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 carrier holding part 54 is provided at the tip of a second shaft 48. The carrier holding part 54 includes a pressing surface 58 and a first protrusion 100. The pressing surface 58 presses a medical sheet supported on a first support surface 261 of a first support part 26 in the tip direction. The first protrusion 100 protrudes in the tip direction more than the pressing surface 58 at a place more separated from the first support surface 261 than the pressing surface 58.SELECTED DRAWING: Figure 4

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 area of ​​a living body, comprising: a first carrier member including a first shaft, a first support portion provided at a tip of the first shaft and having a first support surface for supporting the medical sheet, a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a pressing portion provided at the tip of the second shaft, wherein the pressing portion has a pressing surface for pressing the medical sheet supported on the first support surface in a distal direction, and a protrusion portion that protrudes in the distal direction further than the pressing surface at a location farther away from the first support surface than the pressing surface.

[0006] With this configuration, with the medical sheet supported on the first support surface, the second shaft can be moved along the first shaft, allowing the medical sheet to be efficiently transported to the area to be treated.

[0007] Furthermore, with this configuration, a protrusion that protrudes distally beyond the pressing surface is provided at a location that is farther from the first support surface than the pressing surface. As a result, when the second shaft is moved distally and the pressing surface presses the medical sheet distally, the protrusion is located above the medical sheet, preventing the medical sheet from riding up onto the pressing portion. As a result, the medical sheet can be smoothly transferred to the treatment target area.

[0008] (2) In the transfer device described in (1) above, the second carrier member may further include a second support portion fixed to the pressing portion and having a second support surface smaller than the first support surface, the medical sheet being supported on the second support surface, and a first recess into which the base end of the medical sheet fits may be formed by the pressing surface, the protrusion portion, and the second support portion.

[0009] According to this configuration, the second support part is fixed to the pressing surface, and the medical sheet is supported on the second support surface. As a result, when the second shaft is moved in the distal direction, the base end of the medical sheet enters the first recess and abuts on the pressing surface. As a result, by pressing the medical sheet in the distal direction with the pressing surface, the medical sheet can be smoothly transferred to the treatment target while reliably preventing the medical sheet from riding up on the pressing part.

[0010] (3) In the transfer device described in (2) above, the pressing portion may be provided at a location closer to the first support surface than the pressing surface, and may further have a second protrusion protruding toward the tip side beyond the pressing surface, and the pressing surface, the second protrusion, and the second support portion may form a second recess into which the base end of the medical sheet fits.

[0011] According to this configuration, the second protrusion is provided at a location closer to the first support surface than the pressing surface. As a result, when the second shaft is rotated 180° about its axis and the medical sheet is placed on the second support portion, the second protrusion is located above the medical sheet. Even when the second shaft rotates about its axis, the base end of the medical sheet can be inserted into the second recess and abutted against the pressing surface by moving the second shaft in the distal direction. As a result, by pressing the medical sheet in the distal direction with the pressing surface, the medical sheet can be smoothly transferred to the treatment target while reliably preventing the medical sheet from riding up onto the pressing portion.

[0012] (4) In the transferring device described in any one of (1) to (3) above, a protruding length of the protrusion in the distal direction may be equal to or greater than half of an overall length of the medical sheet in the distal direction.

[0013] With this configuration, the protruding length of the protrusion in the distal direction is equal to or greater than half the total length of the medical sheet, so that the medical sheet can be reliably supported between the first support portion and the protrusion. Furthermore, when the medical sheet is pressed in the distal direction by the pressing surface, lifting of the medical sheet from the first support surface and the occurrence of wrinkles in the medical sheet can be suppressed.

[0014] (5) In the transfer device described in (4) above, the pressing portion may be made of a flexible material, and the protrusion portion may have a lower surface facing the first support surface and an upper surface opposite the lower surface, and a rib may be provided on the upper surface protruding away from the first support surface and extending toward the tip.

