Transfer equipment

Abstract

To provide transfer equipment capable of transferring a medical sheet to a treatment object part more efficiently.SOLUTION: A second carrier member 20 of transfer equipment 10 include a sheet-like cover member 94 for covering a second support surface 74 of a second support part 50. The space over a medical sheet 300 placed on the second support surface 74 is covered with the cover member 94. At a second position in which the first and second support parts 26 and 50 protrude from the tip opening of an external cylinder 22, the cover member 94 moves in the tip direction together with the second support part 50 when the second support part 50 is relatively moved in the tip direction with respect to the first support part 26 from the state that the medical sheet 300 is placed on the first and second support parts 26 and 50.SELECTED DRAWING: Figure 13

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: an outer tube having a tip opening; a first carrier member having 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-like support part disposed at the tip of the first shaft; and a second carrier member having a second shaft extending along the first shaft and disposed so as to be movable along the first shaft, wherein the support part has a support surface capable of holding the medical sheet and a back surface opposite to the support surface, and the second carrier member has a sheet-like cover member covering the support surface, and the first and second carrier members are arranged so that the support part is housed within the outer tube. This is a transfer device in which, at a first position where the shaft is moved in a base end direction relative to the outer tube, the support part and the cover member are contained within the outer tube in a curved and deformed state, and at a second position where the first and second shafts are moved in a distal end direction relative to the outer tube so that the support part protrudes from a distal opening of the outer tube, the support part unfolds by being exposed in the distal direction from the outer tube, and the cover member and the support surface of the support part face each other in the thickness direction of the support part, and when the second shaft is moved in the distal direction relative to the first shaft from a state in which the medical sheet is placed on the support part at the second position, the cover member moves in the distal direction together with the second shaft.

[0006] According to this transfer device, the medical sheet can be effectively protected by the cover member when the medical sheet is transferred to the treatment target area, and therefore the medical sheet can be efficiently transferred to the treatment target area of ​​the living body by the support part.

[0007] (2) In the transfer device described in (1) above, the second carrier member has a sheet-like second support portion arranged at the tip of the second shaft, the second support portion has a second support surface on which the medical sheet can be placed, the width of the second support portion is formed to be smaller than the width of the support portion, at the first position, the second support portion is contained within the outer tube in a curved and deformed state together with the support portion and the cover member, at the second position, the second support portion unfolds by being exposed in the tip direction from the outer tube together with the support portion, and the second support portion is arranged between the cover member and the support portion in the thickness direction of the second support portion, and at the second position, when the second support portion is moved in the tip direction relative to the support portion, the cover member may move in the tip direction together with the second support portion.

[0008] With this configuration, when the medical sheet placed on the support surface of the support part is transferred in the distal direction by the second support part, the medical sheet can be transferred while being protected by the cover member.

[0009] (3) In the delivery device described in (2) above, the base end of the cover member may be attached to the tip end of the second shaft or the base end of the second support portion.

[0010] With this configuration, the cover member can be attached to the second carrier member in a position covering the second support surface, and the cover member can be moved integrally with the second carrier member.

[0011] (4) In the transferring device according to any one of (1) to (3) above, a maximum width of the cover member in a width direction of the support portion may be larger than a maximum width of the support portion.

[0012] With this configuration, the entire width of the support part can be covered by the cover member, so that the medical sheet placed on the support part can be protected.

[0013] (5) In the transfer device described in (2) or (3) above, when viewed from the direction of movement of the first and second shafts, the cover member may be formed convexly in a direction away from the second support surface of the second support part, and the cover member and the second support surface may be non-contacting.

[0014] This configuration prevents the medical sheet placed on the second support surface from coming into contact with the cover member, thereby preventing damage to the medical sheet. After the medical sheet is placed on the treatment target area, when the second support part is retracted from the treatment target area, the medical sheet is prevented from moving in the proximal direction together with the cover member.

[0015] (6) In the transfer device described in (2) or (3) above, in the first position, the support part and the second support part may be deformed into a curved shape and accommodated within the outer tube so that both widthwise sides of the support part protrude toward the support surface, and the cover member may be positioned outside the support part and contact the inner surface of the outer tube.

[0016] With this configuration, when the support part and the second support part are housed inside the outer cylinder, the cover member can be curved along the inner circumferential surface of the outer cylinder and can be effectively housed inside the outer cylinder.

