Transfer equipment

Abstract

To provide transfer equipment capable of transferring a medical sheet to a treatment object part more efficiently.SOLUTION: Transfer equipment 10 includes: an external cylinder 22; a first carrier member 18 having a first shaft 24 and a sheet-like first support part 26; and a second carrier member 20 having a second shaft 48 and a second support part 50. The first support part 26 can hold a medical sheet 300 larger than the support part in a width direction orthogonal to an axial direction of the external cylinder 22. The second support part 50 includes a plurality of support arms 72 separated from each other in a width direction.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a transfer device. [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) A first 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; a first shaft extending in the axial direction of the outer tube and movably disposed inside the outer tube along the axial direction; a first carrier member having a sheet-like first support part disposed at a tip of the first shaft and including a support surface capable of holding the medical sheet; a second shaft extending along the first shaft and provided movably along the first shaft; and a second carrier member having a second support part disposed at a tip of the second shaft and capable of holding the medical sheet, the first support part being oriented in a width direction perpendicular to the axial direction of the outer tube. the second support part has a plurality of support arms spaced apart from each other in the width direction, and at a first position where the first shaft and the second shaft are moved in a base end direction relative to the outer cylinder so that the first support part and the second support part are contained within the outer cylinder, the first support part is contained within the outer cylinder in a curved and deformed state, and at a second position where the first shaft and the second shaft are moved in a distal end direction relative to the outer cylinder so that the first support part and the second support part protrude from a distal opening of the outer cylinder, the first support part is exposed in the distal end direction from the outer cylinder, thereby unfolding.

[0006] With this configuration, the first support part can be curved and deformed to be housed inside the outer tube, so that the transfer device can be made thinner and less invasive. In addition, since the medical sheet is supported by a plurality of support arms and is housed inside the outer tube in a wave-shaped curved state, a medical sheet wider than the first support part can be housed inside the outer tube. This makes it possible to more effectively realize a thinner transfer device and less invasive. Furthermore, since the transfer device includes a second carrier member having a second support part, the medical sheet can be easily transferred from the first support part to the transplant target part of the living body using the second support part. Therefore, with this transfer device, the medical sheet can be efficiently transferred to the treatment target part.

[0007] (2) In the transfer device described in (1) above, the first support part has a front surface including the support surface and a back surface which is the opposite surface to the front surface, and when the first support part is stored within the outer tube, the first support part has a pair of spaced apart parts spaced apart from the inner surface of the outer tube and protruding into the interior of the outer tube, and the pair of spaced apart parts may contact each other on the back surfaces.

[0008] With this configuration, the first support part can be contained in a heart shape within the outer tube, thereby reducing damage to the medical sheet held by the first support part compared to when the first support part is deformed into a shape that is not heart-shaped.

[0009] (3) In the transfer device described in (2) above, the plurality of support arms may be arranged on both sides of the pair of spaced apart portions in the width direction when the first support portion is housed within the outer tube.

[0010] With this configuration, the pair of spaced apart portions of the first support part are disposed between the support arms when the first support part is housed in the outer cylinder, so the support arms do not structurally interfere with the pair of spaced apart portions, and thus the first support part curved and deformed into a heart shape and the support arms can be housed in the outer cylinder without any hindrance.

[0011] (4) In the transfer device according to any one of (1) to (3) above, each of the plurality of support arms may have a tapered tip, and the top of the tapered tip may be rounded.

[0012] With this configuration, even if the tip of the support arm comes into contact with a treatment target part of a living body, the treatment target part is less likely to be damaged.

[0013] (5) In the transfer device described in any one of (1) to (4) above, when the first support part and the medical sheet are stored within the outer tube, a first sheet portion of the medical sheet supported by the first support part and a second sheet portion of the medical sheet supported by at least one of the multiple support arms may be in contact with each other.

[0014] (6) In the transfer device described in any one of (1) to (5) above, each of the multiple support arms may be hollow with an internal flow path, and may have an arm outer surface that supports the medical sheet, and an ejection hole capable of ejecting a fluid onto the arm outer surface.

