Transfer tool

Abstract

To provide a transfer tool capable of efficiently transferring a medical sheet to a part to be treated.SOLUTION: In a transfer tool 10, a tip edge portion 100 of a first support part 26 has a locking projection 102 and a recess formed adjacently to the locking projection 102 in a width direction of the first support part 26. The locking projection 102 projects so as to incline upward toward a tip direction. The recess allows passage of a second shaft 48.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 part of a living body, comprising: a first carrier member including a first shaft and a first support part provided at a tip of the first shaft and having a first support surface; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft; and a second support part provided at a tip of the second shaft and having a second support surface smaller than the first support surface, wherein the medical sheet is supported by the first support surface and the second support surface, and the The first support part has a surface including the first support surface facing the second support part and the second shaft, and a back surface which is the opposite surface to the surface, and the tip edge part of the first support part has a locking protrusion protruding from the tip of the first support surface and a recess formed adjacent to the locking protrusion in the width direction of the first support part perpendicular to the axial direction of the first shaft, and when the direction from the back surface to the front surface is defined as upward, the locking protrusion protrudes at an angle upward toward the tip, and the recess allows the second shaft to pass through, which is a transfer device.

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

[0007] Furthermore, according to this configuration, the locking protrusion protrudes obliquely upward from the tip of the first support surface of the first support part. The recess is formed adjacent to the locking protrusion and allows the second shaft to pass through. This allows the second shaft to be moved in the tip direction via the recess from a state in which the medical sheet is supported by the first support surface and the second support surface, and the medical sheet can be transferred to the treatment target part. Furthermore, when the second shaft is moved in the base end direction along the first shaft after the medical sheet has been transferred to the treatment target part, when the medical sheet returns together with the second support part, the medical sheet abuts against the locking protrusion, and therefore the medical sheet placed on the treatment target part can be prevented from returning to the first support part.

[0008] (2) In the transfer device described in (1) above, the first support portion may have a pair of the engaging protrusions spaced apart from each other in the width direction, and the recess may be formed between the pair of the engaging protrusions.

[0009] According to this configuration, when the second shaft is moved in the proximal direction along the first shaft after the medical sheet is transferred to the treatment target, the medical sheet abuts against the pair of locking protrusions when it returns together with the second support part, which effectively prevents the medical sheet placed on the treatment target from returning to the first support part.

[0010] (3) In the delivery device described in (1) or (2) above, the locking protrusion may be formed by bending a distal edge of the first support part at an angle within a range of 10° to 60° with respect to the distal direction.

[0011] According to this configuration, when the second shaft is moved in the proximal direction along the first shaft after the medical sheet is transferred to the treatment target, the medical sheet abuts against the locking protrusion when it returns together with the second support part. As a result, the medical sheet placed on the treatment target can be more effectively prevented from returning to the first support part. In addition, because the locking protrusion is bent within an angle range of 10° to 60°, the second support part can easily climb over the locking protrusion when the second shaft moves in the distal direction along the first shaft. Effect of the Invention

[0012] According to the present invention, the medical sheet can be efficiently transported to the treatment area by moving the second shaft along the first shaft while the medical sheet is supported by the first support surface and the second support surface.

[0013] According to the present invention, the locking protrusion protrudes obliquely upward from the tip of the first support surface of the first support part. The recess is formed adjacent to the locking protrusion and allows the second shaft to pass through. This allows the second shaft to be moved in the distal direction via the recess from a state in which the medical sheet is supported by the first support surface and the second support surface, and the medical sheet can be transferred to the treatment target part. Furthermore, when the second shaft is moved in the proximal direction along the first shaft after the medical sheet has been transferred to the treatment target part, when the medical sheet returns together with the second support part, the medical sheet abuts against the locking protrusion, and therefore the medical sheet placed on the treatment target part can be prevented from returning to the first support part. [Brief description of the drawings]