[0017] (7) In the transfer device described in (2) or (3) above, in the first position, the cover member may be disposed inside the support portion, and the back surface of the support portion may contact an inner peripheral surface of the outer tube.

[0018] With this configuration, when the support part and the second support part are housed inside the outer cylinder, the cover member can be curved along the support part and housed effectively inside the outer cylinder.

[0019] (8) In the transfer device according to any one of (1) to (7) above, the support portion may have 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 tube.

[0020] With this configuration, the support portion having a width larger than the inner peripheral length of the outer cylinder can be effectively housed within the outer cylinder. Effect of the Invention

[0021] According to the present invention, since the second carrier member is provided with a sheet-like cover member that covers the support surface, the medical sheet placed on the support surface can be effectively protected by the cover member when it is transferred to the treatment target part of the living body, and therefore the medical sheet can be efficiently transferred to the treatment target part by the support part. [Brief description of the drawings]

[0022] [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 an explanatory diagram of the accommodation step. [Figure 10] FIG. 10 is a cross-sectional view taken along line XX in FIG. [Figure 11] FIG. 11 is an explanatory diagram of the arrangement process. [Figure 12] FIG. 12 is an explanatory diagram of the development process. [Figure 13] FIG. 13 is a first explanatory view of the moving step. [Figure 14] FIG. 14 is a second explanatory view of the moving step. [Figure 15] FIG. 15 is an explanatory diagram of the removal step. [Figure 16] FIG. 16 is a cross-sectional view of a transportation device having a first support part according to a first modified example. [Figure 17] FIG. 17 is an enlarged perspective view of a tip portion of a transportation device according to a second modified example. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0023] 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.

[0024] 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).

[0025] 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.

[0026] 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.

[0027] 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.

[0028] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0029] 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.

[0030] 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.

[0031] 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.

[0032] 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.

[0033] 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.

[0034] 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.

[0035] 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.

[0036] 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).

[0037] 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.

[0038] 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).

[0039] 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.

[0040] 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.

[0041] 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.

[0042] 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).

[0043] 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.

[0044] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0045] 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.

[0046] 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.

[0047] 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.

[0048] 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.

[0049] In Fig. 4, the pressing surface 58 is provided on the tip surface of the carrier holding part 54. An attachment hole 60 opens in the pressing surface 58. The second support part 50 is attached to the pressing surface 58. The pressing surface 58 presses the outer peripheral end surface of the medical sheet 300 in the tip direction (the direction of the arrow X1) (see Fig. 13).

[0050] 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.

[0051] 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.

[0052] In FIG. 2, the hub 52 is attached to the proximal end of the second shaft 48 .

[0053] 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.

[0054] 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.

[0055] 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.

[0056] 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.

[0057] 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.

[0058] As shown in FIG. 2, the second carrier member 20 further includes a cover member 94. The cover member 94 is configured in a flexible sheet shape. As shown in FIG. 3, the cover member 94 is provided above the second support portion 50 and covers the second support surface 74 of the second support portion 50. That is, in the thickness direction of the second support portion 50, the second support portion 50 is disposed between the cover member 94 and the first support portion 26. In a plan view of the cover member 94, the cover member 94 is formed in an inverse tapered shape that widens in the width direction (W direction) from the base end portion 942 toward the tip portion 941.

[0059] As shown in Figure 5, when viewed from the movement direction of the first and second shafts 24, 48, the cover member 94 is formed convexly in a direction away from the second support surface 74 of the second support part 50 (upward), and the cover member 94 and the second support surface 74 are not in contact with each other.

[0060] As shown in FIG. 3, in the width direction (W direction) of the first support portion 26, the maximum width W2 of the cover member 94 is larger than the maximum width W3 of the first support portion 26 in which the protruding portion 37 is bent. The maximum width W2 of the cover member 94 is the width of the tip portion 941 of the cover member 94. In a second position where the first support portion 26 and the second support portion 50 overlap in a plan view, the cover member 94 covers a part of the first support portion 26. The cover member 94 covers the base end support portion 34 and the intermediate support portion 36 of the first support portion 26. A part of the inner surface of the cover member 94 is held in contact with the pair of first protruding portions 38 (see FIG. 5). The cover member 94 is supported by the first support portion 26 by the pair of first protruding portions 38. The cover member 94 is supported approximately parallel to the second support portion 50.

