Transfer equipment

Abstract

To achieve a reduced diameter and reduced invasion in transfer equipment for transferring a medical sheet to a treatment object part of a living body.SOLUTION: Transfer equipment 10 includes an external cylinder 22 and a carrier member (first carrier member) having a shaft (first shaft) and a sheet-like support part (first support part 26). At a first position in which the shaft is moved in a base end direction with respect to the external cylinder 22 so that the support part is housed in the external cylinder 22, the support part includes a pair of separation parts 39 housed in the external cylinder 22 in the state of being deformed into a curved shape, which are separated from an inner peripheral surface of the external cylinder 22, and protrude inside the external cylinder 22. The pair of separation parts 39 do not come in contact with each other.SELECTED DRAWING: Figure 9

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 have smaller, less invasive delivery instruments. [Means for solving the problem]

[0005] (1) One aspect of the present invention is a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: an outer tube having a tip opening; a shaft extending in the axial direction of the outer tube and disposed inside the outer tube so as to be movable along the axial direction; and a carrier member having a sheet-shaped support part disposed at the tip of the shaft, wherein the support part includes a support surface capable of holding the medical sheet and a back surface opposite to the support surface, the width of the support part in a direction perpendicular to the extension direction of the shaft is greater than the inner peripheral length of the outer tube, and the support part is This is a transfer device in which, at a first position where the shaft is moved in a base end direction relative to the outer tube so as to be accommodated within the outer tube, the support portion is accommodated within the outer tube in a curved and deformed state, and has a pair of spaced portions that are spaced apart from the inner surface of the outer tube and protrude into the inside of the outer tube, the pair of spaced portions being non-contact with each other, and at a second position where the shaft is moved in a distal direction relative to the outer tube so that the support portion protrudes from the tip opening of the outer tube, the support portion deploys by being exposed in the distal direction from the outer tube.

[0006] With this configuration, the support part can be curved and deformed to be housed inside the outer tube, making the transport device thinner and less invasive. In addition, when the support part is housed inside the outer tube, a pair of separated parts of the support part that are separated from the inner circumferential surface of the outer tube do not come into contact with each other, so the force required to pull the support part into the outer tube can be reduced, improving the operability of the transport device.

[0007] (2) In the transfer device described in (1) above, the support portion has a support base portion having the support surface and a pair of protrusions protruding upward from both sides of the support base portion in the width direction of the support portion, and the support base portion and the pair of protrusions are connected via a pair of curved portions curved in an arc, and the pair of curved portions may be formed so as to keep the pair of spaced portions non-contact with each other when the support portion is contained within the outer tube.

[0008] With this simpler configuration, the pair of spaced apart portions can be made non-contact with each other.

[0009] (3) In the transport device described in (1) or (2) above, an endoscope may be provided with at least a tip portion disposed inside the outer tube, and in the axial direction, a space formed between the pair of spaced apart portions may face the tip portion of the endoscope.

[0010] With this configuration, the tip of the endoscope is disposed inside the outer tube, so that the front of the transfer instrument can be visually confirmed by the endoscope without increasing the outer diameter of the tip of the transfer instrument. Also, since the space formed between the pair of separating parts faces the tip of the endoscope, the endoscope can capture an image of the front of the transfer instrument through the space. Effect of the Invention

[0011] According to the transport device of the present invention, the support part can be curved and deformed to be housed in the outer tube, so that the transport device can be made thinner and less invasive. In addition, when the support part is housed in the outer tube, a pair of separated parts of the support part that are separated from the inner circumferential surface of the outer tube do not contact each other, so that the force required to pull the support part into the outer tube can be reduced, and the operability of the transport device can be improved. [Brief description of the drawings]

