Transfer device

Abstract

To provide a transfer device capable of efficiently transferring a medical sheet to a treatment target part.SOLUTION: A first carrier member 18 of a transfer device 10 comprises: a first shaft 24 disposed movably along an axial direction inside an outer tube 22; and a sheet-like first support part 26 disposed at a tip of the first shaft 24. The first support part 26 has: a slit 94 formed in a first support surface 261 and penetrating the first support part 26 in a thickness direction; and a holding part 96 provided adjacently to the slit 94 and capable of holding a second support part 50 inserted into the slit 94.SELECTED DRAWING: Figure 3

Description

[Technical field]

[0001] The present invention relates to a transfer device for transferring a medical sheet to a treatment target part of a living body. [Background technology]

[0002] Patent Document 1 discloses a transfer device for transferring a medical sheet (cell sheet) used, for example, in organ transplantation to a treatment target part of a living body. This transfer device comprises an outer tube, a sliding member slidably supported within the outer tube, and a sheet support member provided at the tip of the sliding member. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2009-000511 A Summary of the Invention [Problem to be solved by the invention]

[0004] It is desirable to more efficiently transport medical sheets to the treatment site. [Means for solving the problem]

[0005] (1) An aspect of the present invention is a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: a first carrier member having an outer tube having a tip opening; a first 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 sheet-shaped first support part disposed at the tip of the first shaft; a second carrier member having a second shaft extending along the first shaft and disposed so as to be movable along the first shaft; and a sheet-shaped second support part disposed at the tip of the second shaft; The medical sheet may be supported by a first support surface capable of supporting the medical sheet, a slit formed on the first support surface and penetrating the first support portion in a thickness direction, and a supporting portion provided adjacent to the slit and capable of supporting the second support portion inserted into the slit, wherein the width of the first support portion in a direction perpendicular to an extension direction of the first shaft is greater than an inner peripheral length of the outer cylinder, and at a first position where the first and second shafts are moved in a proximal direction relative to the outer cylinder so that the first and second support portions are housed within the outer cylinder, the first and second support portions are in a curved and deformed state. and at a second position where the first and second shafts are moved in a distal direction relative to the outer cylinder so that the first and second support parts protrude from a distal opening of the outer cylinder, the first and second support parts are exposed in the distal direction from the outer cylinder and are deployed, and the first support part and the second support part are arranged to overlap each other in a plan view. At the first position and the second position, the second support part is inserted through the slit and held by the holding part on the first support part, and the first and second support parts protrude in the distal direction from the distal end of the outer cylinder. when the first and second support parts are moved relative to the outer tube in the base end direction from the extended state, the first and second support parts are guided toward the tip opening of the outer tube, and the first and second support parts are deformed into a curved shape so that both widthwise sides of the first support part protrude toward the first support surface, and when the second support part is moved relative to the first support part in the tip direction from a state in which the medical sheet is placed on the first and second support parts at the second position, the second support part is guided in the tip direction by the slit.

[0006] According to this transfer device, when a medical sheet is placed on the first support part, moisture on the first support surface can be effectively discharged to the outside of the first support part through the slit, so that when the medical sheet placed on the first support surface is transferred to a treatment target part, the medical sheet can be placed at a predetermined position on the treatment target part while suppressing the influence of moisture. This allows the medical sheet to be efficiently transferred to the treatment target part by the first support part. When the first and second support parts are housed in the outer tube, the second support part is inserted into the slit and held by the holding part, so that the second support part can be curved and deformed to follow the first support part. Since the holding part prevents the second carrier member from rotating relative to the first carrier member, the second support part can be stably moved along the first support part.

[0007] (2) In the conveying device described in (1) above, the slit may extend in a direction intersecting a direction of movement of the first support part on the first support surface.

[0008] With this configuration, when the second support part is moved from a state in which it protrudes distally relative to the first support part toward the base end and returned to the second position, the second support part is inserted through the slit. Therefore, even when the second support part is moved relative to the first support part to place the medical sheet on the treatment target, the second support part does not come out of the slit, so there is no need to reinsert the second support part into the slit before transferring the next medical sheet with the transfer tool. This provides good efficiency when repeatedly transferring medical sheets with the transfer tool.

[0009] (3) In the transfer device described in (1) or (2) above, the first support portion may include a tip support portion that constitutes the tip side of the first support portion, the slit may be provided in the tip support portion, and the retaining portion may be provided between the tip edge of the first support portion and the slit.