[0015] According to this configuration, the pressing part having the protrusion is made of a flexible material, and the rib is provided on the upper surface of the protrusion, which makes it easy to place the medical sheet between the first support part and the protrusion with the rib raised.

[0016] (6) In the conveying device according to any one of (1) to (5) above, a tip of the protrusion may be formed in an arc shape.

[0017] According to this configuration, the tip of the protrusion is formed in an arc shape, so that it is possible to prevent the medical sheet from coming into contact with the tip of the protrusion and being damaged. Effect of the Invention

[0018] According to the present invention, by moving the second shaft along the first shaft while the medical sheet is supported on the first support surface, the medical sheet can be efficiently transported to the area to be treated.

[0019] Furthermore, according to the present invention, a protrusion that protrudes distally beyond the pressing surface is provided at a location that is farther from the first support surface than the pressing surface. As a result, when the second shaft is moved distally and the pressing surface presses the medical sheet distally, the protrusion is located above the medical sheet, preventing the medical sheet from riding up onto the pressing portion. As a result, the medical sheet can be smoothly transferred to the treatment target area. [Brief description of the drawings]

[0020] [Figure 1] FIG. 1 is a perspective view of a delivery device according to a first 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 arrangement of the medical sheet in the sheet placing step. [Figure 8] FIG. 8 is a second explanatory diagram showing the arrangement of the medical sheet in the sheet placing step. [Figure 9] FIG. 9 is an explanatory diagram of the accommodation step. [Figure 10] FIG. 10 is a cross-sectional view taken along line XX in FIG. [Figure 11] FIG. 11 is an explanatory diagram of the arrangement process. [Figure 12] FIG. 12 is an explanatory diagram of the development process. [Figure 13] FIG. 13 is a first explanatory view of the moving step. [Figure 14] FIG. 14 is a second explanatory view of the moving step. [Figure 15] FIG. 15 is a third explanatory view of the moving step. [Figure 16] FIG. 16 is an explanatory diagram of the removal step. [Figure 17] FIG. 17 is a perspective view of a delivery device according to a second embodiment of the invention. [Figure 18] FIG. 18 is an explanatory diagram of the accommodation step. [Figure 19] FIG. 19 is a cross-sectional view taken along line XIX-XIX in FIG. [Figure 20] FIG. 20 is an explanatory diagram of the development process. [Figure 21] FIG. 21 is a first explanatory diagram of the moving step. [Figure 22] FIG. 22 is a second explanatory diagram of the moving step. [Diagram 23] FIG. 23 is a third explanatory view of the moving step. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] FIG. 1 is a perspective view of a transfer device 10 according to a first embodiment of the present invention. The transfer device 10 is a medical device for transferring a medical sheet 300 to a treatment target portion 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 portion 402 of a heart 400 (a treatment target portion of a living body) (see FIGS. 12 to 16). The transfer device 10 can attach multiple medical sheets 300 to the transplant target portion 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 the first embodiment) having a first lumen 28. The first lumen 28 opens at the tip end (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 part 34 extends from the tip of the first joint part 30 in the tip direction (arrow X1 direction) so as to generally follow the axis Ax of the first shaft 24 (see FIG. 4). The intermediate support part 36 extends from the tip of the base end support part 34 in the tip direction (arrow X1 direction) to intersect with the axis Ax of the first shaft 24 and in the tip direction (arrow X1 direction) of the first support part 26.

[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 the first 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 (pressing portion) 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 in 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 the first 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 arrow X1) (see Figs. 13 to 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 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 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. 10). 10, 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] As shown in Fig. 5, in a cross section perpendicular to the axis of the second shaft 48, the carrier holding portion 54 has a shape that is line-symmetrical with respect to a virtual line L1 that passes through the center line C of the carrier holding portion 54 and is parallel to the width direction of the carrier holding portion 54. In other words, the carrier holding portion 54 has a shape that is symmetrical in the up-down direction with the virtual line L1 as the center. As shown in Fig. 5, the carrier holding portion 54 has a flat cross section. Note that the carrier holding portion 54 is not limited to being formed with a flat cross section, and may be formed with, for example, a circular cross section, an elliptical cross section, a square cross section, a rectangular cross section, or the like.