[0012] [Figure 1] FIG. 1 is a perspective view of a delivery device according to an embodiment of the present invention. [Diagram 2] FIG. 2 is an exploded perspective view of the delivery device of FIG. [Diagram 3] FIG. 3 is a plan view of the tip of the delivery device of FIG. [Figure 4] FIG. 4 is a vertical cross-sectional view taken along line IV-IV in FIG. [Diagram 5] FIG. 5 is a cross-sectional view taken along line VV in FIG. [Figure 6] FIG. 6 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 7] FIG. 7 is an explanatory diagram of the sheet placing step. [Figure 8] FIG. 8 is an explanatory diagram of the accommodation step. [Figure 9] FIG. 9 is a cross-sectional view taken along line IX-IX in FIG. [Figure 10] FIG. 10 is an explanatory diagram of the placement process. [Figure 11] FIG. 11 is an explanatory diagram of the development process. [Figure 12] FIG. 12 is an explanatory diagram of the movement process. [Figure 13] FIG. 13 is an explanatory diagram of the removal step. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] As shown in Fig. 1, the transfer device 10 according to this embodiment is a medical device for transferring a medical sheet 300 to a treatment target part of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure caused by ischemic heart disease. In this case, the medical sheet 300 is transplanted to a transplant target part 402 of a heart 400 (a treatment target part of a living body) (see Fig. 12). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

[0014] Such medical sheet 300 includes pharmaceuticals for medical use, regenerative medicine products, medical devices, etc. The medical sheet 300 is formed in a sheet shape such as a film or membrane (gel-like substance). The medical sheet 300 may be reinforced by applying fibrin or the like. Regenerative medicine products containing cells include, for example, cell sheets (sheet-shaped cell cultures), spheroids, etc. The cell sheet can be formed by culturing autologous cells or allogeneic cells. The cells constituting the cell sheet include, for example, somatic stem cells (adult stem cells), mesenchymal stem cells, or cardiomyocytes derived from iPS cells (induced pluripotent stem cells). The somatic stem cells preferably include skeletal myoblasts (myoblast cells).

[0015] The medical sheet 300 may contain a tissue adhesive, a local anesthetic, etc. The thickness of the medical sheet 300 is, for example, about 100 μm, and the diameter of the medical sheet 300 is, for example, about 60 mm. However, the thickness and diameter (size) of the medical sheet 300 can be set appropriately.

[0016] The medical sheet 300 may be a sheet to be transplanted into an organ (such as the lung, liver, pancreas, kidney, small intestine, or esophagus) other than the heart 400. Furthermore, the medical sheet 300 may be a sheet for preventing adhesions, for example, so long as it is for medical use.

[0017] 1 and 2, the transportation instrument 10 includes an instrument body 12, an endoscope 14, and a fixing member 16. The instrument body 12 includes a first carrier member 18, a second carrier member 20, and an outer cylinder 22. Note that the transportation instrument 10 is not limited to including the endoscope 14.

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

[0019] The first shaft 24 is a tubular body (a circular tube member in this embodiment) having a first lumen 28. The first lumen 28 opens at the tip (the end in the direction of the arrow X1) of the first shaft 24 and at the base end (the end in the direction of the arrow X2) of the first shaft 24. An airtight valve body 55 that is in close contact with the outer circumferential surface of the second shaft 48 is provided at the base end of the first shaft 24. A marker 551 is provided on the outer circumferential surface of the valve body 55. When using the transfer device 10, the user can see the marker 551. Note that the first shaft 24 is not limited to a tubular body, and may not be a tubular body.

[0020] The first shaft 24 extends in the axial direction of the outer cylinder 22 and is disposed inside the outer cylinder 22 so as to be movable along the axial direction. The first shaft 24 is made of, for example, a resin material. The constituent material of the first shaft 24 is not particularly limited, but examples thereof include polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyether ether ketone, polyvinyl chloride, ABS resin, polyamide elastomer, and polyester elastomer. The first shaft 24 may be made of a metal material.

[0021] The first shaft 24 may be flexible. The first shaft 24 may have a flexible tube portion capable of retaining a bent shape. In this case, the first shaft 24 can be bent into an appropriate shape within the body cavity and can retain the bent shape.

[0022] 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.

[0023] 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.

[0024] 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.

[0025] 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.

[0026] 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).

[0027] 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.

[0028] 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).

[0029] 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.

[0030] 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.