[0015] With this configuration, when placing the medical sheet on the treatment target area, the fluid is discharged onto the outer surface of the arm to facilitate the removal of the medical sheet from the support arm, which prevents the medical sheet from retracting together with the second support part when the second support part is retracted relative to the treatment target area. Effect of the Invention

[0016] According to the present invention, the first support part can be curved and deformed to be housed in the outer tube, so that the transfer device can be made thinner and less invasive. In addition, the medical sheet is supported by a plurality of support arms and is housed in the outer tube in a wave-shaped curved state, so that a medical sheet wider than the first support part can be housed in the outer tube. This makes it possible to more effectively realize a thinner transfer device and a less invasive transfer device. Furthermore, since the transfer device includes a second carrier member having a second support part, the second support part can be used to easily transfer the medical sheet from the first support part to the transplantation target part of the living body. Therefore, this transfer device makes it possible to efficiently transfer the medical sheet to the treatment target part. [Brief description of the drawings]

[0017] [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. [Figure 14] FIG. 14 is a perspective view of a second support portion according to a modified example. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0018] 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.

[0019] 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).

[0020] 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.

[0021] 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.

[0022] 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.

[0023] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0024] 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.

[0025] 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.

[0026] 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 in the body cavity and can retain the bent shape. As shown in Figs. 2 to 4, the first support portion 26 is attached to the tip portion of the first shaft 24. The first support portion 26 is made of, for example, a resin material. The first support portion 26 can hold a medical sheet 300. The first support portion 26 is formed by folding a flexible resin sheet material (film material) into a predetermined shape. The first support portion 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 portion 26 has a first joint portion 30 and a first support body 32.

[0027] 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.

[0028] 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.

[0029] 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 support surface 261. The marker 551 is arranged so that the marker 551 of the first shaft 24 faces upward when the support surface 261 faces upward. In other words, the marker 551 allows the user to confirm the direction of the support surface 261 of the first support portion 26.

[0030] 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).

[0031] 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 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.

[0032] 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).

[0033] 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 support surface 261.

[0034] 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 of the intermediate support part 36 from both sides in the width direction 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 have a lower protruding height from the support surface 261 than the first protrusions 38.

[0035] 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 support surface 261 (middle support portion 36) of the first support portion 26 (see FIG. 5).

[0036] The first support body 32 has a front surface 461 that faces upward (in the direction of arrow Y) and includes the support surface 261, and a back surface 462 that is the opposite surface to the front surface 461. The 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 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 support surface 261.

[0037] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0038] 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.

[0039] 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.

[0040] 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.

[0041] 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.

[0042] 4, the pressing surface 58 is provided on the tip surface of the carrier holding part 54. 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).

[0043] 2 to 4, the second support part 50 protrudes from a pressing surface 58 of the carrier holding part 54 toward the tip side. The second support part 50 is formed of an elastic body such as an elastomer material. The overall length of the second support part 50 is shorter than the overall length of the first support part 26. The second support part 50 may be molded integrally with the carrier holding part 54.

[0044] As shown in FIG. 3, the second support section 50 has a plurality of support arms 72 spaced apart from each other in the width direction. In this embodiment, the second support section 50 has two (a pair of) support arms 72. The second support section 50 may have three or more support arms 72. Each support arm 72 protrudes from the carrier holding section 54 toward the tip. In FIG. 3, the pair of support arms 72 are not parallel to each other. Specifically, the distance between the axes A1 of the pair of support arms 72 gradually increases toward the tip. The axes A1 of the pair of support arms 72 may be parallel to each other.

[0045] The width (thickness) of each support arm 72 is smaller than the width (thickness) of the second shaft 48. The width of each support arm 72 may be the same as the width of the second shaft 48. The width of each support arm 72 may be larger than the width of the second shaft 48. Each support arm 72 is elastically deformable in the width direction. Each support arm 72 has a tapered tip 73. The width of the tapered tip 73 gradually decreases toward the tip. An apex 731 of the tapered tip 73 is rounded.

[0046] 5, the cross-sectional shape of the support arm 72 is a substantially triangular shape with each apex chamfered in an arc shape. The cross-sectional shape of the support arm 72 is not limited to a substantially triangular shape, and may be, for example, a circular shape, an elliptical shape, or a substantially polygonal shape other than a triangle. Each support arm 72 is provided with an arm outer surface 721 on which the medical sheet 300 is placed.