[0057] The mounting hole 60 is disposed on the center line C of the carrier holding portion 54 on the pressing surface 58. The mounting hole 60 is slit-shaped extending parallel to the width direction of the carrier holding portion 54 from the center line C. The mounting hole 60 is symmetrical in the width direction with the center line C as the center. The mounting hole 60 extends in the axial direction from the pressing surface 58 (see FIG. 4). As described above, the second joint portion 70 of the second support portion 50 is inserted into and connected to the mounting hole 60.

[0058] 1 to 5, the carrier holding portion 54 further has a first protrusion 100 (protrusion) and a second protrusion 102 (second protrusion). The first protrusion 100 and the second protrusion 102 are provided at the tip of the carrier holding portion 54. The first protrusion 100 and the second protrusion 102 have the same shape. Note that the first protrusion 100 and the second protrusion 102 may have different shapes.

[0059] Specifically, as shown in Fig. 4 and Fig. 5, the first protrusion 100 is provided at a location on the tip of the carrier holding part 54 that is farther away from the first support surface 261 than the pressing surface 58. That is, the first protrusion 100 is provided above the pressing surface 58 on the tip of the carrier holding part 54. As shown in Figs. 2 to 4, the first protrusion 100 protrudes in the tip direction beyond the pressing surface 58 on the tip of the carrier holding part 54. As shown in Figs. 2 and 3, the first protrusion 100 protrudes in a semicircular shape from the tip of the carrier holding part 54.

[0060] The tip of the first protrusion 100 is formed in an arc shape. However, the tip of the first protrusion 100 is not limited to an arc shape. The tip of the first protrusion 100 may have any shape as long as it does not damage the medical sheet 300 when it comes into contact with the medical sheet 300.

[0061] 4 and 5, the second protrusion 102 is provided at a location on the tip of the carrier holding portion 54 closer to the first support surface 261 than the pressing surface 58. That is, the second protrusion 102 is provided below the pressing surface 58 on the tip of the carrier holding portion 54. As shown in FIGS. 2 and 4, the second protrusion 102 protrudes in the tip direction beyond the pressing surface 58 on the tip of the carrier holding portion 54. As shown in FIG. 2, the second protrusion 102 protrudes in a semicircular shape from the tip of the carrier holding portion 54.

[0062] The tip of the second protrusion 102 is formed in an arc shape. Note that the tip of the second protrusion 102 is not limited to an arc shape. The tip of the second protrusion 102 may have any shape that does not damage the medical sheet 300 when it comes into contact with the medical sheet 300.

[0063] As described above, the carrier holding portion 54 is configured to be symmetrical in the up-down direction with respect to the imaginary line L1. Therefore, the first protrusion 100 and the second protrusion 102 are provided at equal distances in the up-down direction with respect to the center line C.

[0064] As shown in Fig. 4, the protruding amounts of the first protrusion 100 and the second protrusion 102 in the tip direction are the same. As shown in Fig. 5, the widths of the first protrusion 100 and the second protrusion 102 in the width direction of the carrier holding part 54 are the same.

[0065] 4 and 5, a first recess 104 is formed by the portion of the pressing surface 58 above the second support portion 50, the first protrusion 100, and the second support portion 50. When the medical sheet 300 is placed on the second support surface 74, the base end portion 304 of the medical sheet 300 can enter the first recess 104 (see FIGS. 13 and 14).

[0066] As shown in Fig. 4 and Fig. 5, the second recess 106 is formed by the portion of the pressing surface 58 below the second support portion 50, the second protrusion 102, and the second support portion 50. As described above, the carrier holding portion 54 is symmetrical in the up-down direction with respect to the imaginary line L1 (see Fig. 5). Therefore, when the user rotates the second shaft 48 about the axis of the second shaft 48 and the up-down direction of the second support portion 50 is reversed, the second protrusion 102 is disposed on the upper portion of the carrier holding portion 54. At this time, if the medical sheet 300 is placed on the second support portion 50, the base end portion 304 of the medical sheet 300 can enter the second recess 106.