[0014] [Figure 1] FIG. 1 is a perspective view of a delivery device according to an embodiment of the present invention. [Diagram 2] FIG. 2 is an exploded perspective view of the delivery device of FIG. [Diagram 3] FIG. 3 is a plan view of the tip of the delivery device of FIG. [Figure 4] FIG. 4 is a vertical cross-sectional view taken along line IV-IV in FIG. [Diagram 5] FIG. 5 is a cross-sectional view taken along line VV in FIG. [Figure 6] FIG. 6 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 7] FIG. 7 is a first explanatory diagram showing the 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 an explanatory diagram of the movement process. [Figure 14] FIG. 14 is a first explanatory view of the removal step. [Figure 15] FIG. 15 is a second explanatory view of the removal step. [Figure 16] FIG. 16 is a third explanatory view of the removal step. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] FIG. 1 is a perspective view of a transfer device 10 according to an 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. 11 to 16). The transfer device 10 can attach multiple medical sheets 300 to the transplant target portion 402.

[0016] 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).

[0017] 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.

[0018] 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.

[0019] 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.

[0020] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0021] 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.

[0022] 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.

[0023] 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.

[0024] 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.

[0025] 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.

[0026] 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.

[0027] 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.

[0028] 3, the base end support portion 34 is formed to be wider in the extension direction. In other words, both sides of the base end support portion 34 in the width direction (arrow W direction perpendicular to the arrow X1 direction, the arrow X2 direction, and the arrow Y direction (see FIG. 2)) are tapered toward the first joint portion 30. The intermediate support portion 36 is formed to be tapered so that its width gradually decreases from the tip toward the base end (arrow X2 direction).

[0029] 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 toward the tip direction (the direction of the arrow X1). 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 connects the pair of second protrusions 40. Both side portions of the tip support portion 42 are arc-shaped.

[0030] 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).

[0031] 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 (in the direction of arrow W) of the intermediate support part 36 that is 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.

[0032] 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.

[0033] 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).

[0034] 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.

[0035] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0036] 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.

[0037] 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.

[0038] 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.

[0039] 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.

[0040] 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. 13).

[0041] 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.

[0042] 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.

[0043] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0044] 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.

[0045] 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.

[0046] 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.

[0047] 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.

[0048] 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.

[0049] 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.

[0050] 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 (arrow W 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.

[0051] 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.

[0052] The medical sheet 300 is supported by the first supporting surface 261 and the second supporting surface 74 (see FIGS. 7 and 8). Specifically, the medical sheet 300 is placed on the first supporting surface 261 and the second supporting surface 74. When the medical sheet 300 is placed on the second supporting surface 74, the portion of the medical sheet 300 that does not fit on the second supporting surface 74 is supported by the first supporting surface 261. The first supporting surface 261 faces the second support part 50 and the second shaft 48. The first supporting surface 261 is included in a surface 461 of the first support body 32.

[0053] As shown in FIGS. 1 to 3, the first support body 32 of the first support portion 26 has a tip edge portion 100. The tip edge portion 100 is a tip portion of the first support body 32. The tip edge portion 100 is connected to the tip support portion 42 in the tip direction. More specifically, the tip edge portion 100 is connected to the tip of the first support surface 261 in the tip direction. The tip edge portion 100 has a pair of locking protrusions 102 and a recess 104.

[0054] The pair of locking protrusions 102 are provided on the tip of the first support surface 261, spaced apart from each other in the width direction (direction of arrow W) of the first support part 26, so as to sandwich the axis Ax (see FIG. 4) of the first shaft 24. Each of the pair of locking protrusions 102 protrudes from the tip of the first support surface 261 in the tip direction.

[0055] In this embodiment, the direction from the back surface 462 (see FIG. 4) toward the front surface 461 is defined as the upward direction. As shown in FIG. 2 and FIG. 4, each of the pair of locking protrusions 102 protrudes from the tip of the first support surface 261 so as to be inclined upward toward the tip direction. That is, each of the pair of locking protrusions 102 protrudes obliquely upward from the tip of the first support surface 261. The pair of locking protrusions 102 is formed by bending a part of the tip portion (tip edge portion 100) of the first support portion 26 obliquely upward with respect to the tip direction. As shown in FIG. 4, for each of the pair of locking protrusions 102, the bending angle θ with respect to the tip direction is preferably within a range of 10° to 60°. In this embodiment, at least one locking protrusion 102 may be formed.

