Transfer device

Abstract

To provide a transfer device for transferring a medical sheet to a treatment target part of a living body.SOLUTION: A first carrier member 18 of a transfer device 10 comprises: a first shaft 24 disposed movably along an axial direction inside an outer tube 22; and a sheet-like first support part 26 disposed at a tip of the first shaft 24. The first support part 26 includes: a first support surface 261 capable of holding a medical sheet; a pair of first projecting parts 38 projecting upward from the first support surface 261; and first bending parts 444 provided at boundaries between the first support surface 261 and the first projecting parts 38 and bending the first projecting parts 38. The first support part 26 has first slits 961 provided in the first bending parts 444 and penetrating the first support part 26 in a thickness direction.SELECTED DRAWING: Figure 3

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: an outer tube having a tip opening; a shaft extending in the axial direction of the outer tube and disposed inside the outer tube so as to be movable along the axial direction; and a carrier member having a sheet-shaped support part disposed at the tip of the shaft, wherein the support part has a support surface capable of holding the medical sheet, a pair of protrusions protruding upward from both sides in a width direction of the support surface perpendicular to the movement direction of the shaft, and a slit penetrating the support part in a thickness direction, wherein the width of the support part in a direction perpendicular to the extension direction of the shaft is greater than the inner peripheral length of the outer tube, and the support part is arranged so as to be accommodated within the outer tube. In 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 in a second position where the shaft is moved in a distal end 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, the support part protrudes in the distal direction from the distal end of the outer tube, and when the support part is moved relatively in the base end direction relative to the outer tube with the medical sheet placed on it, the support part is guided toward the distal opening of the outer tube, and the support part deforms into a curved shape so that both widthwise sides of the support part protrude toward the support surface.

[0006] According to this transfer device, when a medical sheet is placed on the support surface of the support part, moisture on the support surface can be effectively discharged to the outside of the support part through the slits, so that when the medical sheet placed on the support surface is transferred to a treatment target part, the medical sheet can be placed at a predetermined position on the treatment target part while suppressing the effects of moisture. Therefore, the medical sheet can be efficiently transferred to the treatment target part by the support part. When the support part is unfolded in the second position, the slits can effectively maintain the shape (folding) of the protruding part relative to the support surface.

[0007] (2) In the transfer device described in (1) above, the support portion may be provided at the boundary between the support surface and the protrusion, and may have a bent portion by bending the protrusion toward the support surface, and the slit may be provided at the bent portion.

[0008] With this configuration, when the support portion is deployed in the second position, the slits can effectively maintain the shape (bending) of the protruding portion starting from the bent portion.

[0009] (3) In the conveying device described in (2) above, the slit may be provided along an extending direction of the bent portion.

[0010] With this configuration, the slit extends along the bent portion, so that the long slit allows moisture on the support surface to be more effectively discharged to the outside of the support portion while also more effectively maintaining the shape of the protrusion.

[0011] (4) In the conveying device described in (2) or (3) above, the slit may have a plurality of cutout portions spaced apart from each other in the extending direction of the bent portion.

[0012] With this configuration, the multiple slits can be arranged over a wider area in the direction of extension of the bent portion than in a structure with a single continuous slit along the direction of extension of the bent portion, which allows the moisture discharge range on the support surface to be expanded and allows the protrusions to be shaped over a wider area.

[0013] (5) In the conveying device according to any one of (2) to (4) above, the slit provided in each of the bent portions may be a single cutout extending along the extension direction of the bent portion. This configuration makes it easy to form the slit in the support portion.

[0014] (6) In the transfer device described in any one of (2) to (5) above, the support portion may include a base end support portion constituting a base end side of the support portion, the base end support portion having a second bent portion, and the second bent portion may be provided with a second slit penetrating the support portion in the thickness direction.

[0015] With this configuration, when the support part is housed in the outer cylinder from the base end support part side, the support part can be effectively curved and deformed with the second bent part as a base point, and the support part can be smoothly housed in the outer cylinder. The second slit allows moisture on the support surface to be more effectively discharged to the outside of the support part.

[0016] (7) In the delivery device described in (1) above, the slit may be provided in the protrusion.