[0031] As shown in FIG. 3, hereinafter, the combined portion of the first protrusion 38 and the second protrusion 40 of the first support portion 26 is referred to as the "protrusion 37". Therefore, a pair of protrusions 37 is provided on both sides of the width direction of the first support portion 26. In FIG. 3, the direction perpendicular to the axial direction of the first shaft 24 (W direction) is the width direction of the first support portion 26. The W direction is also the width direction of other components (such as the outer tube 22). In this embodiment, the first support portion 26 has a pair of protrusions 37, and W1 in FIG. 3 is the width of the portion where the width of the first support portion 26 is maximum when the first support portion 26 is developed in a planar state. That is, the width W1 of the first support portion 26 is the maximum width of the first support portion 26P in a planar state before the pair of protrusions 37 are formed (before bending). The width W1 of the first support portion 26 is greater than the inner circumferential length L of the outer tube 22 (see FIG. 9). 9, the inner peripheral length L of the outer cylinder 22 is the length of the inner peripheral surface along the circumferential direction of the outer cylinder 22 (L=2πR). R is the radius of the inner cavity 78 of the outer cylinder 22.

[0032] 5, the first support portion 26 has a support base portion 264 having a first support surface 261. The pair of protrusions 37 protrude upward from both sides of the support base portion 264 in the width direction of the first support portion 26. The support base portion 264 and the pair of protrusions 37 are connected via a pair of curved portions 444 curved in an arc shape. Each curved portion 444 is curved such that a part of the front surface 461 of the first support portion 26 forms the inside of the curved portion 444 (the inside of the curved shape) and a part of the back surface 462 of the first support portion 26 forms the outside of the curved portion 444 (the outside of the curved shape).

[0033] 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.

[0034] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0035] 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.

[0036] 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.

[0037] 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.

[0038] 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.

[0039] In Fig. 4, the pressing surface 58 is provided on the tip surface of the carrier holding part 54. An attachment hole 60 opens in the pressing surface 58. The second support part 50 is attached to the pressing surface 58. The pressing surface 58 presses the outer peripheral end surface of the medical sheet 300 in the tip direction (the direction of the arrow X1) (see Fig. 12).

[0040] 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.

[0041] 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.

[0042] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0043] 1 and 2, the outer tube 22 is a cylindrical member having a cavity 78. The cavity 78 has a tip opening 80 that opens at the tip (end in the direction of arrow X1) of the outer tube 22. The cavity 78 opens at the base end (end in the direction of arrow X2) of the outer tube 22. The outer tube 22 is flexible. The outer tube 22 may be made of the same material as the first shaft 24 described above. The first shaft 24 is inserted into the cavity 78 of the outer tube 22. The length of the outer tube 22 in the axial direction is shorter than the length of the first shaft 24 in the axial direction. The base end of the outer tube 22 is provided with an airtight valve body 84 that is in close contact with the outer circumferential surface of the first shaft 24.

[0044] 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.

[0045] 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.

[0046] 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.

[0047] Next, a method for transferring the medical sheet 300 to a treatment target part of a living body will be described. Specifically, as shown in Fig. 10 to Fig. 13, a method for transferring the medical sheet 300 to a transplant target part 402 of a heart 400 (treatment target part of a living body) by thoracoscopic surgery will be described. As shown in Fig. 6, the transfer method according to this embodiment includes a preparation step, a sheet placement step, a storage step, a positioning step, a deployment step, a movement step, and a removal step.

[0048] 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.

[0049] 7, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. The medical sheet 300 protrudes outward from the second support portion 50 when placed on the second support surface 74. The first support surface 261 supports the protruding portion 302 of the medical sheet 300 that protrudes outward from the second support portion 50.

[0050] Thereafter, in the accommodation step (step S3 in FIG. 6), the medical sheet 300 is accommodated in the outer cylinder 22 together with the first support part 26 and the second support part 50 to a accommodated position (first position) as shown in FIG. 8. Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the base end direction (the direction of the arrow X2) relative to the outer cylinder 22.

[0051] 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.

[0052] When the base end support portion 34 of the first support portion 26 is deformed, a force acts on the intermediate support portion 36 of the first support portion 26 to curl up along the circumferential direction of the outer tube 22, so that the intermediate support portion 36 (see FIG. 2) is drawn into the outer tube 22 while curling up. At this time, the intermediate support portion 36 is deformed into a cylindrical shape along the inner surface of the outer tube 22. Each of the pair of first protrusions 38 is curved so that the surface 461 of the first support portion 26 is on the inside and the back surface 462 of the first support portion 26 is on the outside. As shown in FIG. 9, the back surfaces 462 on both sides in the width direction of the first support portion 26 face each other across a virtual line L2 extending perpendicular to the central axis of the outer tube 22. One first protrusion 38 and the other first protrusion 38 are accommodated downward (the first support surface 261, the surface 461).