[0067] 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. 12 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 the first 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.

[0068] First, in a preparation step (step S1), the transfer device 10 according to the first 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.

[0069] 7 and 8, in the sheet placement step (step S2), 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.

[0070] 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 portion 26 and the second support portion 50 (see FIG. 8) to a accommodated position (first position) as shown in FIG. 9. 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 (arrow X2 direction) relative to the outer cylinder 22.

[0071] 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.

[0072] 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. 10, 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).

[0073] 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.

[0074] 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. 10).

[0075] 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.

[0076] 9, the accommodating step is completed when the entire first support part 26 is completely inserted into the outer cylinder 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 cylinder 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 cylinder 22 is the first position of the first support part 26.

[0077] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 11, 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).

[0078] 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. 12. Specifically, in the unfolding step, the first shaft 24 is grasped and moved toward the tip (arrow X1 direction) relative to the outer tube 22. As a result, the valve body 55 of the first shaft 24 moves the second shaft 48 together with the first shaft 24 toward the tip (arrow X1 direction). Then, the first support part 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. In the second position where the first support part 26 is unfolded, the second support part 50 spreads out into a planar shape.

[0079] 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.

[0080] 13 to 15, the second carrier member 20 is moved in the distal direction (arrow X1 direction) relative to the first carrier member 18. As a result, the second support part 50 carrying the medical sheet 300 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 distal end of the first support part 26.

[0081] Specifically, in the moving step, the second shaft 48 is moved in the distal direction relative to the first shaft 24. As a result, the second support part 50 moves in the distal direction (the direction of the arrow X1) relative to the first support part 26. At this time, the base end part 304 of the medical sheet 300 enters the first recess part 104 of the carrier holding part 54, and the base end part 304 of the medical sheet 300 abuts against the pressing surface 58 (see FIGS. 13 and 14).

[0082] When the second shaft 48 is further moved in the distal direction relative to the first shaft 24, the carrier holding portion 54 presses the base end 304 of the medical sheet 300 in the distal direction via the pressing surface 58. As a result, the entire medical sheet 300 moves in the distal direction together with the second carrier member 20.

[0083] In this moving step, the medical sheet 300 is moved above the transplantation target portion 402 of the heart 400 so that the protruding portions 302 of the medical sheet 300 come into contact with the transplantation target portion 402 (see FIG. 15).

[0084] 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.

[0085] The first embodiment provides the following advantages.

[0086] 13, with the medical sheet 300 supported on the first support surface 261, 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).

[0087] As shown in Fig. 4, a first protrusion 100 (protrusion) that protrudes distally beyond the pressing surface 58 is provided in the carrier holding part 54 (pressing part) at a location farther from the first support surface 261 than the pressing surface 58. As a result, as shown in Figs. 13 and 14, when the second shaft 48 is moved distally and the pressing surface 58 presses the medical sheet 300 distally, the first protrusion 100 is positioned above the medical sheet 300, so that the medical sheet 300 can be prevented from riding up onto the carrier holding part 54. As a result, as shown in Fig. 15, the medical sheet 300 can be smoothly transferred to the transplantation target portion 402 of the heart 400 (the treatment target portion of the living body).

[0088] 4 and 5, the second support part 50 is fixed to the pressing surface 58 of the carrier holding part 54, and the medical sheet 300 is supported on the second support surface 74 of the second support part 50. As a result, as shown in FIG. 14, when the second shaft 48 is moved in the distal direction, the base end 304 of the medical sheet 300 enters the first recess 104 and abuts against the pressing surface 58. As a result, as shown in FIG. 15, by pressing the medical sheet 300 in the distal direction with the pressing surface 58, the medical sheet 300 can be smoothly transferred to the transplantation target site 402 while reliably preventing the medical sheet 300 from riding up onto the carrier holding part 54.