[0047] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0048] 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.

[0049] 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.

[0050] 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.

[0051] 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.

[0052] 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.

[0053] 1, first support part 26 is capable of holding a medical sheet 300 that is larger in the width direction (W direction) than first support part 26. The width W2 of medical sheet 300 shown in this embodiment is larger than the width W1 of first support part 26. When medical sheet 300 is circular, width W2 is the diameter of medical sheet 300.

[0054] 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.

[0055] 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. The first support portion 26 is exposed in the distal direction from the outer tube 22 and deployed, and the second support portion 50 is disposed on the support surface 261 of the first support portion 26. That is, the second support portion 50 is disposed in a retracted position overlapping the 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.

[0056] 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 first support part 26 (support surface 261) and the second support part 50 (multiple support arms 72). The medical sheet 300 has a portion supported by the support surface 261 of the first support part 26 and a portion supported by the multiple support arms 72 of the second support part 50. Therefore, both widthwise sides and the tip side of the medical sheet 300 are supported by the support surface 261. Furthermore, the portions of the medical sheet 300 between the multiple support arms 72 are curved (slackened) downward and supported by the support surface 261.

[0057] 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.

[0058] 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.

[0059] When the base end support portion 34 of the first support portion 26 is deformed, a force acts on the middle support portion 36 of the first support portion 26 to curl up along the circumferential direction of the outer tube 22, so that the middle support portion 36 (see FIG. 2) is drawn into the outer tube 22 while curling up. At this time, the middle support portion 36 is deformed into a cylindrical shape along the inner surface of the outer tube 22. Each of the pair of first protrusions 38 is curved so that the surface 461 of the first support portion 26 is on the inside and the back surface 462 of the first support portion 26 is on the outside. As shown in FIG. 9, the back surfaces 462 on both sides in the width direction of the first support portion 26 come into contact with each other on a virtual line L2 extending in a direction perpendicular to the central axis of the outer tube 22. One first protrusion 38 and the other first protrusion 38 come into contact with each other and are accommodated downward (support surface 261, surface 461).

[0060] 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.

[0061] 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 lumen 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. 9).

[0062] 9, in a state in which the first support part 26 is housed in the outer tube 22, 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. Each of the spaced parts 39 includes a protruding part 37. The pair of spaced parts 39 are in contact with each other on the back surface 462 of the first support part 26.

[0063] As the first support part 26 curves, the two support arms 72 are pushed inwardly of the outer tube 22 by the first support part 26, causing them to elastically deform, and the two support arms 72 are displaced in directions approaching each other. As the first support part 26 curves, the medical sheet 300 also deforms into a shape corresponding to the shapes of the first support body 32 and the second support part 50, and the medical sheet 300 is contained within the outer tube 22.

[0064] 9, with the first support part 26 and the second support part 50 housed within the outer cylinder 22, two support arms 72 are disposed on either side of a pair of spaced parts 39 in the width direction. With the medical sheet 300 supported by the first support part 26 and the second support part 50 within the outer cylinder 22 (hereinafter also referred to as the "sheet housed state"), the relationship between the first support part 26, the second support part 50, and the medical sheet 300 is as follows.

[0065] A first sheet portion 311 of the medical sheet 300 supported by the first support portion 26 and a second sheet portion 322 of the medical sheet 300 supported by the two support arms 72 are in contact with each other. The pair of second sheet portions 322 are curved to be convex upward. The medical sheet 300 has a U-shaped portion 314 curved in a U-shape between the two support arms 72, and a pair of sheet ends 316 supported by a pair of spaced portions 39. In the sheet storage state, the pair of spaced portions 39 and the pair of sheet ends 316 are disposed inside the U-shaped portion 314. Therefore, one sheet end 316 is disposed between one spaced portion 39 and one arm of the U-shaped portion 314. The other sheet end 316 is disposed between the other spaced portion 39 and the other arm of the U-shaped portion 314. The portion of the medical sheet 300 between the sheet end portion 316 and the second sheet portion 322 is an intermediate curved portion 318 curved in an arc shape because it is supported by a portion of the first support portion 26 that is curved in an arc shape along the inner surface of the outer tube 22. The medical sheet 300 is folded back at a portion 319 connecting the intermediate curved portion 318 and the second sheet portion 322.

[0066] In addition, in the sheet-stored state, only one of the pair of second sheet portions 322 may be in contact with the first sheet portion 311. In the sheet-stored state, both of the pair of second sheet portions 322 may be out of contact with the first sheet portion 311.

[0067] 8, the accommodating step is completed when the first support part 26, the second support part 50, and the medical sheet 300 are entirely 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.

[0068] 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).

[0069] 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 gripped 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) as a unit. 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. As the first support part 26 unfolds at the second position, the two support arms 72 of the second support part 50 are displaced away from each other by an elastic restoring force, returning to the initial state interval (see FIG. 3). The shapes of the first support portion 26 and the second support portion 50 at the completion of the unfolding step shown in FIG. 11 are similar to the shapes of the first support portion 26 and the second support portion 50 shown in FIG.

[0070] 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.

[0071] 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 further distally than the first support part 26. In this moving step, the medical sheet 300 is moved above the transplantation target part 402 of the heart 400, and the medical sheet 300 is brought into contact with the transplantation target part 402.

[0072] 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.

[0073] This embodiment provides the following advantages.

[0074] Since the transfer instrument 10 includes the second carrier member 20 that is movable in the axial direction relative to the first carrier member 18, the medical sheet 300 can be transferred from the first support portion 26 to the transplantation target portion 402 of the living body by utilizing the second carrier member 20 without using any other device (forceps, etc.). Therefore, the medical sheet 300 can be efficiently transferred to the transplantation target portion 402.

[0075] 1, a second support part 50 capable of holding a medical sheet 300 is provided at the tip of the second shaft 48. The second support part 50 is movable relative to the first support part 26 between a retracted position where it overlaps with the support surface 261 and an advanced position where it is positioned further distally (in the direction of arrow X1) than the support surface 261. With this configuration, the second support part 50 can move the medical sheet 300 along the support surface 261 of the first support part 26.

[0076] At a first position obtained by moving the first shaft 24 and the second shaft 48 in the proximal direction relative to the outer tube 22 so that the first support part 26 and the second support part 50 are housed within the outer tube 22, the first support part 26 is housed within the outer tube 22 in a curved and deformed state. With this configuration, the first support part 26 can be curved and deformed to be housed within the outer tube 22, so that the diameter of the delivery device 10 can be made thinner and less invasive.

[0077] The first support portion 26 has a pair of first protrusions 38 protruding upward from both sides in the width direction of the support surface 261 perpendicular to the moving direction of the first shaft 24. With this configuration, when the first support portion 26 is accommodated in the outer tube 22, the back surfaces 462 of the first protrusions 38, which are curved and deformed into a convex shape, come into contact with each other. The pair of first protrusions 38 are displaced toward the support surface 261, and the first support portion 26 is curved and deformed into a heart shape. As a result, the first support portion 26 can be accommodated in the outer tube 22 in a heart shape, and therefore damage to the medical sheet 300 held by the first support portion 26 can be effectively suppressed compared to a case in which the first support portion 26 is deformed into a shape other than a heart shape. In addition, since the first support portion 26 can be smoothly and compactly accommodated in the outer tube 22, the diameter of the outer tube 22 can be made smaller compared to a configuration in which the first support portion 26 is not curved and deformed into a heart shape.

[0078] As shown in Fig. 3, the second support part 50 has a plurality of support arms 72 spaced apart from each other in the width direction perpendicular to the axial direction. As shown in Fig. 9, in the sheet stored state, the medical sheet 300 is supported by the plurality of support arms 72 and is stored in a wave-shaped curved state within the outer tube 22, so that a medical sheet 300 that is wider than the first support part 26 can be stored within the outer tube 22. This makes it possible to more effectively achieve a thinner diameter and less invasiveness of the transferring device 10.

[0079] With the first support part 26 housed in the outer tube 22, the multiple support arms 72 are disposed on both sides of the pair of spaced apart portions 39 in the width direction. With this configuration, with the first support part 26 housed in the outer tube 22, the pair of spaced apart portions 39 of the first support part 26 are disposed between the multiple support arms 72, so that the multiple support arms 72 do not structurally interfere with the pair of spaced apart portions 39. As a result, the first support part 26, which has been curved and deformed into a heart shape, and the multiple support arms 72 can be housed in the outer tube 22 without hindrance.

[0080] 3, each of the multiple support arms 72 has a tapered tip 73, and the top 731 of the tapered tip 73 is rounded. With this configuration, even if the tip of the support arm 72 comes into contact with a treatment target part of a living body, the treatment target part is unlikely to be damaged.

[0081] As shown by imaginary lines in FIG. 9, each of the multiple support arms 72 is hollow and has a flow path 96 therein, and may have an outlet hole 98 capable of discharging a fluid to the arm outer surface 721. The fluid is, for example, physiological saline. The flow path 96 communicates with the second inner cavity 57 (FIG. 2) of the second shaft 48. A fluid supply tool (not shown) can be connected to the hub 52 (FIG. 2) to supply the fluid to the flow path 96 via the second inner cavity 57. The outlet hole 98 communicates between the flow path 96 and the arm outer surface 721. The outlet hole 98 opens, for example, at the upper part of the support arm 72.

[0082] When the second support part 50 is placed on the transplantation target part 402 in the moving step (FIG. 12), fluid is discharged from the arm outer surface 721 via the flow path 96 and the discharge hole 98, thereby facilitating detachment of the medical sheet 300 from the support arm 72. This makes it possible to prevent the medical sheet 300 from retracting together with the second support part 50 when the second support part 50 is retracted relative to the transplantation target part 402. As shown in FIG. 14, a plurality of discharge holes 98 may be provided at intervals in the extension direction of the support arm 72. This makes it possible to further facilitate detachment of the medical sheet 300 from the support arm 72.

[0083] The present invention is not limited to the above disclosure, and various configurations can be adopted without departing from the gist of the present invention. [Explanation of symbols]

[0084] 10…Transfer device 18...First carrier member 20...Second carrier member 22…Outer cylinder 24…First shaft 26, 26P...1st support part 48…Second shaft 50…Second support part 72…Support arm 261…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, 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-like first support portion disposed at a tip portion of the first shaft and including a support surface capable of holding the medical sheet; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a second support portion disposed at a tip of the second shaft and capable of holding the medical sheet; Equipped with the first support portion is capable of holding the medical sheet that is larger than the first support portion in a width direction perpendicular to the axial direction of the outer cylinder, The second support portion has a plurality of support arms spaced apart from each other in the width direction, at a first position obtained by moving the first shaft and the second shaft in a proximal direction relative to the outer cylinder so that the first support portion and the second support portion are accommodated in the outer cylinder, the first support portion is accommodated in the outer cylinder in a curved and deformed state, A transfer device in which, at a second position where the first shaft and the second shaft are moved in a distal direction relative to the outer tube so that the first support portion and the second support portion protrude from a distal opening of the outer tube, the first support portion is deployed by being exposed in the distal direction from the outer tube.

2. 2. The transfer device of claim 1, The first support portion has a front surface including the support surface and a back surface opposite to the front surface, A transfer device wherein, when the first support portion is stored within the outer tube, the first support portion has a pair of spaced apart portions that are spaced apart from the inner surface of the outer tube and protrude into the interior of the outer tube, and the pair of spaced apart portions contact each other on the back surfaces.

3. 3. The transfer device of claim 2, A transfer device in which, with the first support portion housed within the outer cylinder, the multiple support arms are arranged on both sides of the pair of spaced portions in the width direction.

4. 2. The transfer device of claim 1, Each of the plurality of support arms has a tapered tip; A transfer device wherein the tapered tip has a rounded apex.

5. 2. The transfer device of claim 1, A transfer device in which, when the first support part and the medical sheet are stored within the outer tube, a first sheet portion of the medical sheet supported by the first support part and a second sheet portion of the medical sheet supported by at least one of the multiple support arms come into contact with each other.

6. A transfer device according to any one of claims 1 to 5, A transfer device, wherein each of the plurality of support arms is hollow with an internal flow path, and has an arm outer surface that supports the medical sheet, and a discharge hole capable of discharging a fluid on the arm outer surface.

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