Transfer appliance

Abstract

To provide a transfer appliance capable of more efficiently transferring a medical sheet to a treatment target part.SOLUTION: A transfer appliance 10 comprises a regulation part 102 and a linkage member 104. The regulation part 102 regulates a relative movement of a second shaft 48 to a first shaft 24, in an arrow X1 direction in a range from a storage position to a protrusion position. The linkage member 104 couples an outer cylinder 22 and the second shaft 48. The linkage member 104 relatively moves the second shaft 48 in the arrow X1 direction to the first shaft 24, in linkage with the movement of the first shaft 24 in the arrow X1 direction in a range from the protrusion position to the transfer position.SELECTED DRAWING: Figure 10

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, the transfer device comprising: an outer tube having a distal opening which is an opening in the distal direction and a proximal opening which is an opening in the proximal direction; a first carrier member including a first shaft movable along the outer tube inside the outer tube; a first support part provided at the distal end of the first shaft and having a first support surface for supporting the medical sheet; a second shaft extending along the first shaft and movable along the first shaft; and a pressing part provided at the distal end of the second shaft for pressing the medical sheet supported on the first support surface in the distal direction, the proximal end of the first shaft protruding in the proximal direction from the proximal opening, and at a first position where the first shaft and the second shaft are moved in the proximal direction relative to the outer tube so that the first support part and the pressing part are contained within the outer tube, the first support part is in a curved and deformed state and is in the a medical sheet is transferred to the treatment target area at a third position where the second shaft is moved in the distal direction relative to the outer tube and the first shaft so that the pressing portion pushes the medical sheet out of the first support portion, and the medical sheet is transferred to the treatment target area. The transfer device further comprises a regulating portion that regulates relative movement of the second shaft in the base end direction with respect to the first shaft between the first position and the second position, and an interlocking member that connects the outer tube and the second shaft and moves the second shaft in the distal direction with respect to the first shaft in interlocking with the movement of the first shaft in the distal direction between the second position and the third position.

[0006] According to this configuration, by moving the second shaft in the distal direction while the medical sheet is supported by the first support surface, the medical sheet can be efficiently transported to the treatment target area.

[0007] Furthermore, with this configuration, since the restricting portion restricts the relative movement of the second shaft in the proximal direction relative to the first shaft, when the user pushes the proximal end of the first shaft protruding from the proximal opening of the outer tube in the distal direction, the first shaft and the second shaft can be moved together in the distal direction relative to the outer tube. Therefore, the first carrier member and the second carrier member can be moved together from the first position to the second position by simply pushing the first shaft in the distal direction.

[0008] Furthermore, with this configuration, when the user presses the base end of the first shaft further in the distal direction in the second position, the interlocking member connecting the outer tube and the second shaft moves the second shaft in the distal direction relative to the first shaft. Therefore, the user can move the second carrier member from the second position to the third position relative to the first carrier member by simply pressing the first shaft in the distal direction.

[0009] Thus, with this configuration, the user can easily deploy the first support part at the second position and transfer the medical sheet to the treatment target area at the third position with a simple operation of simply pushing the first shaft toward the tip.

[0010] (2) In the transfer device described in (1) above, the first shaft may be a tubular body having an inner cavity, the second shaft may be inserted into the first shaft, one end of the interlocking member may be connected to the outer tube, the other end of the interlocking member may be connected to the second shaft, and the portion between the one end and the other end of the interlocking member may be inserted into an opening provided in the first shaft.

[0011] According to this configuration, when the user pushes the base end of the first shaft in the distal direction in the second position, the second shaft moves in the distal direction due to the force in the distal direction transmitted from the first shaft via the interlocking member, thereby making it easy to move the second shaft in the distal direction relative to the first shaft.

[0012] (3) In the delivery device described in (2) above, the interlocking member may be flexible, and at least a portion of the interlocking member may be relaxed in the first position, and the interlocking member may be tensed in the second position.

[0013] According to this configuration, when the user pushes the base end of the first shaft in the distal direction in the first position and the first and second shafts move together in the distal direction, the interlocking member becomes tensed in the second position. As a result, when the user pushes the base end of the first shaft in the distal direction in the second position, a force in the distal direction can be efficiently transmitted from the first shaft to the second shaft via the interlocking member. As a result, the second shaft can be more easily moved in the distal direction relative to the first shaft.