[0089] 4 and 5, the carrier holding part 54 has a second protrusion 102 (second protrusion) at a location closer to the first support surface 261 of the first support part 26 than the pressing surface 58. As a result, when the medical sheet 300 (see FIG. 1) is placed on the second support part 50 with the second shaft 48 rotated 180° about the axis of the second shaft 48, the second protrusion 102 is located below the medical sheet 300. At this time, even when the second shaft 48 rotates about the axis of the second shaft 48, the base end 304 of the medical sheet 300 can be inserted into the second recess 106 and brought into contact with the pressing surface 58 by moving the second shaft 48 in the distal direction. As a result, by pressing the medical sheet 300 toward the tip with the pressing surface 58, the medical sheet 300 can be smoothly transferred to the transplant target area 402 while reliably preventing the medical sheet 300 from riding onto the carrier holding portion 54.

[0090] 3, the tip of the first protrusion 100 is formed in an arc shape. This prevents the medical sheet 300 (see FIG. 1) from coming into contact with the tip of the first protrusion 100 and damaging the medical sheet 300.

[0091] In the first embodiment, the carrier holding portion 54 does not necessarily have to have the second protrusion portion 102.

[0092] A transfer device 120 according to a second embodiment of the present invention will be described with reference to Figures 17 to 23. Note that in the transfer device 120 according to the second embodiment, the same components as those in the transfer device 10 according to the first embodiment (see Figures 1 to 16) are given the same reference symbols, and detailed descriptions of the same components will be omitted.

[0093] Fig. 17 is a perspective view of a transferring device 120 according to the second embodiment. The transferring device 120 does not have a second support part 50 (see Figs. 1 to 5). The medical sheet 300 is supported on a first support surface 261 of a first support part 26 (see Figs. 20 to 22).

[0094] That is, the transfer device 120 has a second carrier member 20A. The second carrier member 20A has a second shaft 48 and a pressing portion 122 provided at the tip of the second shaft 48. The pressing portion 122 has a pressing base 124 and a protrusion 130 protruding from the pressing base 124 in the tip direction. The tip surface of the pressing base 124 is formed as a pressing surface 58. The protrusion 130 is provided at the tip of the pressing base 124.

[0095] 17, the protrusion 130 is provided at the tip of the pressing base 124 at a location farther away from the first support surface 261 than the pressing surface 58. That is, the protrusion 130 is provided at the tip of the pressing base 124 above the pressing surface 58. The protrusion 130 is provided at the tip of the pressing base 124 in the center of the pressing base 124 in the width direction.

[0096] At the tip of the pressing base 124, the protrusion 130 protrudes further in the tip direction than the pressing surface 58 and extends in the tip direction. The tip of the protrusion 130 is formed in an arc shape. The tip of the protrusion 130 is not limited to an arc shape. The tip of the protrusion 130 may have any shape that does not damage the medical sheet 300 when it comes into contact with the medical sheet 300.

[0097] The protruding length of protrusions 130 from the tip of pressing base 124 in the tip direction (protruding length of protrusions 130 in the tip direction) is desirably half or more of the overall length of medical sheet 300 in the tip direction. The protruding length of protrusions 130 is, for example, 10 mm to 50 mm. Therefore, when medical sheet 300 is placed on first support surface 261, protrusions 130 are located above medical sheet 300.

[0098] The protrusion 130 has a lower surface 132 facing the first support surface 261 and an upper surface 134 opposite to the lower surface 132. A rib 136 is provided on the upper surface 134 of the protrusion 130. The rib 136 is provided at the center of the upper surface 134 in the width direction. The rib 136 protrudes upward from the upper surface 134 of the protrusion 130 so as to be separated from the first support surface 261. The rib 136 extends toward the tip on the upper surface 134 of the protrusion 130. Therefore, as shown in FIG. 19, the protrusion 130 and the rib 136 are formed in a T-shape in cross section. The base end of the rib 136 extends to the upper surface of the pressing base 124. This makes it possible to prevent the protrusion 130 from sagging toward the first support surface 261 due to its own weight.