[0017] With this configuration, it is possible to effectively shape the protrusion while discharging moisture from the support portion to the outside through the slits. Effect of the Invention

[0018] According to the present invention, the support part of the transfer device is provided with a slit at the folded part where the protruding part is folded relative to the support surface, and the slit penetrates the support part in the thickness direction. Therefore, when a medical sheet is placed on the support surface of the support part, moisture on the support surface can be effectively discharged to the outside of the support part through the slit. Therefore, when the medical sheet placed on the support surface is transferred to a treatment target part, the medical sheet can be placed at a predetermined position on the treatment target part while suppressing the influence of moisture. This allows the medical sheet to be efficiently transferred to the treatment target part by the support part. When the support part is unfolded in the second position, the slit can effectively maintain the shape (folding) of the protruding part relative to the support surface. [Brief description of the drawings]

[0019] [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 plan view of a tip of a delivery device having a slit in a first protrusion. [Figure 7] FIG. 7 is a plan view showing the first support portion in a planar state before the protrusion portion is formed. [Figure 8] FIG. 8 is a plan view of a tip portion of a conveying device having a first support portion according to a first modified example. [Figure 9] FIG. 9 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 10] FIG. 10 is a first explanatory view of the sheet placing step. [Figure 11] FIG. 11 is a second explanatory view of the sheet placing step. [Figure 12] FIG. 12 is an explanatory diagram of the accommodation step. [Figure 13] FIG. 13 is a cross-sectional view taken along line XIII-XIII in FIG. [Figure 14] FIG. 14 is an explanatory diagram of the arrangement process. [Figure 15] FIG. 15 is an explanatory diagram of the development process. [Figure 16] FIG. 16 is an explanatory diagram of the movement process. [Figure 17] FIG. 17 is an explanatory diagram of the removal step. [Figure 18] FIG. 18 is a plan view of a tip portion of a conveying device having a first support portion according to a second modified example. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0020] 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. 14 to 17). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

[0021] 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).

[0022] 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.

[0023] 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.

[0024] 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.

[0025] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0026] 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.

[0027] 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.

[0028] 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.

[0029] 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.

[0030] 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.

[0031] 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.

[0032] 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.

[0033] 3, the base end support part 34 is formed to be wider in the extension direction. In other words, both sides in the width direction of the base end support part 34 are tapered toward the first joint part 30. The intermediate support part 36 is formed to be tapered so that the width gradually decreases from the tip toward the base end (arrow X2 direction).

[0034] 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.

[0035] 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).

[0036] 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.

[0037] 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.

[0038] 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. 13). 13, 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.

[0039] Each of the pair of first protruding portions 38 has a pair of bent portions 444. Hereinafter, the bent portions 444 are referred to as "first bent portions 444." Each of the pair of first 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 inside 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. 16).

[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 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.

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

[0050] 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.

[0051] 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.

[0052] 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.

[0053] 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.

[0054] As shown in FIG. 3, the first support body 32 of the first support portion 26 further has a pair of base end protrusions 94. The pair of base end protrusions 94 are provided on the base end support portion 34. The base end protrusions 94 protrude obliquely upward from both sides of the base end support portion 34 in a width direction (W direction) perpendicular to the movement direction of the first shaft 24, and obliquely outward in the width direction of the base end support portion 34 and toward the base end direction. The tips of the pair of base end protrusions 94 are connected to the first protrusion 38. The rear ends of the pair of base end protrusions 94 are connected to the first joint portion 30 (see FIG. 2).

[0055] Each of the pair of base end protrusions 94 has a pair of bent portions 98. Hereinafter, the bent portions 98 are referred to as "second bent portions 98". Each of the pair of second bent portions 98 bends the pair of base end protrusions 94 toward the first support surface 261 of the first support portion 26. The second bent portions 98 are formed along the shape of the base end support portion 34. In a plan view of the first support portion 26, the second bent portion 98 has a substantially arc shape that is convexly curved toward the width direction inward and toward the tip direction of the first support portion 26. In the width direction (W direction) of the first support portion 26, the separation distance between the pair of second bent portions 98 gradually decreases toward the first joint portion 30. That is, the pair of second bent portions 98 expand outward in the width direction from the base end of the base end support portion 34 toward the tip direction (arrow X1 direction). The second bent portion 98 is provided at the boundary between the first support surface 261 of the first support portion 26 and the base end protruding portion 94. The second bent portion 98 is a portion where the base end protruding portion 94 is bent relative to the first support surface 261.