[0056] As shown in Figs. 1 to 3, the recess 104 is formed adjacent to the pair of locking protrusions 102 in the width direction (arrow W direction) of the first support part 26. The recess 104 is formed between the pair of locking protrusions 102. That is, the recess 104 is formed in the center of the tip edge part 100 in the arrow W direction. The recess 104 is formed in the tip edge part 100 so as to be recessed in the base end direction further than the tips of the pair of locking protrusions 102. The recess 104 has a size sufficient to allow the second shaft 48 to pass through.

[0057] 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. 11 to Fig. 16, a method for transferring the medical sheet 300 to a transplant target part 402 of a heart 400 (treatment target part of a living body) by thoracoscopic surgery will be described. As shown in Fig. 6, the transfer method according to this embodiment includes a preparation step, a sheet placement step, a storage step, a positioning step, a deployment step, a movement step, and a removal step.

[0058] 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.

[0059] Next, in the sheet placement step (step S2), as shown in Figs. 7 and 8, 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. As described above, the leading edge portion 100 of the first support body 32 is connected in the leading direction to the leading end of the first support surface 261. In other words, the leading edge portion 100 is not the first support surface 261. Therefore, in the sheet placement step, the medical sheet 300 is not placed on the leading edge portion 100.

[0060] 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.

[0061] 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.

[0062] 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).

[0063] 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.

[0064] 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).

[0065] 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.

[0066] 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.

[0067] 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).

[0068] 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). At this time, the first shaft 24 and the second shaft 48 move toward the tip together. 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 in a planar shape.

[0069] 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.

[0070] Next, in the movement step (step S6 in FIG. 6), as shown in FIG. 13, 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.

[0071] 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 of the medical sheet 300 comes into contact with the pressing surface 58 of the carrier holding part 54.

[0072] 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 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.

[0073] In the moving step, the second support part 50, with the medical sheet 300 supported on the second support surface 74, moves toward the distal end, climbing over the pair of locking protrusions 102. The second shaft 48 moves toward the distal end, passing through the recess 104. This allows the second carrier member 20 to move the medical sheet 300 up to above the transplantation target part 402 of the heart 400. When the medical sheet 300 moves up to above the transplantation target part 402, the protruding part 302 of the medical sheet 300 comes into contact with the transplantation target part 402.

[0074] Thereafter, in the removal step (step S7 in FIG. 6), as shown in FIG. 14, 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 recipient part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation recipient part 402. This completes the transfer of the medical sheet 300 to the transplantation recipient part 402.

[0075] In the removal step, when the second shaft 48 is moved in the proximal direction, the medical sheet 300 may return together with the second support part 50. That is, even if the medical sheet 300 is transferred to the transplantation target site 402, the medical sheet 300 may return together with the second support part 50 while still in contact with the second support surface 74 due to contact resistance (friction) between the second support surface 74 and the medical sheet 300.

[0076] In this embodiment, a pair of locking protrusions 102 are provided on the tip edge 100 of the first support body 32. As shown in Figs. 14 to 16, even if the medical sheet 300 returns together with the second support part 50 when the second shaft 48 is moved in the proximal direction, the second shaft 48 passes through the recess 104 and only the medical sheet 300 abuts against the pair of locking protrusions 102. When the second shaft 48 is further moved in the proximal direction, the medical sheet 300 remains in the transplantation target part 402 while abutting against the pair of locking protrusions 102. This makes it possible to prevent the medical sheet 300 from returning to the first support part 26.

[0077] Thereafter, the delivery device 10 is removed from the chest 408 with the first support part 26 and the second support part 50 still housed within the outer tube 22 .