[0099] In the transfer device 120, the pressing portion 122 is desirably made of a flexible material. When a user pulls the rib 136 upward using tweezers or the like, the protrusion 130 can bend upward with the connection point with the pressing base 124 (the base end of the protrusion 130) as a fulcrum.

[0100] Next, a method for transporting the medical sheet 300 (see FIG. 17) in the second embodiment will be described.

[0101] In the preparation step (step S1 in FIG. 6), a transportation device 120 according to the second embodiment is prepared. Note that the transportation device 120 is in an initial state as shown in FIG.

[0102] In the sheet placement step (step S2 in FIG. 6), the medical sheet 300 placed in the petri dish 401 (see FIG. 7) is placed on the first support surface 261. In the sheet placement step, the user uses tweezers or the like to pull the ribs 136 upward. This causes the protrusions 130 to bend upward with the connection points with the pressing base 124 (the base ends of the protrusions 130) as the fulcrum. The user places the medical sheet 300 on the first support surface 261. In this case, the tips of the protrusions 130 are spaced upward from the first support surface 261 compared to before the protrusions 130 were pulled up. This allows the medical sheet 300 to be placed on the first support surface 261 without coming into contact with the tips of the protrusions 130. After placing the medical sheet 300 on the first support surface 261, the user returns the protrusions 130 and the ribs 136 to their original positions. As a result, the medical sheet 300 is placed (supported) on the first supporting surface 261, between the first supporting surface 261 and the protrusions 130.

[0103] In the accommodation step (step S3 in FIG. 6), as shown in FIG. 18, the medical sheet 300 is accommodated in the outer tube 22 together with the first support portion 26 at an accommodation position (first position). As shown in FIG. 19, the first support portion 26 is accommodated in the outer tube 22 in a state where it is curved into a heart shape along the inner surface of the outer tube 22. The medical sheet 300 is accommodated in the outer tube 22 in a state where it is curved into a heart shape inside the first support portion 26. In the outer tube 22, the back surfaces 462 on both sides in the width direction of the first support portion 26 contact the rib 136 while facing each other. In other words, in the outer tube 22, the rib 136 is sandwiched between the back surfaces 462 on both sides in the width direction of the first support portion 26. As a result, the protrusion portion 130 is accommodated in the central portion of the outer tube 22 in the width direction of the outer tube 22.

[0104] In the placement step (step S 4 in FIG. 6), the delivery device 120 is inserted into the thoracic cavity 410 through an incision 409 in the chest 408 .

[0105] In the unfolding step (step S5 in FIG. 6), as shown in FIG. 20, the first support part 26 and the medical sheet 300 are unfolded while the medical sheet 300 is supported on the first support surface 261. As described above, the protrusion 130 is disposed in the center inside the outer tube 22 (see FIG. 19), so that the first support part 26 and the medical sheet 300 can be stably moved in the distal direction and unfolded. When the first support part 26 and the medical sheet 300 are unfolded, the base end 304 of the medical sheet 300 is located between the first support surface 261 and the protrusion 130.

[0106] In the moving step (step S6 in FIG. 6), as shown in FIG. 21 to FIG. 23, the second shaft 48 is moved in the distal direction relative to the first shaft 24. This causes the base end 304 of the medical sheet 300 to abut against the pressing surface 58 (see FIG. 21 and FIG. 22).

[0107] When the second shaft 48 is further moved in the distal direction relative to the first shaft 24, the pressing portion 122 presses the base end 304 of the medical sheet 300 in the distal direction via the pressing surface 58. As a result, the entire medical sheet 300 moves in the distal direction together with the second carrier member 20A.