[0056] As shown in Fig. 2, the first support portion 26 further has a slit structure 96. As shown in Fig. 5, the slit structure 96 penetrates the first support portion 26 in the thickness direction. As shown in Fig. 3, the slit structure 96 includes a slit 961 (hereinafter referred to as "first slit 961") provided in the first bent portion 444 and a slit 962 (hereinafter referred to as "second slit 962") provided in the second bent portion 98.

[0057] The first slits 961 are provided in each of the pair of first bent portions 444. Each of the first slits 961 is provided along the extending direction of the first bent portion 444. That is, the pair of first slits 961 are arranged on the outer side in the width direction of the first support portion 26 with the first support surface 261 interposed therebetween. The pair of first slits 961 are spaced apart from each other in the width direction (W direction) of the first support portion 26. The pair of first slits 961 are arranged approximately parallel to each other. The first bent portion 444 is provided at the boundary between the first support surface 261 and the first protruding portion 38 in the first support portion 26. The first bent portion 444 is a portion where the first protruding portion 38 is bent with respect to the first support surface 261.

[0058] The first slit 961 is a perforation composed of a plurality of first cutouts 1001. The first cutouts 1001 penetrate the first support portion 26 in the thickness direction (see FIG. 5). The length of each of the first cutouts 1001 along the extension direction of the first bent portion 444 is greater than the width perpendicular to the extension direction of the first bent portion 444. The plurality of first cutouts 1001 are spaced apart from each other in the extension direction of the first bent portion 444. The number of the first cutouts 1001 and the width of the first cutouts 1001 perpendicular to the extension direction of the first bent portion 444 are appropriately set. Through the first slits 961, the first support surface 261 (front surface 461) and the back surface 462 of the first support portion 26 communicate with each other. The first slits 961 are not limited to being formed in the first bent portion 444. As shown in FIG. 6, for example, a pair of first protrusions 38 may have first slits 961A.

[0059] Note that each first cutout 1001 is not limited to a case in which the length along the extension direction of the first bent portion 444 is larger than the width perpendicular to the extension direction of the first bent portion 444. For example, the length along the extension direction of the first bent portion 444 of the first cutout 1001 may be smaller than the width perpendicular to the extension direction of the first bent portion 444, or the width perpendicular to the extension direction of the first bent portion 444 and the length along the extension direction of the first bent portion 444 may be the same.

[0060] The second slit 962 is provided in the second bent portion 98 of the first support portion 26. The second slit 962 is provided along the extending direction of the second bent portion 98. In the plan view of the first support portion 26 shown in FIG. 3, the second slit 962 has a generally arc shape that is curved in a convex shape toward the inside in the width direction of the first support portion 26. That is, the second slit 962 is provided in the base end support portion 34 of the first support portion 26.

[0061] The second slit 962 is a perforation composed of a plurality of second cutouts 1002. The second cutouts 1002 penetrate the first support portion 26 in the thickness direction. The length along the extension direction of the second bent portion 98 is greater than the width perpendicular to the extension direction of the second bent portion 98. The plurality of second cutouts 1002 are spaced apart from each other in the extension direction of the second bent portion 98. The number of the second cutouts 1002 and the width of the second cutouts 1002 perpendicular to the extension direction of the second bent portion 98 are appropriately set. Through the second slits 962, the first support surface 261 (front surface 461) and the back surface 462 of the first support portion 26 communicate with each other.

[0062] Note that each second cutout 1002 is not limited to a case in which the length along the extension direction of the second bent portion 98 is larger than the width perpendicular to the extension direction of the second bent portion 98. For example, the length along the extension direction of the second cutout 1002 may be smaller than the width perpendicular to the extension direction of the second bent portion 98, or the width perpendicular to the extension direction of the second bent portion 98 and the length along the extension direction of the second bent portion 98 may be the same.

[0063] 3, in a plan view of the first support portion 26, a slit structure 96 including first and second slits 961, 962 is disposed so as to surround the first support surface 261 of the first support portion 26. Note that the slit structure 96 is not limited to the case where it includes the first and second slits 961, 962. For example, the slit structure 96 may be configured to include only the first slit 961.