[0010] With this configuration, the tip side of the first support part can guide the second support part in the moving direction, so that the medical sheet placed on the first support surface can be stably transferred to the treatment target part in the tip direction. Moisture can be effectively discharged from the tip of the first support surface close to the treatment target part.

[0011] (4) In the transfer device described in (1) above, the slits may extend along the movement direction of the second support part on the first support surface and be provided in a pair spaced apart in the width direction, the holding parts may be positioned widthwise outward of the slits in the width direction and be provided in a pair spaced apart in the width direction of the second support part, and the widthwise side parts of the second support part may be inserted into the slits.

[0012] With this configuration, the pair of slits and the holding portion can effectively guide the second support portion along the moving direction of the second support portion. The pair of slits can more effectively discharge moisture on the first support surface to the outside of the first support portion. Effect of the Invention

[0013] According to the present invention, the first support part of the transfer device includes a slit formed on the first support surface and penetrating the first support part in the thickness direction, and a holding part provided adjacent to the slit and capable of holding the second support part inserted into the slit. Thereby, when the medical sheet is placed on the first support part, moisture on the first support surface can be effectively discharged to the outside of the first support part through the slit. Therefore, when the medical sheet placed on the first support surface is transferred to the treatment target part, the medical sheet can be placed at a predetermined position on the treatment target part while suppressing the influence of moisture, and the medical sheet can be efficiently transferred to the treatment target part by the first support part. When the first and second support parts are housed in the outer tube, the second support part is inserted into the slit and held by the holding part, so that the second support part can be curved and deformed to follow the first support part. The holding part prevents the second carrier member from rotating relative to the first carrier member, so that the second support part can be stably moved along 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 view of the sheet placing step. [Figure 8] FIG. 8 is a second explanatory view of the sheet placing step. [Figure 9] FIG. 9 is a first explanatory view 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 a first 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 an explanatory diagram of the removal step. [Figure 16] FIG. 16 is a plan view of a tip portion of a transportation device having a first support portion according to a modified example. [Figure 17] FIG. 17 is a cross-sectional view taken along line XVII-XVII in FIG. [Figure 18] FIG. 18 is a plan view showing the conveying device of FIG. 16 in a moving process. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] As shown in Fig. 1, the transfer device 10 according to this embodiment is a medical device for transferring a medical sheet 300 to a treatment target part of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure caused by ischemic heart disease. In this case, the medical sheet 300 is transplanted to a transplant target part 402 of a heart 400 (a treatment target part of a living body) (see Figs. 11 to 15). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 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 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.

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

[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 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.

[0030] 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.

[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 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.

[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] 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. 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.

[0034] 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).

[0035] 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.

[0036] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0037] 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.

[0038] 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.

[0039] 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.

[0040] 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.

[0041] 4, the pressing surface 58 is provided on the tip surface of the carrier holding portion 54. An attachment hole 60 opens in the pressing surface 58. The second support portion 50 is attached to the pressing surface 58.

[0042] 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.

[0043] 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.

[0044] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0045] 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.

[0046] 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.

[0047] 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.

[0048] 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.

[0049] 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.

[0050] The first support body 32 of the first support portion 26 further includes a slit 94 and a retaining portion 96 .

[0051] The slit 94 is formed in the first support surface 261 of the first support body 32 and penetrates the first support part 26 in the thickness direction (see FIG. 4). The second support part 50 is inserted into the slit 94. The slit 94 is provided in the tip support part 42 of the first support part 26. The slit 94 is provided at a position spaced from the tip edge 262 of the first support part 26 in the base end direction (arrow X2 direction). The range of the tip support part 42 is, for example, 1 / 3 of the length from the tip edge 262 of the first support part 26 to the tip of the first shaft 24.

[0052] The slit 94 is disposed at the center in the width direction of the tip support part 42. The slit 94 is disposed on the movement trajectory of the second support part 50. The movement trajectory of the second support part 50 is the direction of the arrows X1 and X2 in FIG. 3. The slit 94 extends in the width direction (W direction) intersecting with the movement direction of the second support part 50 on the first support surface 261. The slit 94 has an arc shape that is convex toward the tip direction (arrow X1 direction). The slit 94 is not limited to being formed in an arc shape that is convex toward the tip direction. For example, the slit 94 may extend linearly along the width direction of the first support part 26. The slit 94 is formed in a shape that corresponds to the shape of the tip of the first support part 26. The slit 94 and the tip edge 262 of the first support part 26 are disposed approximately parallel to each other. The width of the slit 94 along the extension direction is greater than the width of the second support part 50. The width of the slit 94 in the extending direction and the width of the second support portion 50 may be substantially the same.