[0014] (4) In the delivery device described in (3) above, in the first position, a portion of the interlocking member between the outer cylinder and the opening of the first shaft may contract in a bellows-like manner.

[0015] According to this configuration, the interlocking member contracts in a bellows shape at the first position, so that the interlocking member can be housed compactly between the inside of the outer cylinder and the first shaft.

[0016] (5) In the delivery device according to any one of (2) to (4) above, in the first position, a base end of the second shaft may be housed within the first shaft.

[0017] According to this configuration, since the second shaft is not exposed from the first shaft in the first position, the user can operate the first shaft without hesitation.

[0018] (6) The delivery device described in any one of (2) to (5) above may further include an elastic body that connects the first shaft and the second shaft and urges the second shaft in the base end direction between the second position and the third position.

[0019] According to this configuration, when the user stops pushing the first shaft in the distal direction, the second shaft moves in the proximal direction relative to the first shaft due to the biasing force of the elastic body, which makes it possible to easily return the second shaft from the third position to the second position.

[0020] (7) In the transfer device described in (1) above, the first shaft may be a tubular body having an inner cavity, and the second shaft may be inserted into the first shaft, and the regulating portion may be formed by the tip of the first shaft and the pressing portion which engage with each other between the first position and the second position.

[0021] According to this configuration, when the user presses the first shaft in the distal direction in the first position, the first shaft and the second shaft can be easily moved integrally in the distal direction.

[0022] (8) In the transfer device described in any one of (2) to (5) and (7) above, the first shaft may have a locking portion formed on the inside of the first shaft, and the second shaft may have an engagement portion protruding in a direction intersecting the axial direction of the second shaft, and the engagement portion may abut the locking portion when the second shaft moves relative to the first shaft in the tip direction between the second position and the third position.

[0023] According to this configuration, when the second shaft moves to the third position, the engaging portion comes into contact with the locking portion, so that the second shaft is prevented from moving in the distal direction more than necessary, thereby preventing the second carrier member from coming off the transport instrument in the distal direction while transporting the medical sheet to the treatment target area.

[0024] (9) In the transfer device described in any one of (1) to (8) above, the second carrier member may further include a second support portion provided at the tip of the pressing portion and having a second support surface smaller than the first support surface, and the medical sheet may be supported by the first support surface and the second support surface.

[0025] With this configuration, the medical sheet can be efficiently transported to the treatment target area by moving the second shaft while the medical sheet is supported by the first support surface and the second support surface. Effect of the Invention

[0026] According to the present invention, by moving the second shaft in the distal direction from a state in which the medical sheet is supported by the first support surface, the medical sheet can be efficiently transported to the treatment target area.

[0027] Furthermore, according to the present invention, since the restricting portion restricts the relative movement of the second shaft in the proximal direction relative to the first shaft, when the user pushes the proximal end of the first shaft protruding from the proximal opening of the outer tube in the distal direction, the first shaft and the second shaft can be moved integrally in the distal direction relative to the outer tube. Therefore, the first carrier member and the second carrier member can be moved integrally from the first position to the second position by the user simply pushing the first shaft in the distal direction.

[0028] Furthermore, according to the present invention, when the user presses the base end of the first shaft further in the distal direction in the second position, the second shaft moves in the distal direction relative to the first shaft due to the interlocking member connecting the outer tube and the second shaft. Therefore, the second carrier member can be moved from the second position to the third position relative to the first carrier member by the user simply pressing the first shaft in the distal direction.

[0029] In this way, in the present invention, the user can easily deploy the first support part at the second position and transfer the medical sheet to the treatment target area at the third position with a simple operation of simply pushing the first shaft toward the tip. [Brief description of the drawings]