[0108] In the moving step, the medical sheet 300 is moved above the transplantation recipient portion 402 of the heart 400 and brought into contact with the transplantation recipient portion 402 (see FIG. 23). This brings the entire medical sheet 300 into contact with the surface of the transplantation recipient portion 402. As a result, the transfer of the medical sheet 300 to the transplantation recipient portion 402 is completed.

[0109] In the removal step (step S7 in FIG. 6), the second carrier member 20A is moved from the second position to the first position. The transportation instrument 120 is removed from the chest 408 with the first support part 26 housed in the outer cylinder 22.

[0110] The second embodiment provides the following advantages.

[0111] 17, the pressing portion 122 has a protrusion 130 (protrusion) that protrudes distally beyond the pressing surface 58 at a location farther from the first support surface 261 than the pressing surface 58. As a result, as shown in FIGS. 21 and 22, when the second shaft 48 is moved distally and the pressing surface 58 presses the medical sheet 300 distally, the protrusion 130 is positioned above the medical sheet 300, preventing the medical sheet 300 from riding up onto the pressing portion 122. As a result, as shown in FIG. 23, the medical sheet 300 can be smoothly transferred to the transplant target portion 402 of the heart 400 (the treatment target portion of the living body).

[0112] 21 and 22, the protruding length of protrusion 130 in the distal end direction is equal to or more than half the total length of medical sheet 300 in the distal end direction, so that medical sheet 300 can be reliably supported between first support portion 26 and protrusion 130. Furthermore, when medical sheet 300 is pressed in the distal end direction by pressing surface 58, lifting of medical sheet 300 from first support surface 261 and the occurrence of wrinkles in medical sheet 300 can be suppressed.

[0113] The pressing portion 122 having the protrusion 130 is made of a flexible material, and the rib 136 is provided on the upper surface 134 of the protrusion 130. This makes it possible to easily place the medical sheet 300 between the first support portion 26 and the protrusion 130 with the rib 136 raised.

[0114] The tips of the protrusions 130 are formed in an arc shape, which prevents the medical sheet 300 from coming into contact with the tips of the protrusions 130 and damaging the medical sheet 300.

[0115] 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]

[0116] 10, 120...transfer equipment 18...First carrier member 20, 20A...Second carrier member 24…First shaft 26…First support part 48…Second shaft 54...Carrier holding portion (pressing portion) 58...Pressing surface 100...First protrusion (protrusion) 122...Pressing part 130...Protrusion 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 for supporting the medical sheet; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a pressing portion provided at a tip end of the second shaft; Equipped with The pressing portion has a pressing surface for pressing the medical sheet supported on the first support surface in a distal direction, and a protrusion portion that protrudes in the distal direction further than the pressing surface at a location farther away from the first support surface than the pressing surface.

2. 2. The transfer device of claim 1, The second carrier member further includes a second support portion fixed to the pressing portion and having a second support surface smaller than the first support surface, the medical sheet is supported on the second support surface; A transfer instrument, wherein a first recess into which a base end of the medical sheet fits is formed by the pressing surface, the protrusion, and the second support portion.

3. 3. The transfer device of claim 2, The pressing portion is provided at a location closer to the first support surface than the pressing surface, and further includes a second protruding portion protruding in the tip direction beyond the pressing surface, A transfer instrument, wherein the pressing surface, the second protrusion portion, and the second support portion form a second recess into which the base end portion of the medical sheet fits.

4. 2. The transfer device of claim 1, A transfer instrument, wherein the protruding length of the protrusion in the distal direction is equal to or greater than half of the overall length of the medical sheet in the distal direction.

5. 5. The transfer device of claim 4, The pressing portion is made of a flexible material, The protrusion has a lower surface facing the first support surface and an upper surface opposite to the lower surface, The upper surface is provided with a rib that projects away from the first support surface and extends in the distal direction.

6. A transfer device according to any one of claims 1 to 5, A transfer device, wherein a tip of the protrusion is formed in an arc shape.

Images