[0053] As a result, the back surface 462 of the first support portion 26 is curved in intimate contact with the inner surface of the outer tube 22, and each of the first protrusions 38 is further curved so as to be folded back toward the center of the outer tube 22, and the free end of each of the first protrusions 38 is disposed below the central axis of the outer tube 22. In other words, the first support portion 26 is curved into a heart shape that follows the inner surface of the outer tube 22.

[0054] 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. 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, so that the overall outline becomes a generally circular shape along the inner surface of the tubular body (see the shape of the first support part 26 in FIG. 9).

[0055] As the first support part 26 curves, the second support part 50 (see FIGS. 1 to 3) also curves along the inside (surface 461 side) of the first support part 26. As the first support part 26 and the second support part 50 curve, the medical sheet 300 deforms 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.

[0056] As shown in FIG. 9, in a state where the first support part 26 is accommodated in the outer tube 22 (hereinafter, also referred to as the "curved state of the first support part 26"), the first support part 26 has a pair of spaced parts 39 that are spaced from the inner circumferential surface of the outer tube 22 and protrude into the interior (cavity 78) of the outer tube 22. The pair of spaced parts 39 are not in contact with each other. Each of the spaced parts 39 includes a protruding part 37 and a curved part 444. The pair of spaced parts 39 are spaced from each other in the width direction (W direction) of the first support part 26. The pair of curved parts 444 are formed so as to make the pair of spaced parts 39 not in contact with each other. In the curved state of the first support part 26, the pair of protruding parts 37 that are located below the curved part 444 of the pair of spaced parts 39 have a mutual spacing that increases downward. In the curved state of the first support part 26, the pair of protruding parts 37 may be parallel to each other along the virtual line L2.

[0057] 8, the accommodating step is completed when the entire first support part 26 is completely inserted into the outer tube 22. When the accommodating step is completed, a part of the first support part 26 may protrude from the tip opening 80 of the outer tube 22. In this case, the state in which a part of the first support part 26 protrudes from the tip opening 80 of the outer tube 22 is the first position of the first support part 26.

[0058] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 10, the transfer instrument 10 is inserted into the thoracic cavity 410 through the incision 409 in the chest 408. At this time, the tip of the transfer instrument 10 is positioned near the transplant target portion 402 in the heart 400, and the tip of the endoscope 14 is positioned inside the thoracic cavity 410. Note that before inserting the transfer instrument 10 into the thoracic cavity 410, a liquid supply instrument (not shown) may be connected to the connection port of the hub 52 to introduce liquid (e.g., physiological saline).

[0059] Next, in the unfolding step (step S5 in FIG. 6), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 11. Specifically, in the unfolding step, the first shaft 24 is grasped and moved toward the tip (arrow X1 direction) relative to the outer tube 22. As a result, the valve body 55 of the first shaft 24 moves the second shaft 48 together with the first shaft 24 toward the tip (arrow X1 direction). Then, the first support part 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. In the second position where the first support part 26 is unfolded, the second support part 50 spreads out into a planar shape.

[0060] 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.

[0061] 12, by moving the second carrier member 20 in the distal direction (arrow X1 direction) relative to the first carrier member 18, the second support part 50 on which the medical sheet 300 is placed moves from the retracted position to the advanced position, and the second support part 50 protrudes in the distal direction (arrow X1 direction) beyond the tip of the first support part 26. Specifically, in the moving step, the second shaft 48 is moved in the distal direction relative to the first shaft 24.

[0062] As a result, the second support part 50 moves in the distal direction (direction of arrow X1) relative to the first support part 26. At this time, when the distal end surface of the carrier holding part 54 (pressing part 56) presses the outer peripheral end surface of the medical sheet 300 in the distal direction, the entire medical sheet 300 is positioned in the distal direction further than the first support part 26. In this moving step, the medical sheet 300 is moved above the transplant target part 402 of the heart 400, and the overhanging part 302 of the medical sheet 300 is brought into contact with the transplant target part 402.