[0053] The holding portion 96 is capable of holding the second support portion 50 inserted through the slit 94. The holding portion 96 is provided between the slit 94 and the tip edge 262 of the first support portion 26 in the extension direction of the first support portion 26. In other words, the holding portion 96 is provided in the tip direction of the slit 94. At this time, the second support portion 50 and the first support portion 26 are maintained in a substantially parallel state.

[0054] 3, when the second support part 50 moves in the proximal direction relative to the first support part 26 and the first support part 26 and the second support part 50 are arranged so as to overlap each other in a plan view, the tip part 501 of the second support part 50 is inserted into the slit 94 and the leading end 503 of the second support part 50 is arranged on the back surface 462 side of the first support part 26. The leading end 503 of the second support part 50 abuts against the back surface 462 of the first support part 26 and is held by the holding part 96.

[0055] 14, when the second support part 50 moves in the distal direction (the direction of the arrow X1) relative to the first support part 26, the base end part 502 of the second support part 50 is inserted into the slit 94, and the base end part 502 is disposed on the back surface 462 side of the first support part 26. The base end part 502 of the second support part 50 abuts against the back surface 462 of the first support part 26 and is held by the holding part 96. At this time, the second support part 50 and the first support part 26 are maintained in a substantially parallel state.

[0056] 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. 15, 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.

[0057] 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.

[0058] Next, in the sheet placement step (step S2), as shown in Fig. 7, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. When placed on the second support surface 74, the medical sheet 300 protrudes outward from the second support part 50. The first support surface 261 supports the protruding part 302 of the medical sheet 300 that protrudes outward from the second support part 50. As shown in Fig. 8, at this time, in the first support part 26, moisture M contained in the medical sheet 300 flows along the first support surface 261 and is discharged from the first support surface 261 to the back surface 462 side (outside) through the slits 94 (see the dashed arrow in Fig. 8).

[0059] 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. 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 (the direction of the arrow X2) relative to the outer cylinder 22.

[0060] 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.

[0061] 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 protruding portions 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 D extending perpendicular to the central axis of the outer tube 22. One first protruding portion 38 and the other first protruding portion 38 come into contact with each other and are accommodated downward (first support surface 261, surface 461).

[0062] 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.

[0063] 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).

[0064] As the first support portion 26 is curved and deformed, the second support portion 50 is also curved and deformed along the first support portion 26 on the inside (surface 461 side) of the first support portion 26. As the first support portion 26 and the second support portion 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 in the outer tube 22. At this time, the second support portion 50 is inserted into the slit 94 of the first support portion 26 and held by the holding portion 96. Therefore, the first and second support portions 26, 50 are curved and deformed together with the second support portion 50 in close contact with the first support portion 26 so that the second support portion 50 follows the first support portion 26.

[0065] 9, the accommodating step is completed when the entire first support part 26 is completely accommodated in 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.

[0066] 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).

[0067] 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.

[0068] 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.

[0069] 13, 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.

[0070] 14, the second support part 50 moves in the distal direction (arrow X1 direction) relative to the first support part 26 through the slits 94. Specifically, the second support part 50 moves in the distal direction (arrow X1 direction) on the back surface 462 side of the first support part 26 through the slits 94. The medical sheet 300 moves in the distal direction together with the second support part 50. At this time, the second support part 50 is stably guided in the distal direction by being inserted through the slits 94. In this moving process, the medical sheet 300 is moved above the transplantation target part 402 of the heart 400, and the protruding part 302 of the medical sheet 300 is brought into contact with the transplantation target part 402.

[0071] Then, in the removal step (step S7 in FIG. 6), as shown in FIG. 15, the second carrier member 20 is moved from the second position to the first position to remove the second support part 50 from between the transplantation target part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation target part 402. This completes the transfer of the medical sheet 300 to the transplantation target part 402. Thereafter, the transferring instrument 10 is removed from the chest 408 with the first support part 26 and the second support part 50 housed within the outer cylinder 22.

[0072] In the removal process, when the second support part 50 is moved in the proximal direction (the direction of the arrow X2) relative to the first support part 26, the second support part 50 returns to a predetermined position of the first support part 26 through the slit 94 and assumes the second position. The tip part 501 of the second support part 50 is held by the holding part 96 of the first support part 26 (see FIG. 3).

[0073] This embodiment provides the following advantages.