[0078] This embodiment provides the following advantages.

[0079] As shown in Figure 12, by moving the second shaft 48 along the first shaft 24 from a state in which the medical sheet 300 is supported by the first support surface 261 and the second support surface 74, the medical sheet 300 can be efficiently transported to the transplant target area 402 (the treatment target area of ​​the living body) (see Figure 13).

[0080] As shown in Fig. 2, the first support part 26 has at least one locking protrusion 102. The locking protrusion 102 protrudes obliquely upward from the tip of the first support surface 261 of the first support part 26. The recess 104 is formed adjacent to the locking protrusion 102 and allows the second shaft 48 to pass through. This makes it possible to move the second shaft 48 in the tip direction via the recess 104 from a state in which the medical sheet 300 is supported by the first support surface 261 and the second support surface 74 (see Fig. 12), and to transport the medical sheet 300 to the transplantation target site 402 (see Fig. 13). 14, when the second shaft 48 is moved in the proximal direction along the first shaft 24 after the medical sheet 300 has been transferred to the transplantation target portion 402, as the medical sheet 300 returns together with the second support portion 50, the medical sheet 300 abuts against the locking protrusions 102, so that the medical sheet 300 placed in the transplantation target portion 402 can be prevented from returning to the first support portion 26 (see FIG. 16). As a result, when placing the medical sheet 300 in the transplantation target portion 402 which is located in a narrow space inside the living body, the medical sheet 300 can be transferred and placed in the transplantation target portion 402 without using a support member such as forceps.

[0081] A pair of locking protrusions 102 spaced apart from each other in the width direction (arrow W direction) is provided on the distal end edge 100 of the first support part 26. A recess 104 is formed between the pair of locking protrusions 102. Therefore, when the second shaft 48 is moved in the base end direction along the first shaft 24 after the medical sheet 300 is transferred to the transplantation target part 402 as shown in FIG. 13, when the medical sheet 300 returns together with the second support part 50, the medical sheet 300 abuts against the pair of locking protrusions 102 (see FIG. 14). As a result, the medical sheet 300 placed in the transplantation target part 402 can be effectively prevented from returning to the first support part 26.

[0082] As shown in FIG. 4, since the locking protrusion 102 is bent within a bending angle θ range of 10° to 60°, when the second shaft 48 moves toward the tip along the first shaft 24, the second support portion 50 easily climbs over the locking protrusion 102.

[0083] 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]

[0084] 10…Transfer device 18...First carrier member 20...Second carrier member 24…First shaft 26…First support part 48…Second shaft 50…Second support part 74…Second support surface 100...Tip edge 102...Latching protrusion 104...Recess 261...1st support surface 300…Medical sheets 402... Transplant target part (treatment target part of living body) 461…Surface 462...Back side

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, a first carrier member including a first shaft and a first support portion provided at a tip portion of the first shaft and having a first support surface; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a second support portion provided at a tip end of the second shaft and having a second support surface smaller than the first support surface; Equipped with the medical sheet is supported by the first support surface and the second support surface, the first support portion has a front surface including the first support surface facing the second support portion and the second shaft, and a back surface that is the opposite surface to the front surface, a tip edge portion of the first support portion has a locking protrusion protruding from a tip of the first support surface and a recessed portion formed adjacent to the locking protrusion in a width direction of the first support portion perpendicular to an axial direction of the first shaft, When a direction from the back surface to the front surface is defined as an upward direction, the locking protrusion protrudes so as to be inclined upward toward a tip end direction, The recess allows passage of the second shaft.

2. 2. The transfer device of claim 1, The first support portion has a pair of the locking protrusions spaced apart from each other in the width direction, The recess is formed between a pair of the engagement protrusions.

3. 3. The transfer device according to claim 1 or 2, The transfer device, wherein the locking protrusion is formed by bending a tip edge of the first support portion at an angle within a range of 10° to 60° with respect to the tip direction.

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