[0063] Then, in the removal step (step S7 in FIG. 6), as shown in FIG. 13, the second carrier member 20 is moved from the second position to the first position to remove the second support part 50 from between the transplantation target part 402 and the medical sheet 300. Then, the entire medical sheet 300 comes into contact with the surface of the transplantation target part 402. This completes the transfer of the medical sheet 300 to the transplantation target part 402. Thereafter, the transferring instrument 10 is removed from the chest 408 with the first support part 26 and the second support part 50 housed within the outer cylinder 22.

[0064] This embodiment provides the following advantages.

[0065] 9, the transport device 10 can accommodate the first support part 26 in the outer tube 22 by bending and deforming the first support part 26. This allows the transport device 10 to be thinner and less invasive. In addition, when the first support part 26 is accommodated in the outer tube 22, a pair of spaced parts 39 of the first support part 26 that are spaced from the inner circumferential surface of the outer tube 22 do not come into contact with each other. This reduces the force required to draw the first support part 26 into the outer tube 22, improving the operability of the transport device 10.

[0066] The support base portion 264 and the pair of protruding portions 37 are connected via a pair of curved portions 444 curved in an arc shape. The pair of curved portions 444 are formed so as to keep the pair of spaced portions 39 out of contact with each other when the first support portion 26 is housed in the outer cylinder 22. This makes it possible to keep the pair of spaced portions 39 out of contact with each other with a simple configuration.

[0067] In FIG. 1, the endoscope 14 is disposed outside the outer tube 22, but as shown by the imaginary line in FIG. 9, the tip of the endoscope 14 may be disposed inside the outer tube 22. In this case, the tip of the endoscope 14 is disposed on the base end side of the first support portion 26 (projection portion 37) housed in the outer tube 22. Since the tip of the endoscope 14 is disposed inside the outer tube 22, the front of the transportation instrument 10 can be visually confirmed by the endoscope 14 without increasing the outer diameter of the tip of the transportation instrument 10. In this case, in the axial direction of the outer tube 22, a space S formed between a pair of separation portions 39 faces the tip of the endoscope 14. With this configuration, the endoscope 14 can capture an image of the front of the transportation instrument 10 through the space S.

[0068] The present invention is not limited to the above disclosure, and various configurations may be adopted without departing from the gist of the present invention. For example, the second support part 50 may be eliminated from the second carrier member 20. The second carrier member 20 may be eliminated from the transfer device 10, and the medical sheet 300 may be moved from above the first support part 26 to above the transplantation target portion 402 using another device. [Explanation of symbols]

[0069] 10…Transfer device 18...First carrier member 22…Outer cylinder 24…First shaft 26…First support part 37...Protruding part 39…Separation part 261...1st support surface 300…Medical sheets 402…Transplant target area

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, An outer cylinder having a tip opening; a carrier member having a shaft extending in an axial direction of the outer cylinder and disposed inside the outer cylinder so as to be movable along the axial direction, and a sheet-shaped support portion disposed at a tip portion of the shaft; the support portion includes a support surface capable of holding the medical sheet and a back surface opposite to the support surface, and a width of the support portion in a direction perpendicular to an extension direction of the shaft is greater than an inner peripheral length of the outer tube, at a first position obtained by moving the shaft in a base end direction relative to the outer cylinder so that the support portion is accommodated within the outer cylinder, the support portion is accommodated within the outer cylinder in a curved and deformed state, and has a pair of spaced portions that are spaced apart from an inner circumferential surface of the outer cylinder and protrude into the inside of the outer cylinder, the pair of spaced portions being in non-contact with each other; A delivery device in which, at a second position where the shaft is moved in a distal direction relative to the outer tube so that the support portion protrudes from the distal opening of the outer tube, the support portion is deployed by being exposed in the distal direction from the outer tube.

2. 2. The transfer device of claim 1, The support portion has a support base portion having the support surface, and a pair of protrusions protruding upward from both sides of the support base portion in a width direction of the support portion, The support base portion and the pair of protruding portions are connected via a pair of curved portions curved in an arc shape, A transfer device, wherein the pair of curved portions are formed so as to keep the pair of spaced portions out of contact with each other when the support portion is housed within the outer cylinder.

3. 3. The transfer device according to claim 1 or 2, an endoscope having at least a tip portion disposed inside the outer tube; A transfer instrument, wherein a space formed between the pair of spaced portions in the axial direction faces the tip portion of the endoscope.

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