[0074] As shown in FIG. 8, the first support portion 26 of the first carrier member 18 in the transfer device 10 comprises a first support surface 261 capable of holding a medical sheet 300, a slit 94 penetrating the first support portion 26 in the thickness direction, and a holding portion 96 arranged adjacent to the slit 94 and capable of holding the second support portion 50 of the second carrier member 20 inserted through the slit 94.

[0075] 8, when the medical sheet 300 is placed on the first support part 26, moisture M on the first support surface 261 can be effectively discharged to the outside of the first support part 26 through the slits 94. Therefore, when the medical sheet 300 placed on the first support surface 261 is transferred to the transplantation recipient part 402, the influence of moisture M can be suppressed and the medical sheet 300 can be placed at a predetermined position on the transplantation recipient part 402. This allows the first support part 26 to efficiently transfer the medical sheet 300 to the transplantation recipient part 402. Since the holding part 96 prevents the second carrier member 20 from rotating relative to the first carrier member 18, the second support part 50 can be stably moved along the first support part 26.

[0076] When the first and second support parts 26, 50 are housed in the outer tube 22, the second support part 50 is inserted through the slit 94 and held by the holding part 96, so that the second support part 50 can be curved and deformed following the first support part 26. In the above preparation step, a confirmation step for confirming the operation of the transport device 10 may be performed by the user before using the transport device 10. In the confirmation step, after the initial state shown in FIG. 1 is established, the operation of housing the first support part 26 and the second support part 50 in the outer tube 22 is confirmed. The user moves the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 together from the initial state in the base end direction (arrow X2 direction) relative to the outer tube 22. At this time, since the second support part 50 is inserted through the slit 94 of the first support part 26, the first shaft 24 and the second shaft 48 do not rotate relatively. The tip portion 501 of the second support part 50 is inserted through the slit 94 and its leading edge is held in contact with the holding part 96. In this confirmation process, the medical sheet 300 is not placed on the first support surface 261 and there is no moisture M on the first support surface 261, but by providing the slit 94, it is possible to make the second support part 50 effectively follow the first support part 26 and the occurrence of wrinkles in the second support part 50 is suppressed.

[0077] The slits 94 extend in a direction intersecting the moving direction of the first support part 26 on the first support surface 261. As a result, when the second support part 50 is moved in the base end direction and returned to the second position as shown in FIG. 3 from the state in which the second support part 50 protrudes in the distal direction relative to the first support part 26 shown in FIG. 14, the second support part 50 is inserted through the slits 94. Therefore, even when the second support part 50 is moved relative to the first support part 26 in order to place the medical sheet 300 on the transplantation target part 402 of the heart 400, the second support part 50 does not come out of the slits 94. Therefore, it is not necessary to reinsert the second support part 50 into the slits 94 before transferring the next medical sheet 300 by the transfer device 10. This allows for efficient repeated transfer of the medical sheet 300 by one transfer device 10.

[0078] The first support part 26 includes a tip support part 42 that constitutes the tip side of the first support part 26, a slit 94 is provided in the tip support part 42, and a holding part 96 is provided between the tip edge 262 of the first support part 26 and the slit 94. This allows the tip side of the first support part 26 to guide the second support part 50 in the movement direction, so that the medical sheet 300 placed on the first support surface 261 can be stably transferred in the tip direction (arrow X1 direction) to the transplantation target part 402, as shown in Fig. 13. Moisture M at the tip of the first support surface 261 close to the transplantation target part 402 can be effectively discharged.

[0079] As shown in Fig. 16, a conveying device 10A having a first support portion 26A according to a modified example has a pair of slits 94A, 94B and a pair of holding portions 96A, 96B. Each of the pair of slits 94A, 94B extends along the movement direction of the second support portion 50 on the first support surface 261. The slits 94A, 94B are provided from the intermediate support portion 36 to the tip support portion 42 of the first support portion 26A. The slits 94A, 94B are equally spaced apart outward in the width direction with respect to the width center of the first support surface 261. The width direction side portions 504 of the second support portion 50 can be inserted into the slits 94A, 94B.

[0080] The pair of retaining portions 96A, 96B are disposed on the widthwise outer side of the slits 94A, 94B in the width direction of the first support portion 26A. The pair of retaining portions 96A, 96B are provided spaced apart in the width direction of the second support portion 50. When the widthwise side portions 504 of the second support portion 50 are inserted into the pair of slits 94A, 94B, as shown in FIG. 17, the widthwise side portions 504 are disposed on the rear surface 462 side of the first support portion 26A with respect to the pair of retaining portions 96A, 96B.

[0081] 16, in a plan view of the transfer device 10A, at the second position where the first support portion 26A and the second support portion 50 are arranged to overlap, the width direction side portion 504 of the second support portion 50 is covered by the pair of holding portions 96A, 96B. The pair of holding portions 96A, 96B hold the width direction side portion 504 of the second support portion 50 so that it can move along the slits 94A, 94B. In the sheet placing step, when the medical sheet 300 is placed on the first support surface 261 at the second position, moisture M contained in the medical sheet 300 flows along the first support surface 261 and is discharged from the first support surface 261 to the outside through the pair of slits 94A, 94B.

[0082] 18, when the second support part 50 moves from the second position toward the distal end (the direction of arrow X1) relative to the first support part 26A in the movement process of the transfer device 10A, the second support part 50 is guided toward the distal end by the pair of holding parts 96A, 96B. The medical sheet 300 is transferred by the second support part 50 toward the distal end of the first support part 26A.

[0083] This modified example has the following advantages.

[0084] 16, the slits 94A, 94B of the first support portion 26A extend along the movement direction of the second support portion 50 on the first support surface 261, and are provided as a pair spaced apart in the width direction. The holding portions 96A, 96B of the first support portion 26A are disposed outward in the width direction from the slits 94A, 94B, and are provided as a pair spaced apart in the width direction of the second support portion 50, and the width direction side portions 504 of the second support portion 50 are inserted into the slits 94A, 94B.

[0085] As a result, the pair of slits 94A, 94B and the holding portions 96A, 96B can effectively guide the second support portion 50 along the movement direction of the second support portion 50. The pair of slits 94A, 94B can more effectively discharge moisture M on the first support surface 261 to the outside of the first support portion 26A.

[0086] 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]

[0087] 10, 10A...Transportation equipment 18...First carrier member 20...Second carrier member 22…Outer cylinder 24…First shaft 26, 26A...1st support part 261...1st support surface 48…Second shaft 50…Second support part 94, 94A, 94B...Slit 96, 96A, 96B...Holding part

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, An outer cylinder having a tip opening; a first carrier member including a first 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 first support portion disposed at a tip portion of the first shaft; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a sheet-shaped second support portion disposed at a tip of the second shaft; The first support portion has a first support surface capable of holding the medical sheet; A slit is formed on the first support surface and penetrates the first support portion in a thickness direction. a holding portion provided adjacent to the slit and capable of holding the second support portion inserted into the slit; having The first support portion has a width in a direction perpendicular to an extension direction of the first shaft that is greater than an inner peripheral length of the outer cylinder, At a first position obtained by moving the first and second shafts in a proximal direction relative to the outer cylinder so that the first and second support parts are housed in the outer cylinder, the first and second support parts are housed in the outer cylinder in a curved and deformed state, At a second position where the first and second shafts are moved in a distal direction relative to the outer tube so that the first and second support portions protrude from a distal opening of the outer tube, the first and second support portions are exposed in the distal direction from the outer tube and are deployed, and the first support portion and the second support portion are arranged to overlap each other in a plan view, At the first position and the second position, the second support portion is inserted into the slit and held by the first support portion by the holding portion, when the first and second support parts are moved relative to the outer cylinder in the base end direction from a state in which the first and second support parts protrude in the distal direction from the distal end portion of the outer cylinder, the first and second support parts are guided toward a distal opening of the outer cylinder, and the first and second support parts are deformed into a curved shape so that both sides in the width direction of the first support part protrude toward the first support surface, a transfer device in which, when the second support part is moved relative to the first support part in a distal direction from a state in which the medical sheet is placed on the first and second support parts in the second position, the second support part is guided in the distal direction by the slit.

2. 2. The transfer device of claim 1, A transfer device, wherein the slit extends in a direction intersecting a direction of movement of the first support portion on the first support surface.

3. 3. The transfer device of claim 2, The first support portion includes a tip support portion that configures a tip side of the first support portion, A transfer device, wherein the slit is provided in the tip support portion, and the holding portion is provided between the tip edge of the first support portion and the slit.

4. 2. The transfer device of claim 1, The slits are provided in a pair on the first support surface, extending along a moving direction of the second support portion and spaced apart in the width direction, A transfer device in which the holding portion is arranged widthwise outward from the slit in the width direction, and a pair of holding portions are provided spaced apart in the width direction of the second support portion, and the widthwise side portions of the second support portion are inserted into the slit.

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