[0030] [Figure 1] FIG. 1 is a perspective view of a delivery device according to a first embodiment of the present invention. [Diagram 2] FIG. 2 is an exploded perspective view of the delivery device of FIG. [Diagram 3] FIG. 3 is a plan view of the tip of the delivery device of FIG. [Figure 4] FIG. 4 is a vertical cross-sectional view taken along line IV-IV in FIG. [Diagram 5] FIG. 5 is a cross-sectional view taken along line VV in FIG. [Figure 6] FIG. 6 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. [Figure 7] FIG. 7 is a first explanatory diagram showing the arrangement of the medical sheet in the sheet placing step. [Figure 8] FIG. 8 is a second explanatory diagram showing the arrangement of the medical sheet in the sheet placing step. [Figure 9] FIG. 9 is a first explanatory view of the accommodation step. [Figure 10] FIG. 10 is a second explanatory view of the accommodation step. [Figure 11] FIG. 11 is a cross-sectional view taken along line XI-XI in FIG. [Figure 12] FIG. 12 is an explanatory diagram of the arrangement process. [Figure 13] FIG. 13 is a first explanatory diagram of the development process. [Figure 14] FIG. 14 is a second explanatory diagram of the unfolding step. [Figure 15] FIG. 15 is a first explanatory diagram of the moving step. [Figure 16] FIG. 16 is a second explanatory view of the moving step. [Figure 17] FIG. 17 is an explanatory diagram of the removal step. [Figure 18] FIG. 18 is an explanatory diagram of a storage step in a transportation device according to the second embodiment of the present invention. [Figure 19] FIG. 19 is an explanatory diagram of the deployment process of the delivery device of FIG. [Figure 20] FIG. 20 is an explanatory diagram of a moving process in the transfer device of FIG. [Figure 21] FIG. 21 is a perspective view of a delivery device according to a third embodiment of the invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0031] FIG. 1 is a perspective view of a transfer device 10 according to a first embodiment of the present invention. The transfer device 10 is a medical device for transferring a medical sheet 300 to a treatment target portion of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure caused by ischemic heart disease. In this case, the medical sheet 300 is transplanted to a transplant target portion 402 of a heart 400 (a treatment target portion of a living body) (see FIGS. 12 to 17). The transfer device 10 can attach multiple medical sheets 300 to the transplant target portion 402.

[0032] 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).

[0033] 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.

[0034] 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.

[0035] 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.

[0036] In FIG. 2, the first carrier member 18 includes a first shaft 24 and a first support 26 .

[0037] The first shaft 24 is a tubular body (a circular tube member in the first embodiment) having a first lumen 28 (lumen). The first lumen 28 opens at the tip (end in the direction of arrow X1) of the first shaft 24 and at the base end (end in the direction of arrow X2) of the first shaft 24. A sealing member 55 is provided at the base end of the first shaft 24. A marker 551 is provided on the outer circumferential surface of the sealing member 55. When using the transfer device 10, the user can see the marker 551. It should be noted that the first shaft 24 is not limited to a tubular body and does not have to be a tubular body.

[0038] The first shaft 24 extends in the axial direction of the outer cylinder 22 and is disposed inside the outer cylinder 22 so as to be movable along the axial direction. The first shaft 24 is made of, for example, a resin material. The material of the first shaft 24 is not particularly limited, but may include polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyether ether ketone, polyvinyl chloride, ABS resin, polyamide elastomer, polyester elastomer, etc. The first shaft 24 may be made of a metal material.

[0039] 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.

[0040] As shown in Figs. 2 to 4, the first support part 26 is attached to the tip part 94 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.

[0041] 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.

[0042] 4, the first joint portion 30 is bonded to the inner circumferential surface of the tip portion 94 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-based instant adhesive). The first joint portion 30 may be heat fused to the inner circumferential surface of the first shaft 24. The first support portion 26 may be detachable from the tip portion 94 of the first shaft 24.

[0043] 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.

[0044] 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).

[0045] 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.

[0046] 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).

[0047] 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.

[0048] 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.

[0049] 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).

[0050] 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.

[0051] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 and a second support portion 50.

[0052] The second shaft 48 is a tubular body (a circular tube member in the first embodiment) having a second lumen 57. The length of the second shaft 48 along the axial direction is shorter 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 from the distal opening 98 (opening) of the first shaft 24 in the distal direction (arrow X1 direction). The proximal end of the second shaft 48 is accommodated inside the first shaft 24 (first lumen 28) (see Figs. 9 and 10). The second shaft 48 is provided so as to extend along the first shaft 24 and to be movable along the first shaft 24. The second shaft 48 is not limited to a tubular body, and may not be a tubular body.

[0053] 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.

[0054] As shown in Fig. 4, the second shaft 48 has a pressing portion 56 constituted by a carrier holding portion 54 (pressing portion). The pressing portion 56 is formed of an elastic body such as an elastomer material. With the first support portion 26 housed within the outer tube 22, the pressing portion 56 presses the first support portion 26 against the inner surface of the outer tube 22. As shown in Fig. 3, the tip portion 94 of the first shaft 24 can abut against the carrier holding portion 54 in the axial direction.

[0055] 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 the first 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.

[0056] 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. 16).

[0057] 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.

[0058] 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.

[0059] 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 the arrow X1) of the outer cylinder 22, and a proximal end opening 100 that opens at the proximal end (end in the direction of the arrow X2) of the outer cylinder 22 (see FIG. 10). 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.

[0060] The first shaft 24 is inserted into the inner cavity 78 of the outer cylinder 22. The axial length of the outer cylinder 22 is shorter than the axial length of the first shaft 24. An airtight valve body 84 is provided at the base end of the outer cylinder 22 and is in close contact with the outer circumferential surface of the first shaft 24. The base end of the first shaft 24 protrudes from a base end opening 100 of the outer cylinder 22 in the direction of arrow X2.

[0061] 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.

[0062] 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.

[0063] 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.

[0064] As shown in FIG. 3, hereinafter, the combined portion of the first protrusion 38 and the second protrusion 40 of the first support portion 26 is referred to as the "protrusion 37". Therefore, a pair of protrusions 37 is provided on both sides of the width direction of the first support portion 26. In FIG. 3, the direction perpendicular to the axial direction of the first shaft 24 (W direction) is the width direction of the first support portion 26. The W direction is also the width direction of other components (such as the outer tube 22). In the first embodiment, the first support portion 26 has a pair of protrusions 37, and W1 in FIG. 3 is the width of the portion where the width of the first support portion 26 is maximum when the first support portion 26 is developed in a planar state. That is, the width W1 of the first support portion 26 is the maximum width of the first support portion 26P in a planar state before the pair of protrusions 37 are formed (before bending). The width W1 of the first support portion 26 is greater than the inner circumferential length L of the outer tube 22 (see FIG. 11). 11, 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.

[0065] As shown in Fig. 5, in a cross section perpendicular to the axis of the second shaft 48, the carrier holding portion 54 has a shape that is line-symmetrical with respect to a virtual line L1 that passes through the center line C of the carrier holding portion 54 and is parallel to the width direction of the carrier holding portion 54. In other words, the carrier holding portion 54 has a shape that is symmetrical in the up-down direction with the virtual line L1 as the center. As shown in Fig. 5, the carrier holding portion 54 has a flat cross section. Note that the carrier holding portion 54 is not limited to being formed with a flat cross section, and may be formed with, for example, a circular cross section, an elliptical cross section, a square cross section, a rectangular cross section, or the like.

[0066] The mounting hole 60 is disposed on the center line C of the carrier holding portion 54 on the pressing surface 58. The mounting hole 60 is slit-shaped extending parallel to the width direction of the carrier holding portion 54 from the center line C. The mounting hole 60 is symmetrical in the width direction with the center line C as the center. The mounting hole 60 extends in the axial direction from the pressing surface 58 (see FIG. 4). As described above, the second joint portion 70 of the second support portion 50 is inserted into and connected to the mounting hole 60.

[0067] The medical sheet 300 is supported by the first supporting surface 261 and the second supporting surface 74 (see FIGS. 7 and 8). Specifically, the medical sheet 300 is placed on the first supporting surface 261 and the second supporting surface 74. When the medical sheet 300 is placed on the second supporting surface 74, the portion of the medical sheet 300 that does not fit on the second supporting surface 74 is supported by the first supporting surface 261.

[0068] In the transfer device 10, the user can move the base end of the first shaft 24 in the direction of arrow X1 or the direction of arrow X2 to displace the positions of the first carrier member 18 and the second carrier member 20 to a storage position (first position) (see Figures 9 and 10), a protruding position (second position) (see Figures 13 and 14), or a transfer position (third position) (see Figures 15 and 16).

[0069] As shown in Figs. 9 and 10, in the stored position, the first support portion 26 and the second support portion 50 can be stored in the outer tube 22. More specifically, the stored position is the position of the first carrier member 18 and the second carrier member 20 when the first shaft 24 and the second shaft 48 move in the direction of the arrow X2 (towards the base end) relative to the outer tube 22 and the first support portion 26 and the second support portion 50 are stored in the outer tube 22. In the stored position, the first support portion 26 is stored in the outer tube 22 in a curved and deformed state (see Fig. 11). When the medical sheet 300 is supported by the first support surface 261 and the second support surface 74, if the first carrier member 18 and the second carrier member 20 move to the stored position, the medical sheet 300 is also stored in the outer tube 22 in a curved and deformed state.