[0064] As shown in FIG. 7, the slit structure 96 is formed in advance in the first support portion 26P (hereinafter, also referred to as the sheet material S) in a flat state before forming the pair of protruding portions 37 (before bending). The sheet material S has a substantially elliptical shape that is long in the longitudinal direction. The tip end Sa of the sheet material S has a curved shape that is convex toward the tip end direction. The base end Sb of the sheet material S has a curved shape that is convex toward the base end direction. The base end Sb of the sheet material S has a bulging portion Sc that protrudes in the base end direction and becomes the first joint portion 30. A pair of first slits 961 of the slit structure 96 are arranged from the center in the longitudinal direction of the sheet material S to the base end direction (arrow X2 direction). The first slits 961 are arranged approximately parallel to each other and spaced apart from the width center outward in the width direction. The first slits 961 are formed along the longitudinal direction of the sheet material S. The first slit 961 is formed at a position that will become the first folded portion 444 when the first protruding portion 38 is formed by folding both widthwise sides of the sheet material S. In other words, the first slit 961 (first cutout portion 1001) is formed in advance at a position that will become the boundary between the first protruding portion 38 and the first support surface 261.

[0065] A pair of second slits 962 of the slit structure 96 are provided at the base end Sb of the sheet material S. The second slits 962 are arranged in the base end direction with respect to the base end of the first slit 961. The pair of second slits 962 are arranged such that their tips are farthest apart from each other in the width direction, and are curved so as to gradually approach each other in the width direction from the tips toward the base end direction. The base end of the second slit 962 extends to the middle of the bulging portion Sc. The base end of the second slit 962 may extend to the base end of the bulging portion Sc. The second slit 962 is formed at a position that becomes the second bent portion 98 when the base end protruding portion 94 is formed by folding the sheet material S. In other words, the second slit 962 (second cutout portion 1002) is formed in advance at a position that becomes the boundary between the base end protruding portion 94 and the first support surface 261.

[0066] The sheet material S is formed into a predetermined shape using a sheet forming die (not shown) to form the first support portion 26, whereby the first bent portion 444 having the first slit 961 is bent to form the first protrusion 38, and the second bent portion 98 having the second slit 962 is bent to form the base end protrusion 94 (see FIG. 3).

[0067] In addition, the first and second slits 961, 962 are not limited to a long configuration along the extension direction of the first and second bent portions 444, 98. For example, as shown in FIG. 8, the first support portion 26A according to the first modification includes a slit structure 96A provided along the first bent portion 444 and the second bent portion 98. The slit 961A of the slit structure 96A has a plurality of first cutout portions 1001A formed in a circular shape in a plan view. Hereinafter, the slit 961A is referred to as the "first slit 961A". The first cutout portions 1001A (first slit 961A) penetrate the first support portion 26A and are provided in a plurality of portions spaced apart from each other along the extension direction of the first bent portion 444. The slit 962A of the slit structure 96A has a second cutout portion 1002A formed in a circular shape in a plan view. Hereinafter, the slit 962A is referred to as the "second slit 962A". The second cutout portion 1002A (second slit 962A) penetrates the first support portion 26A and is provided in a plurality of portions spaced apart from each other along the extension direction of the second bent portion 98. The shapes of the first cutout portion 1001A and the second cutout portion 1002A are not limited to a circular shape.

[0068] Next, a method for transferring the medical sheet 300 to a treatment target part of a living body will be described. Specifically, as shown in Fig. 14 to Fig. 17, 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. 9, the transfer method according to this embodiment includes a preparation step, a sheet placement step, a storage step, a positioning step, a deployment step, a movement step, and a removal step.

[0069] First, in a preparation step (step S1), the transfer device 10 according to the present embodiment described above is prepared. In the following, the state shown in FIG. 1 will be described as the initial state of the transfer device 10. In the initial state, the first 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.

[0070] Next, in the sheet placement step (step S2), as shown in Fig. 10, 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 protrudes outward from the second support section 50. The first support surface 261 supports the protruding section 302 of the medical sheet 300 that protrudes outward from the second support section 50. As shown in Fig. 11, at this time, in the first support section 26, moisture M contained in the medical sheet 300 flows along the first support surface 261 and is discharged from the first support surface 261 to the back surface 462 side (outside) through the first slits 961 (plurality of first cutouts 1001) and the second slits 962 (plurality of second cutouts 1002) (see the dashed arrow in the figure).

[0071] Thereafter, in the accommodation step (step S3 in FIG. 9), 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. 12. Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the base end direction (the direction of the arrow X2) relative to the outer cylinder 22.

[0072] 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.

[0073] When the base end support portion 34 of the first support portion 26 is deformed, a force acts on the intermediate support portion 36 of the first support portion 26 to curl up along the circumferential direction of the outer tube 22, so that the intermediate support portion 36 (see FIG. 2) is drawn into the outer tube 22 while curling up. At this time, the intermediate 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. 13, 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 D 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).

[0074] 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.

[0075] The heart shape refers to a generally circular shape consisting of a convexly curved shape on one side and two convexly curved shapes on the other side opposite to the one side. When a heart shape is formed in the inner cavity 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. 13).

[0076] 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.

[0077] 12, 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.

[0078] Thereafter, in a placement step (step S4 in FIG. 9), as shown in FIG. 14, 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).

[0079] Next, in the unfolding step (step S5 in FIG. 9), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 15. Specifically, in the unfolding step, the first shaft 24 is grasped and moved in the distal direction (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 in the distal direction (arrow X1 direction). Then, the first support part 26 exposed from the distal 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 in a planar shape.

[0080] 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.

[0081] 16, in the movement step (step S6 in FIG. 9), 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.

[0082] 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.

[0083] Then, in the removal step (step S7 in FIG. 9), as shown in FIG. 17, the second carrier member 20 is moved from the second position to the first position to remove the second support part 50 from between the transplantation target part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation target part 402. This completes the transfer of the medical sheet 300 to the transplantation target part 402. Thereafter, the transferring instrument 10 is removed from the chest 408 with the first support part 26 and the second support part 50 housed within the outer cylinder 22.

[0084] This embodiment provides the following advantages.

[0085] As shown in FIG. 3, the first support portion 26 of the first carrier member 18 in the transfer device 10 includes a first support surface 261 capable of holding a medical sheet 300, a pair of protrusions 37 protruding upward from both widthwise sides of the first support surface 261, and a first slit 961 penetrating the first support portion 26 in the thickness direction.

[0086] As a result, when the medical sheet 300 is placed on the first support part 26 as shown in Fig. 11, moisture M on the first support surface 261 can be effectively discharged to the outside of the first support part 26 through the first slits 961, so that when the medical sheet 300 placed on the first support surface 261 is transferred to a transplantation recipient part 402 of a living body as shown in Fig. 16, the medical sheet 300 can be placed at a predetermined position on the transplantation recipient part 402 while suppressing the influence of moisture M. This allows the medical sheet 300 to be efficiently transferred to the transplantation recipient part 402 by the first support part 26. When the first support part 26 is unfolded at the second position, the first slits 961 can effectively maintain the shaping (folding) of the first protruding part 38 relative to the first support surface 261.

[0087] 5, the first support portion 26 has a first bent portion 444 that is provided at the boundary between the protruding portion 37 and the first support surface 261 and is formed by bending the protruding portion 37 toward the first support surface 261, and a first slit 961 is provided in the first bent portion 444. Thereby, when the first support portion 26 is unfolded in the second position, the first slit 961 can effectively maintain the shape (bending) of the first protruding portion 38 with the first bent portion 444 as the base point.

[0088] 11, the first slit 961 is provided along the extending direction of the first bent portion 444. This allows the elongated first slit 961 extending along the first bent portion 444 to more effectively discharge moisture M on the first support surface 261 to the outside of the first support portion 26. The shape of the first protruding portion 38 relative to the first support surface 261 can be more effectively maintained.

[0089] 3, the first slit 961 has a plurality of first cutout portions 1001 spaced apart from one another in the extension direction of the first bent portion 444. As a result, compared to a structure including a single slit that is continuous along the extension direction of the bent portion, the plurality of first cutout portions 1001 do not cut out continuously along the extension direction of the first bent portion 444. Therefore, the plurality of first cutout portions 1001 can be arranged over a wider range in the first support portion 26, the discharge range of the moisture M on the first support surface 261 can be expanded, and the first protruding portion 38 can be shaped over a wider range.

[0090] The first support portion 26 has a base end support portion 34 that constitutes the base end side of the first support portion 26, and the base end support portion 34 has a second bent portion 98, and the second bent portion 98 is provided with a second slit 962 that penetrates the first support portion 26 in the thickness direction.

[0091] As a result, when the first support portion 26 is housed in the inner cavity 78 of the outer tube 22 from the base end support portion 34 side, the first support portion 26 can be effectively curved and deformed with the second bent portion 98 as a base point, The first support part 26 can be smoothly accommodated in the inner cavity 78 of the outer cylinder 22. In other words, the second bent part 98 having the second slit 962 can create an opportunity for the first support part 26 to be curved and deformed. The second slit 962 can more effectively discharge moisture M on the first support surface 261 to the outside of the first support part 26.

[0092] 6, first slits 961A are provided in the pair of first protruding portions 38. This allows the first protruding portions 38 to be effectively shaped while moisture M in the first support portion 26 is discharged to the outside through the first slits 961A.

[0093] In addition, the first slit 961 is not limited to a configuration having a plurality of first notches 1001 in the extension direction of the first bent portion 444. In addition, the second slit 962 is not limited to a configuration having a plurality of second notches 1002 in the extension direction of the second bent portion 98. For example, as shown in FIG. 18, the first support portion 110 has a slit structure 112. The slit structure 112 has a pair of slits 1141 (hereinafter referred to as "first slits 1141") provided in the first bent portion 444 and a pair of slits 1142 (hereinafter referred to as "second slits 1142") provided in the second bent portion 98. In addition, the slit structure 112 is not limited to a case in which it has the first and second slits 1141, 1142. For example, the slit structure 112 may have a configuration in which it has only the first slit 1141.

[0094] Each first slit 1141 is composed of a single elongated first cutout portion 1161 extending along the extension direction of the first bent portion 444. Each second slit 1142 is composed of a single elongated second cutout portion 1162 extending along the extension direction of the second bent portion 98. Note that only one of the first slit 1141 and the second slit 1142 may be composed of a single continuous cutout portion.

[0095] This modified example has the following advantages.

[0096] 18, in the slit structure 112 of the first support portion 110, a pair of first slits 1141 have a single first notch portion 1161 extending along the extension direction of the first bent portion 444, and a pair of second slits 1142 have a single second notch portion 1162 extending along the extension direction of the second bent portion 98. Therefore, it is easier to form the slit structure 112 than a configuration in which a slit structure having multiple notches is formed along the extension direction of the first and second bent portions 444, 98. Moisture M on the first support surface 261 can be effectively discharged to the outside of the first support portion 26 through the single continuous first and second slits 1141, 1142 (slit structure 112).

[0097] 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]

[0098] 10…Transfer device 18...First carrier member 22…Outer cylinder 24…First shaft 26, 26A, 110...1st support part 38...first protrusion 96, 96A, 112...Slit structure 98…Second bending part 261...1st support surface 300…Medical sheets 402…Transplant target area 444...First bending part (bending part)

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, An outer cylinder having a tip opening; a carrier member including a shaft extending in an axial direction of the outer cylinder and disposed inside the outer cylinder so as to be movable along the axial direction, and a sheet-shaped support portion disposed at a tip end of the shaft; Equipped with The support portion has a support surface capable of holding the medical sheet, A pair of protruding portions protruding upward from both sides of the support surface in a width direction perpendicular to the moving direction of the shaft; A slit penetrating the support portion in a thickness direction; having The support portion has a width in a direction perpendicular to an extension direction of the shaft that is greater than an inner peripheral length 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 portion protrudes in the tip direction from the tip portion of the outer tube, and when the support portion is moved relative to the outer tube in the base end direction with the medical sheet placed on the support portion, the support portion is guided toward the tip opening of the outer tube, and the support portion is deformed into a curved shape so that both widthwise sides of the support portion protrude toward the support surface.

2. 2. The transfer device of claim 1, A transfer device, wherein the support portion is provided at the boundary between the support surface and the protrusion, and has a bent portion where the protrusion is bent relative to the support surface, and the slit is provided at the bent portion.

3. 3. The transfer device of claim 2, The slit is provided along an extension direction of the bent portion.

4. 4. The transfer device of claim 3, A transfer device, wherein the slit has a plurality of cutout portions spaced apart from each other in an extension direction of the bent portion.

5. 3. The transfer device of claim 2, A transfer device, wherein the slit provided in each of the bent portions is a single cutout portion extending along the extension direction of the bent portion.

6. A transfer device according to any one of claims 1 to 5, The support portion includes a base end support portion that configures a base end side of the support portion, The proximal support portion has a second bent portion, the second bent portion defining a second slit extending through the support portion in the thickness direction.

7. 2. The transfer device of claim 1, The slit is provided in the protrusion.

Images