[0061] The cover member 94 has a pair of side walls 945 on both sides in the width direction. The pair of side walls 945 are disposed on the widthwise outer sides of the first protruding portions 38. The cover member 94 is disposed so as to cover the widthwise outer sides of the pair of first protruding portions 38. Note that the maximum width W2 of the cover member 94 is not limited to being larger than the maximum width W3 of the first support portion 26. It is sufficient that the width of the cover member 94 is at least larger than the width (diameter) of the medical sheet 300.

[0062] The base end 942 of the cover member 94 is fixed to the tip of the second shaft 48. The base end 942 of the cover member 94 is attached to the upper surface of the outer circumferential surface of the carrier holding portion 54. As shown in FIG. 4, the base end 942 of the cover member 94 is arranged so as to overlap from the pressing surface 58 of the carrier holding portion 54 in the base end direction (arrow X2 direction) and is bonded to the outer circumferential surface of the carrier holding portion 54. Note that the base end 942 of the cover member 94 is not limited to being attached to the carrier holding portion 54. For example, the base end 942 of the cover member 94 may be fused or welded to the carrier holding portion 54. The base end 942 of the cover member 94 is fixed to the outer circumferential surface of the carrier holding portion 54 so as to cover a part of the side surface from the upper surface. The base end 942 of the cover member 94 and the carrier holding portion 54 may be integrally molded.

[0063] The base end 942 of the cover member 94 is not limited to being fixed to the carrier holding portion 54, which is the tip end of the second shaft 48. For example, the base end 942 of the cover member 94 may be attached to the base end of the second support portion 50.

[0064] The leading end 941A of the cover member 94 extends along the width direction. The leading end 941A of the cover member 94 is disposed further in the leading direction (arrow X1 direction) than the leading end of the second support portion 50. Note that, in the movement direction of the second shaft 48, the leading end 941A of the cover member 94 and the leading end of the second support portion 50 may be in the same position. The leading end 941A of the cover member 94 may be formed in a convex shape toward the leading end direction (arrow X1 direction).

[0065] The tip portion 941 of the cover member 94 has a pair of corners 944. Each of the pair of corners 944 is disposed so as to connect the tip end 941A and a pair of side walls 945. As shown in Fig. 3, when viewed from the thickness direction of the first support portion 26, each corner 944 is formed in a substantially arc shape.

[0066] 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.

[0067] 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. In the second position, when the first shaft 24 and the second shaft 48 are moved in the distal direction (the direction of the arrow X1) relative to the outer cylinder 22, the cover member 94, together with the second support portion 50, is in a protruding position protruding in the distal direction from the distal opening 80 of the outer cylinder 22. The cover member 94 covers the base end support portion 34 and the upper part of the first protruding portion 38 of the first support portion 26, and the inner surface of the cover member 94 contacts the pair of first protruding portions 38. The cover member 94 covers the upper part of the second support portion 50 (second support surface 74).

[0068] 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. At this time, the upper part of the medical sheet 300 is covered by the cover member 94. As shown in FIG. 8, the cover member 94 and the medical sheet 300 overlap in a plan view of the first support part 26. The leading edge 941A of the cover member 94 is positioned in the distal direction (the direction of the arrow X1) from the medical sheet 300.

[0069] Thereafter, in the accommodation step (step S3 in FIG. 6), the medical sheet 300 is accommodated in the outer cylinder 22 together with the first support portion 26 and the second support portion 50 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 proximal direction (the direction of the arrow X2) relative to the outer cylinder 22. The cover member 94 is accommodated in the outer cylinder 22 together with the second support portion 50.

[0070] 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.

[0071] 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. Together with the first support portion 26, the cover member 94 is drawn into the outer tube 22 from the base end portion 942 while curling up. At this time, the cover member 94 is deformed into a cylindrical shape along the inner surface of the outer tube 22, and the intermediate support portion 36 is deformed into a cylindrical shape along the inner surface of the cover member 94 inside the cover member 94. Each of the pair of first protrusions 38 is curved so that the surface 461 of the first support portion 26 is on the inside and the back surface 462 of the first support portion 26 is on the outside. As shown in FIG. 10, the back surfaces 462 on both sides in the width direction of the first support portion 26 come into contact with each other on a virtual line 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).

[0072] 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.

[0073] 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).

[0074] 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 within the outer tube 22. The ends of a pair of side walls 945 of the cover member 94 are disposed at the bottom of the outer tube 22 so as to face the ends of each of the first protrusions 38. The ends of the pair of side walls 945 are spaced apart from each other along the inner circumferential surface of the outer tube 22.

[0075] In the first position where the first and second support parts 26, 50 are accommodated in the outer tube 22, the cover member 94 is disposed between the inner peripheral surface of the outer tube 22 and the first support part 26. The outer surface of the cover member 94 is curved and deformed into a substantially circular shape so as to follow the inner peripheral surface of the outer tube 22. The cover member 94 is sandwiched between the outer tube 22 and the first support part 26 and accommodated in the outer tube 22. The inner surface of the cover member 94 abuts against the back surface 462 of the first support part 26. In the outer tube 22, the lower ends of a pair of side walls 945 are disposed at the lower part of the outer tube 22 and are spaced apart from each other along the inner peripheral surface of the outer tube 22. Note that the pair of side walls 945 are not limited to being spaced apart from each other. For example, the pair of side walls 945 may be in contact with each other in the outer tube 22. Specifically, the ends of the pair of side walls 945 may contact each other in the circumferential direction of the outer cylinder 22, or the pair of side walls 945 may contact each other so as to overlap each other in the radial direction of the outer cylinder 22.

[0076] 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.

[0077] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 11, the transfer instrument 10 is inserted into the thoracic cavity 410 through the incision 409 in the chest 408. At this time, the tip of the transfer instrument 10 is positioned near the transplant target portion 402 in the heart 400, and the tip of the endoscope 14 is positioned inside the thoracic cavity 410. Note that before inserting the transfer instrument 10 into the thoracic cavity 410, a liquid supply instrument (not shown) may be connected to the connection port of the hub 52 to introduce liquid (e.g., physiological saline).

[0078] Next, in the unfolding step (step S5 in FIG. 6), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 12. Specifically, in the unfolding step, the first shaft 24 is grasped and moved in the distal direction (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 in the distal direction (arrow X1 direction). The second shaft 48 and the cover member 94 move in the distal direction together. Then, the first support part 26 exposed from the distal 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 in a flat shape. The cover member 94 unfolds in a shape that is convex toward the top, and covers the upper parts of the medical sheet 300, the first and second support parts 26, 50.

[0079] In the unfolding step, the second carrier member 20 has the second support surface 74 on which the medical sheet 300 is placed positioned entirely on 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 on 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. The second support surface 74 of the second support portion 50 and the upper portion of the medical sheet 300 are covered by the cover member 94. Specifically, the base end support portion 34 and the upper portion of the first protruding portion 38 of the first support portion 26 are covered by the cover member 94, and the inner surface of the cover member 94 contacts the pair of first protruding portions 38 (see FIG. 5). The cover member 94 is disposed above and spaced apart from the second support surface 74 and the medical sheet 300. The medical sheet 300 and the cover member 94 are not in contact with each other.

[0080] Next, in the moving step (step S6 in FIG. 6), as shown in FIG. 13, the second carrier member 20 is moved in the distal direction (arrow X1 direction) relative to the first carrier member 18, so that the second support part 50 on which the medical sheet 300 is placed moves together with the cover member 94 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. At this time, as shown in FIG. 14, the medical sheet 300 placed on the second support part 50 moves in the distal direction while being covered by the cover member 94.

[0081] As a result, the second support part 50 moves in the distal direction (direction of arrow X1) relative to the first support part 26. At this time, when the distal end surface of the carrier holding part 54 (pressing part 56) presses the outer peripheral end surface of the medical sheet 300 in the distal direction, the entire medical sheet 300 is positioned in the distal direction further than the first support part 26. In this moving step, the medical sheet 300 is moved above the transplant target part 402 of the heart 400, and the overhanging part 302 of the medical sheet 300 is brought into contact with the transplant target part 402.

[0082] 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. 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 part 408 with the first support part 26, the second support part 50 and the cover member 94 housed within the outer cylinder 22.

[0083] This embodiment provides the following advantages.

[0084] As shown in FIG. 8, the second carrier member 20 of the transfer device 10 includes a sheet-like cover member 94 that covers the second support surface 74 on which the medical sheet 300 can be placed. As shown in FIG. 12, when the medical sheet 300 placed on the second support surface 74 is transferred to the transplantation target portion 402 of the heart 400, the cover member 94 can effectively protect the medical sheet 300. Therefore, the medical sheet 300 can be efficiently transferred to the transplantation target portion 402 by the second support portion 50. As a result, when the medical sheet 300 is transferred to the transplantation target portion 402 of the heart 400 using the transfer device 10, the cover member 94 prevents the medical sheet 300 from coming into contact with biological tissues in the living body (for example, the pericardium of the heart 400). Therefore, the occurrence of wrinkles in the medical sheet 300 and damage to the medical sheet 300 during transfer are suppressed. When the medical sheet 300 is transplanted through a narrow space such as between the heart 440 and the pericardium, the cover member 94 can expand the space between the heart 440 and the pericardium. The medical sheet 300 is prevented from climbing up onto the carrier holding part 54 during transportation. The cover member 94 effectively prevents the medical sheet 300 from falling off the first supporting surface 261 of the first supporting part 26.

[0085] The second carrier member 20 has a sheet-like second support part 50 disposed at the tip of the second shaft 48, and in the second position, the second support part 50 unfolds by being exposed from the outer tube 22 in the tip direction together with the first support part 26, and the second support part 50 is disposed between the cover member 94 and the first support part 26 in the thickness direction of the second support part 50. As a result, when the medical sheet 300 placed on the first support surface 261 of the first support part 26 is transported in the tip direction by the second support part 50, the medical sheet 300 can be transported while being protected by the cover member 94.

[0086] 3, a base end 942 of the cover member 94 is attached to the tip end of the second shaft 48 or the base end of the second support part 50. This allows the cover member 94 to be attached to the second carrier member 20 in a position where it covers the second support surface 74, and allows the cover member 94 to move integrally with the second carrier member 20.

[0087] In the width direction (W direction) of the first support part 26, the maximum width W2 of the cover member 94 is larger than the maximum width W3 of the first support part 26. This allows the cover member 94 to cover the entire first support part 26 in the width direction, thereby protecting the medical sheet 300 placed on the first support part 26. In other words, the cover member 94 can cover the entire width of the first support part 26.

[0088] As shown in Fig. 5, when viewed from the movement direction of the first and second shafts 24, 48, the cover member 94 is formed in a convex shape in a direction away from the second support surface 74 of the second support part 50, and the cover member 94 and the second support surface 74 are not in contact with each other. This prevents contact between the medical sheet 300 placed on the second support surface 74 and the cover member 94 in the sheet placement step shown in Fig. 7, the unfolding step shown in Fig. 12, and the moving step shown in Fig. 13. This prevents damage to the medical sheet 300. As shown in Fig. 13, after the medical sheet 300 is placed on the transplantation target portion 402 in the moving step, when the second support part 50 is moved back from the transplantation target portion 402, the medical sheet 300 is prevented from moving together with the cover member 94 in the base end direction (arrow X2 direction).

[0089] 10, in a first position where the first and second support parts 26, 50 are accommodated in the outer tube 22, the first and second support parts 26, 50 are deformed into a curved shape so that both widthwise sides of the first support part 26 protrude toward the first support surface 261 and are accommodated in the outer tube 22, and the cover member 94 is disposed outside the first support part 26 and contacts the inner peripheral surface of the outer tube 22. As a result, when the first and second support parts 26, 50 are accommodated in the outer tube 22, the cover member 94 can be curved along the inner peripheral surface of the outer tube 22 and effectively accommodated in the outer tube 22.

[0090] The first support portion 26 has a maximum width W2 (see FIG. 3) of the first support portion 26 in a direction perpendicular to the extending direction of the first shaft 24, which is greater than the inner peripheral length L (see FIG. 10) of the outer tube 22. This allows the first support portion 26, which has a width greater than the inner peripheral length L of the outer tube 22, to be effectively accommodated within the outer tube 22.

[0091] As shown in FIG. 16, in the transfer device 10A according to the first modification, the first support portion 26A is deformed into a cylindrical shape along the inner peripheral surface of the outer tube 22 at the first position. When viewed from the axial direction of the outer tube 22, the first support portion 26A is a substantially annular shape along the inner peripheral surface of the outer tube 22. A back surface 462 of the first support portion 26A contacts the inner peripheral surface of the outer tube 22. The cover member 94A is accommodated inside the first support portion 26A while being curved into a cylindrical shape. The cover member 94A is a substantially annular shape curved along the surface of the first support portion 26A. Note that, when the first support portion 26A is accommodated in the outer tube 22 without being curved into a heart shape, the maximum width W2 of the cover member 94A is not limited to being larger than the maximum width W3 of the first support portion 26A. For example, the maximum width W2 of the cover member 94A may be equal to or smaller than the maximum width W3 of the first support portion 26A.

[0092] This modified example has the following advantages.

[0093] When the transfer device 10A is in the first position, the cover member 94A is disposed inside the first support part 26A, and the back surface 462 of the first support part 26A contacts the inner peripheral surface of the outer tube 22. As a result, when the first and second support parts 26A, 50 are housed inside the outer tube 22, the cover member 94A can be curved along the first support part 26A to be effectively housed inside the outer tube 22.

[0094] As shown in FIG. 17, a transfer device 10B according to the second modification includes a pressing body 200 at the tip of a second shaft 48 of a second carrier member 20B. The tip of the pressing body 200 has a pressing surface 202. The pressing surface 202 is a flat surface perpendicular to the axis of the pressing body 200. The base end of the pressing body 200 is connected to the tip of the second shaft 48. The base end of the cover member 94B is bonded to the outer circumferential surface of the pressing body 200. In other words, the transfer device 10B does not have a second support part 50. The medical sheet 300 placed on the first support surface 261 of the first support part 26 can be pressed by the pressing surface 202 of the pressing body 200, and the medical sheet 300 can be pushed out along the first support surface 261 of the first support part 26 in the tip direction (arrow X1 direction).

[0095] 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]

[0096] 10, 10A, 10B…transfer equipment 18...First carrier member 20, 20B...Second carrier member 22…Outer cylinder 24…First shaft 26, 26A...1st support part 261...1st support surface 462...Back side 48…Second shaft 50…Second support part 74…Second support surface 94, 94A, 94B...Cover members 300…Medical sheets 402…Transplant target area

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, An outer cylinder having a tip opening; a 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 support portion disposed at a tip portion of the first shaft; a second carrier member having a second shaft extending along the first shaft and movable along the first shaft; Equipped with The support portion has a support surface capable of holding the medical sheet and a back surface opposite to the support surface, The second carrier member includes a sheet-like cover member that covers the support surface, At a first position obtained by moving the first and second shafts in a proximal direction relative to the outer cylinder so that the support portion is accommodated in the outer cylinder, the support portion and the cover member are accommodated 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 support portion protrudes from a distal opening of the outer tube, the support portion is exposed in the distal direction from the outer tube and deployed, and the cover member and the support surface of the support portion face each other in a thickness direction of the support portion, A transfer instrument in which, in the second position, when the second shaft is moved relative to the first shaft in a distal direction from a state in which the medical sheet is placed on the support portion, the cover member moves in the distal direction together with the second shaft.

2. 2. The transfer device of claim 1, the second carrier member has a sheet-like second support portion disposed at a tip end of the second shaft, the second support portion has a second support surface on which the medical sheet can be placed, The width of the second support portion is smaller than the width of the support portion, At the first position, the second support portion is accommodated in the outer cylinder in a curved and deformed state together with the support portion and the cover member, At the second position, the second support portion is deployed by being exposed from the outer tube in a distal direction together with the support portion, and the second support portion is disposed between the cover member and the support portion in a thickness direction of the second support portion, A transfer instrument, wherein when the second support part is moved in a distal direction relative to the support part at the second position, the cover member moves in the distal direction together with the second support part.

3. 3. The transfer device of claim 2, A delivery device, wherein the proximal end of the cover member is attached to the distal end of the second shaft or the proximal end of the second support.

4. A transfer device according to any one of claims 1 to 3, A transfer device, wherein the maximum width of the cover member in the width direction of the support portion is greater than the maximum width of the support portion.

5. 4. The transfer device of claim 3, A transfer device, wherein when viewed from the movement direction of the first and second shafts, the cover member is formed convexly in a direction away from the second support surface of the second support part, and the cover member and the second support surface are not in contact.

6. 3. The transfer device of claim 2, a transfer device in which, in the first position, the support part and the second support part are deformed into a curved shape and accommodated within the outer tube so that both widthwise sides of the support part protrude toward the support surface, and the cover member is positioned outside the support part and contacts the inner surface of the outer tube.

7. 2. The transfer device of claim 1, A transfer device, wherein in the first position, the cover member is disposed inside the support portion and the back surface of the support portion contacts the inner peripheral surface of the outer cylinder.

8. 2. The transfer device of claim 1, A transfer device, wherein the width of the support portion in a direction perpendicular to the extension direction of the first shaft is greater than the inner peripheral length of the outer tube.

Images