[0070] 13 and 14, at the protruding position, the first support part 26, the second support part 50, and the carrier holding part 54 protrude from the tip opening 80 of the outer tube 22. More specifically, the first shaft 24 and the second shaft 48 are moved integrally in the direction of arrow X1 relative to the outer tube 22 from the stored position. When the first carrier member 18 and the second carrier member 20 move to the protruding position, the first support part 26, the second support part 50, and the carrier holding part 54 protrude from the tip opening 80 in the direction of arrow X1. At the protruding position, the first support part 26 and the medical sheet 300 are exposed from the outer tube 22 in the direction of arrow X1, and are unfolded as shown in FIGS. 13 and 14.

[0071] 15 and 16, at the transfer position, the second shaft 48 moves in the direction of arrow X1 relative to the outer tube 22 and the first shaft 24. As the second shaft 48 moves in the direction of arrow X1, the carrier holding part 54 pushes the medical sheet 300 out of the first support part 26 in the direction of arrow X1. As a result, at the transfer position, the medical sheet 300 is transferred to the transplantation target area 402.

[0072] As shown in FIG. 10, the delivery device 10 further includes a restricting portion 102, an interlocking member 104, and an elastic body 106.

[0073] The restricting portion 102 restricts the relative movement of the second shaft 48 in the base end direction (arrow X2 direction) with respect to the first shaft 24 between the housed position (see FIG. 10) and the protruding position (see FIG. 14). The restricting portion 102 is configured by the tip portion 94 of the first shaft 24 and the carrier holding portion 54. Between the housed position and the protruding position, the tip portion 94 of the first shaft 24 and the carrier holding portion 54 engage with each other. In detail, the tip portion 94 of the first shaft 24 abuts against the carrier holding portion 54 in the axial direction, restricting the relative movement of the second shaft 48 in the base end direction with respect to the first shaft 24.

[0074] When the user presses the base end of the first shaft 24 in the direction of the arrow X1 between the stored position (see FIG. 10) and the protruding position (see FIG. 14), the tip end 94 of the first shaft 24 presses the carrier holding portion 54 in the direction of the arrow X1. This causes the first shaft 24 and the second shaft 48 to move together in the direction of the arrow X1 relative to the outer cylinder 22.

[0075] The restricting portion 102 is not limited to the form formed by the tip portion 94 of the first shaft 24 and the carrier holding portion 54. For example, the restricting portion 102 may be formed by one protrusion provided on the outer circumferential surface of the first shaft 24 and the other protrusion provided on the outer circumferential surface of the second shaft 48. Axial contact between the two protrusions makes it possible to restrict the relative movement of the second shaft 48 with respect to the first shaft 24 in the base end direction.

[0076] The interlocking member 104 connects the outer tube 22 and the second shaft 48. The interlocking member 104 moves the second shaft 48 relative to the first shaft 24 in the direction of the arrow X1 in conjunction with the movement of the first shaft 24 toward the tip end (the direction of the arrow X1) between the protruding position (see FIG. 14) and the transfer position (see FIG. 15). More specifically, one end of the interlocking member 104 is connected to the outer tube 22. The other end of the interlocking member 104 is connected to the second shaft 48. A portion between the one end and the other end of the interlocking member 104 is inserted into a tip opening 98 provided in the first shaft 24. FIG. 10 illustrates a case in which one end of the interlocking member 104 is connected to the base end side inside the outer tube 22 and the other end of the interlocking member 104 is connected to the base end side of the second shaft 48.

[0077] The interlocking member 104 is a flexible member. The interlocking member 104 is a member that does not easily stretch. The constituent material of the interlocking member 104 is, for example, polyimide, polyethylene terephthalate, or the like. In other words, the constituent material of the interlocking member 104 is not a highly elastic (stretchable) material such as rubber. The interlocking member 104 is a band-shaped member. The interlocking member 104 is a member that is thin enough not to hinder the movement of the first shaft 24 inside the outer tube 22. The interlocking member 104 may be a string-like or wire-like member.

[0078] One end of the interlocking member 104 may be connected to the outer tube 22 so as not to come off from the outer tube 22. One end of the interlocking member 104 may be fixed to the outer tube 22 by, for example, adhering or fusing to the outer tube 22, or by being clamped or locked to the outer tube 22. Fig. 10 illustrates a case in which one end of the interlocking member 104 is clamped and fixed between the base end of the outer tube 22 and the valve body 84.

[0079] The other end of the interlocking member 104 may be connected to the second shaft 48 so as not to come off from the second shaft 48. The other end of the interlocking member 104 may be fixed to the second shaft 48, for example, by bonding or fusing to the second shaft 48, or by being clamped or locked to the second shaft 48. Figure 10 illustrates the case where the other end of the interlocking member 104 is bonded and fixed to the base end of the second shaft 48.

[0080] At least a part of the interlocking member 104 is relaxed in the stored position. As shown in FIG. 10, in the stored position, the part of the interlocking member 104 between the outer tube 22 and the tip opening 98 of the first shaft 24 constitutes a bellows portion 105 that contracts in a bellows shape. Note that the part of the interlocking member 104 between the outer tube 22 and the tip opening 98 of the first shaft 24 is not limited to the case of contracting in a bellows shape. This part only needs to be accommodated between the inside of the outer tube 22 and the outer circumferential surface of the first shaft 24 in a relaxed state in the stored position. This part may be relaxed in a random shape (for example, Z-shape) in the stored position. As shown in FIG. 14, in the protruding position, the interlocking member 104 is tensed. Therefore, in the protruding position, the bellows portion 105 is not constituted, and the interlocking member 104 does not extend any further.

[0081] Therefore, when the user pushes the base end of the first shaft 24 in the distal direction (arrow X1 direction) between the protruding position (see FIG. 14) and the transport position (see FIG. 15), the interlocking member 104 pulls the second shaft 48 in the distal direction. That is, a force in the arrow X1 direction is transmitted from the first shaft 24 to the second shaft 48 via the interlocking member 104. The second shaft 48 moves in the arrow X1 direction relative to the outer tube 22 and the first shaft 24 as a result of the force being transmitted in the arrow X1 direction.

[0082] The elastic body 106 connects the first shaft 24 and the second shaft 48. The elastic body 106 biases the second shaft 48 in the direction of the arrow X2 between the projecting position (see FIG. 14) and the transporting position (see FIG. 15). More specifically, the elastic body 106 is interposed between the base end of the first shaft 24 and the base end of the second shaft 48 in the first inner cavity 28 of the first shaft 24. The base end of the elastic body 106 is fixed to the base end of the first shaft 24. The tip end of the elastic body 106 is fixed to the base end of the second shaft 48. Thus, the elastic body 106 connects the first shaft 24 and the second shaft 48 in the axial direction of the outer tube 22. The elastic body 106 is, for example, a spring member or rubber having a biasing force in the direction of the arrow X2. FIG. 10 illustrates a case where the elastic body 106 is a spring member 108.

[0083] When the user stops pushing the first shaft 24 in the direction of arrow X1 between the protruding position (see FIG. 14) and the transfer position (see FIG. 15), the elastic body 106 returns the second shaft 48 from the transfer position to the protruding position by using a biasing force in the direction of arrow X2.

[0084] In addition, in the housed position (see FIG. 10) and the protruding position (see FIG. 14), the elastic body 106 (spring member 108) is contracted in the direction of the arrow X2. Therefore, in the first embodiment, the elastic body 106 can also function as a restricting portion (second restricting portion) that restricts the relative movement of the second shaft 48 in the base end direction (arrow X2 direction) with respect to the first shaft 24. When the elastic body 106 functions as a restricting portion, the tip end portion 94 of the first shaft 24 and the carrier holding portion 54 do not need to constitute the restricting portion 102.

[0085] The interlocking member 104 is not limited to being inserted into the tip opening 98 of the first shaft 24. The interlocking member 104 may be inserted into an opening (side hole) provided at a position other than the tip opening 98 of the first shaft 24.

[0086] The interlocking member 104 is not limited to a case where one end is connected to the base end of the outer tube 22 and the other end is connected to the base end of the second shaft 48. One end of the interlocking member 104 may be connected to any location of the outer tube 22. The other end of the interlocking member 104 may be connected to any location of the second shaft 48.

[0087] 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. 12 to Fig. 16, a method for transferring the medical sheet 300 to a transplant target part 402 of a heart 400 (treatment target part of a living body) by thoracoscopic surgery will be described. As shown in Fig. 6, the transfer method according to the first 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.

[0088] First, in a preparation step (step S1), the transfer device 10 according to the first 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.

[0089] 7 and 8, in the sheet placement step (step S2), the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. The medical sheet 300 protrudes outward from the second support portion 50 when placed on the second support surface 74. The first support surface 261 supports the protruding portion 302 of the medical sheet 300 that protrudes outward from the second support portion 50.

[0090] 9 and 10, the medical sheet 300 is placed in a storage position (first position) together with the first support part 26 and the second support part 50 in the outer cylinder 22. 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.

[0091] 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.

[0092] 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. 11, the back surfaces 462 on both sides in the width direction of the first support portion 26 come into contact with each other on a virtual line L2 extending in a direction perpendicular to the central axis of the outer tube 22. One first protrusion 38 and the other first protrusion 38 come into contact with each other and are accommodated downward (first support surface 261, surface 461).

[0093] 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.

[0094] 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. 11).

[0095] As the first support part 26 is curved and deformed, the second support part 50 is also curved and deformed along the first support part 26 on the inside (surface 461 side) of the first support part 26. As the first support part 26 and the second support part 50 are curved and deformed, the medical sheet 300 is deformed into a shape corresponding to the shapes of the first support body 32 and the second support body 72, and the medical sheet 300 is contained within the outer cylinder 22.

[0096] As shown in FIG. 10, at the housed position, at least a part of the interlocking member 104 (a part between one end of the interlocking member 104 and the tip opening 98) is relaxed. That is, this part is configured as a bellows part 105 that contracts like a bellows. The bellows part 105 is disposed between the inner peripheral surface of the outer tube 22 and the outer peripheral surface of the first shaft 24. Also, at the housed position, the base end part of the second shaft 48 is housed inside the first shaft 24. Furthermore, at the housed position, the tip part 94 of the first shaft 24 and the carrier holding part 54 are engaged with each other. That is, the tip part 94 of the first shaft 24 abuts against the carrier holding part 54 in the axial direction. This constitutes the restricting part 102.

[0097] 9, the accommodating step is completed when the entire first support part 26 is completely inserted into the outer cylinder 22. When the accommodating step is completed, a part of the first support part 26 may protrude from the tip opening 80 of the outer cylinder 22. In this case, the state in which a part of the first support part 26 protrudes from the tip opening 80 of the outer cylinder 22 is the first position of the first support part 26.

[0098] Thereafter, in a placement step (step S4 in FIG. 6), as shown in FIG. 12, 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 supplying instrument (not shown) may be connected to the second shaft 48 to introduce liquid (e.g., physiological saline).

[0099] 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. 13 and FIG. 14. Specifically, in the unfolding step, the first shaft 24 is grasped and moved toward the tip end (in the direction of arrow X1) relative to the outer tube 22.

[0100] Specifically, the user grasps the base end of the first shaft 24 protruding from the outer tube 22 in the direction of the arrow X2, and pushes the base end of the first shaft 24 in the direction of the arrow X1. At this time, the second shaft 48 moves together with the first shaft 24 in the direction of the arrow X1 by the restricting portion 102. As a result, the first shaft 24 and the second shaft 48 move from the stored position to the protruding position. Then, the first support portion 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. At the second position where the first support portion 26 is deployed, the second support portion 50 spreads in a planar shape. Also, the interlocking member 104 changes from a bellows-like contracted state (relaxed state) to a tensed state.

[0101] In the unfolding step, the second carrier member 20 has the second support surface 74, on which the medical sheet 300 is placed, positioned entirely above the first support surface 261. At this time, the medical sheet 300 is supported by the first support surface 261 and the second support surface 74. This makes it possible to prevent wrinkles from forming in the protruding portion 302 of the medical sheet 300 before the medical sheet 300 is transferred to the transplantation target portion 402 of the heart 400.

[0102] 15 and 16, the second carrier member 20 is moved in the distal direction (arrow X1 direction) relative to the first carrier member 18. As a result, the second support part 50 carrying the medical sheet 300 moves from the retracted position to the advanced position, and the second support part 50 protrudes in the distal direction (arrow X1 direction) beyond the distal end of the first support part 26.

[0103] