuse reflection of light irradiated onto the second support surface from the outside, thereby allowing the light to pass through the reflecting portion and making it possible to observe the treatment target area located below the first support surface via the second support portion.

[0009] In this manner, by using the reflecting portion, it is possible to easily determine whether or not the medical sheet is correctly supported on the second supporting portion.

[0010] (2) In the conveying device described in (1) above, the reflecting portion may be an uneven portion formed on the second support surface.

[0011] According to this configuration, when the medical sheet is not supported by the second support surface, the uneven portion serving as the reflecting portion diffuses light irradiated from the outside onto the second support surface. By visually recognizing the diffusely reflected light, the user can easily determine that the medical sheet has been erroneously placed between the first support portion and the second support portion.

[0012] (3) In the transportation device described in (2) above, the uneven portion may be a diffraction grating provided on the second support surface.

[0013] According to this configuration, when the medical sheet is not supported by the second support surface, the diffraction grating, which is the uneven portion, generates diffracted light due to light externally irradiated onto the second support surface by a diffraction phenomenon. By visually recognizing the diffracted light, the user can easily determine that the medical sheet has been erroneously placed between the first support part and the second support part.

[0014] (4) In the transportation device according to any one of (1) to (3) above, the reflecting portion may be a hologram provided on the second support surface.

[0015] According to this configuration, when the medical sheet is not supported by the second support surface, the hologram reflecting portion reproduces a hologram image by light externally irradiated onto the second support surface. By visually recognizing the hologram image, a user can easily determine that the medical sheet has been erroneously placed between the first support portion and the second support portion. Effect of the Invention

[0016] According to the present invention, by moving the second shaft along the first shaft while the medical sheet is supported on the second support surface, the medical sheet can be efficiently transported to the area to be treated.

[0017] Furthermore, according to the present invention, when the medical sheet is not supported on the second support surface, the reflecting portion diffuses light irradiated from the outside onto the second support surface. By visually checking the light diffusely reflected by the reflecting portion, a user can easily determine that the medical sheet is erroneously supported between the first support portion and the second support portion.

[0018] Furthermore, when the medical sheet is supported on the second support surface and moisture has entered the gap between the medical sheet and the second support surface, the reflecting portion suppresses diffuse reflection of light irradiated onto the second support surface from the outside, thereby allowing the light to pass through the reflecting portion and making it possible to observe the treatment target area located below the first support surface via the second support portion.

[0019] In this manner, by using the reflecting portion, it is possible to easily determine whether or not the medical sheet is correctly supported on the second supporting portion. [Brief description of the drawings]

[0020] [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 a first explanatory diagram showing the correct arrangement of the medical sheet in the sheet placing step. [Figure 8] FIG. 8 is a second explanatory diagram showing the correct placement of the medical sheet in the sheet placing step. [Figure 9] FIG. 9 is a third explanatory diagram showing the correct placement of the medical sheet in the sheet placing step. [Figure 10] FIG. 10 is an explanatory diagram showing an incorrect placement of the medical sheet in the sheet placement process. [Figure 11] FIG. 11 is an explanatory diagram 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 an explanatory diagram of the arrangement process. [Figure 14] FIG. 14 is an explanatory diagram of the development process. [Figure 15] FIG. 15 is an explanatory diagram of the movement process. [Figure 16] FIG. 16 is an explanatory diagram of the removal step. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] 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. 13 to 16). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

[0022] 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).

[0023] 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.

[0024] 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.

[0025] 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.

[0026] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0027] 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.

[0028] 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 material of the first shaft 24 is not particularly limited, but may include polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyether ether ketone, polyvinyl chloride, ABS resin, polyamide elastomer, polyester elastomer, etc. The first shaft 24 may be made of a metal material.

[0029] 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.

[0030] As shown in Figs. 2 to 4, the first support part 26 is attached to the tip part 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.

[0031] 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.

[0032] 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.

[0033] 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.

[0034] 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).

[0035] 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.

[0036] 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).

[0037] 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.

[0038] 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.

[0039] 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).

[0040] 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.

[0041] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0042] 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.

[0043] 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.

[0044] 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 within the outer tube 22.

[0045] 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.

[0046] 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. 15).

[0047] 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.

[0048] The second support body 72 extends from the second joint 70 in the distal 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 on which the medical sheet 300 is placed is provided on the upper surface of the second support body 72. 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.

[0049] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0050] 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.

[0051] 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.

[0052] 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.

[0053] 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.

[0054] 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.

[0055] 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 the first 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. 12). 12, 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.

[0056] 1, in this embodiment, the medical sheet 300, the first support part 26, and the second support part 50 are each made of a material that is transmissible to external light (for example, light irradiated from the endoscope body 86). For example, it is desirable that the second support part 50 be made of the same material as the first support part 26.

[0057] 2, 4, and 5, the first support surface 261 is an upper surface of the first support portion 26. The first support surface 261 is a surface of the first support portion 26 that faces the second support portion 50. The second support surface 74 is an upper surface of the second support portion 50. The second support surface 74 is a surface of the second support portion 50 opposite to a lower surface that faces the first support surface 261.

[0058] As shown in FIGS. 1 to 3, the second support surface 74 is provided with a reflecting portion 100 capable of diffusely reflecting light.

[0059] Specifically, as shown in Fig. 4, the reflecting portion 100 is an uneven portion 104 formed on the second supporting surface 74. The uneven portion 104 is formed on the second supporting surface 74. In the uneven portion 104, mountain-shaped unevenness with different slopes is continuous. Fig. 4 illustrates a case where mountain-shaped unevenness with different slopes is continuously formed in the tip direction on the second supporting surface 74. The uneven portion 104 can diffusely reflect light irradiated to the second supporting surface 74.

[0060] The uneven portion 104 is not limited to unevenness in the shape of a mountain with different inclinations. The uneven portion 104 may be unevenness of any shape that can diffusely reflect light irradiated from the outside onto the second supporting surface 74. The uneven portion 104 may be formed on the second supporting surface 74 by forming at least one unevenness on the second supporting surface 74. Furthermore, the uneven portion 104 may be formed on the second supporting surface 74 in any direction.

[0061] Furthermore, the uneven portion 104 may be formed on the second support surface 74 by a blasting process. The uneven portion 104 is formed on the second support surface 74 by, for example, a sandblasting process. By subjecting the second support surface 74 to a sandblasting process, fine uneven portions 104 like the surface of ground glass are formed on the second support surface 74. By subjecting the second support surface 74 to a blasting process such as a sandblasting process, the uneven portion 104 can be easily formed on the second support surface 74.

[0062] The uneven portion 104 may be a diffraction grating 106 provided on the second support surface 74. The diffraction grating 106 generates diffracted light by a diffraction phenomenon when light is irradiated onto the second support surface 74. The diffracted light is light that is diffusely reflected by the diffraction grating 106. Note that the diffraction grating 106 is not limited to mountain-shaped unevenness with different inclinations. The diffraction grating 106 may have unevenness in a shape that can generate diffracted light by light irradiated onto the second support surface 74 from the outside.

[0063] The reflecting portion 100 may be a hologram 108 provided on the second supporting surface 74. The hologram 108 reproduces a hologram image when light is irradiated onto the second supporting surface 74 from the outside. The hologram image is light that is diffusely reflected by the hologram 108. In this embodiment, the uneven portion 104 or the diffraction grating 106 may be the hologram 108.

[0064] In this embodiment, it is preferable to configure the second support section 50 using, for example, a transmission type diffraction grating replica film made of a light-transmitting resin material. In the transmission type diffraction grating replica film, by making one surface on which the diffraction grating 106 is formed the second support surface 74, the reflector 100 can be easily provided on the second support surface 74.

[0065] When the medical sheet 300 is not supported on the second supporting surface 74, the reflecting portion 100 (the uneven portion 104, the diffraction grating 106, and the hologram 108) diffusely reflects light irradiated from the outside onto the second supporting surface 74, as described above. Specifically, when the medical sheet 300 is disposed between the first supporting portion 26 and the second supporting portion 50 (see FIG. 10), the reflecting portion 100 diffusely reflects light irradiated from the outside onto the second supporting surface 74.

[0066] 8, when the medical sheet 300 is supported on the second support surface 74 and moisture 110 (e.g., physiological saline) has entered the gap 109 between the medical sheet 300 and the second support surface 74, diffuse reflection of light at the reflecting portion 100 (uneven portion 104, diffraction grating 106, hologram 108) is suppressed. That is, when the gap 109 between the medical sheet 300 and the second support surface 74 is filled with moisture 110, diffuse reflection of light at the surface of the reflecting portion 100 is suppressed, and the light passes through the second support portion 50 and the first support portion 26.

[0067] The reflecting portion 100 is not limited to being provided on the second supporting surface 74 of the second supporting portion 50. In this embodiment, a light-transmitting sheet (for example, a transmission type diffraction grating replica film) may be placed on the upper surface of the second supporting portion 50, and the reflecting portion 100 may be formed on the upper surface of the sheet. In this case, the upper surface of the sheet becomes the second supporting surface 74.

[0068] Moreover, the carrier holding portion 54 has a symmetrical shape in the up-down direction with the mounting hole 60 as the center (see FIG. 5). Therefore, when the user rotates the second shaft 48 around the axis of the second shaft 48 and the up-down direction of the second support portion 50 is reversed, the bottom surface of the second support body 72 becomes the upper surface. Therefore, at least one of the upper surface and the bottom surface of the second support portion 50 may be the second support surface 74. Therefore, either one of the upper surface or the bottom surface of the second support portion 50 may be the second support surface 74, and the reflecting portion 100 may be formed on the second support surface 74. Alternatively, both the upper surface and the bottom surface of the second support portion 50 may be the second support surface 74, and the reflecting portion 100 may be formed on each of the two second support surfaces 74. In this embodiment, assuming that the second shaft 48 does not rotate around the axis of the second shaft 48, a case will be described in which the upper surface of the second support part 50 is the second support surface 74, as shown in Figure 4, and a reflecting part 100 is formed on the second support surface 74.

[0069] 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. 13 to Fig. 16, 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.

[0070] 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.

[0071] 7, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. The medical sheet 300 protrudes outward from the second support portion 50 when placed on the second support surface 74. The first support surface 261 supports the protruding portion 302 of the medical sheet 300 that protrudes outward from the second support portion 50.

[0072] The medical sheet 300 is immersed in a liquid (e.g., physiological saline) in a petri dish 401. In the sheet placing step, when the medical sheet 300 is placed on the second support surface 74, moisture 110 (physiological saline) permeates into the gap 109 between the medical sheet 300 and the second support part 50. As a result, the gap 109 between the medical sheet 300 and the second support part 50 becomes filled with moisture 110, as shown in FIG.

[0073] When the gap 109 is filled with moisture 110, diffuse reflection of light is suppressed at the portion of the reflecting portion 100 that overlaps with the medical sheet 300 when light is irradiated from the outside onto the medical sheet 300 (see FIG. 9). As a result, the light is transmitted through the portions of the first support portion 26 and the second support portion 50 that overlap with the medical sheet 300. Therefore, when a user looks at the medical sheet 300, reflected light (diffracted light, hologram image) cannot be visually recognized at the portion where the medical sheet 300 and the reflecting portion 100 overlap. The user can visually recognize the portion of the back surface 462 of the first support body 32 that overlaps with the medical sheet 300. By visually recognizing the portion that overlaps with the medical sheet 300, the user can easily determine that the medical sheet 300 is placed on the second support surface 74.

[0074] In addition, in the reflecting portion 100, the portion not overlapping with the medical sheet 300 (the portion on the pressing portion 56 side) diffusely reflects light irradiated from the outside. The user can visually recognize the reflected light from this portion.

[0075] 10, when the medical sheet 300 is mistakenly placed between the first support part 26 and the second support part 50, the reflecting part 100 diffuses light irradiated from the outside. By visually checking the reflecting part 100 (the light reflected by it), the user can easily determine that the medical sheet 300 is not placed on the second support surface 74 (the medical sheet 300 is mistakenly placed between the first support part 26 and the second support part 50). The user can take measures such as placing the medical sheet 300 on the second support surface 74.

[0076] 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 (see FIG. 10) to a accommodated position (first position) as shown in FIG. 11. 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.

[0077] 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.

[0078] 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. 12, 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 in a direction 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).

[0079] 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 along the inner surface of the outer tube 22.

[0080] 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).

[0081] 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.

[0082] 11, 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.

[0083] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 13, 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).

[0084] 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. 14. 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 (see FIG. 13) 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.

[0085] 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.

[0086] Furthermore, when light is irradiated onto the medical sheet 300 from the endoscope 14, the light passes through the medical sheet 300, the second support part 50, and the first support part 26. By looking at the image captured by the endoscope 14, the user can observe the transplantation target part 402 located below the first support part 26.

[0087] 15, in the movement step (step S6 in FIG. 6), the second carrier member 20 is moved in the distal direction (arrow X1 direction) relative to the first carrier member 18, so that 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 movement step, the second shaft 48 is moved in the distal direction relative to the first shaft 24.

[0088] 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.

[0089] At this time, when light is irradiated onto the medical sheet 300 from the endoscope 14, the light passes through the medical sheet 300 and the second support part 50. By looking at the image captured by the endoscope 14, the user can observe the transplantation target part 402 located below the first support part 26.

[0090] Then, in the removal step (step S7 in FIG. 6), as shown in FIG. 16, 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.

[0091] This embodiment provides the following advantages.

[0092] 14 and 15, with the medical sheet 300 supported on the second support surface 74, the second shaft 48 is moved toward the distal end along the first shaft 24. This allows the medical sheet 300 to be efficiently transported to the transplant target portion 402 of the heart 400 (the treatment target portion of the living body).

[0093] 8, when the medical sheet 300 is supported on the second support surface 74 and moisture 110 has entered the gap 109 between the medical sheet 300 and the second support surface 74, the reflecting part 100 suppresses diffuse reflection of light irradiated from the outside onto the second support surface 74. This allows the light to pass through the reflecting part 100, making it possible to observe the transplantation target part 402 located below the first support part 26 via the second support part 50.

[0094] 10, when the medical sheet 300 is not supported on the second support surface 74, the reflecting portion 100 diffuses light that is externally irradiated onto the second support surface 74. By visually checking the light that is diffusely reflected by the reflecting portion 100, the user can easily determine that the medical sheet 300 is erroneously supported between the first support portion 26 and the second support portion 50.

[0095] In this manner, by using the reflecting portion 100, it is possible to easily determine whether the medical sheet 300 is correctly supported on the second supporting portion 50 or not.

[0096] When the medical sheet 300 is not supported by the second support surface 74, the uneven portion 104 of the reflecting portion 100 diffuses light that is externally irradiated onto the second support surface 74. By visually checking the diffusely reflected light, the user can easily determine that the medical sheet 300 has been erroneously placed between the first support part 26 and the second support part 50.

[0097] When the medical sheet 300 is not supported by the second supporting surface 74, the diffraction grating 106, which is the uneven portion 104, generates diffracted light due to light externally irradiated onto the second supporting surface 74, due to a diffraction phenomenon. By visually recognizing the diffracted light, the user can easily determine that the medical sheet 300 has been erroneously placed between the first supporting part 26 and the second supporting part 50.

[0098] When the medical sheet 300 is not supported by the second support surface 74, the hologram 108, which is the reflecting portion 100, reproduces a hologram image by light externally irradiated onto the second support surface 74. By visually recognizing the hologram image, the user can easily determine that the medical sheet 300 has been erroneously placed between the first support portion 26 and the second support portion 50.

[0099] 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]

[0100] 10…Transfer device 18...First carrier member 20...Second carrier member 24…First shaft 26…First support part 48…Second shaft 50…Second support part 74…Second support surface 100...Reflector 110…Moisture 261...1st support surface 300…Medical sheets 402... Transplant target part (part of living body to be treated)

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, a first carrier member including a first shaft and a first support portion provided at a tip portion of the first shaft and having a first support surface; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a second support portion provided at a tip end of the second shaft and having a second support surface smaller than the first support surface; Equipped with the medical sheet, the first support part, and the second support part are transmissible to light from an outside; the first support surface is a surface of the first support portion facing the second support portion, the second support surface is a surface of the second support portion opposite to a surface facing the first support surface, The second support surface is provided with a reflecting portion capable of diffusely reflecting the light, A transfer device in which the reflecting portion diffusely reflects the light when the medical sheet is not supported on the second support surface, and suppresses the diffuse reflection of the light when the medical sheet is supported on the second support surface and moisture has penetrated into the gap between the medical sheet and the second support surface.

2. 2. The transfer device of claim 1, A transfer device, wherein the reflecting portion is an uneven portion formed on the second support surface.

3. 3. The transfer device of claim 2, The transfer device, wherein the irregular portion is a diffraction grating provided on the second support surface.

4. A transfer device according to any one of claims 1 to 3, The transport device, wherein the reflector is a hologram disposed on the second support surface.

Images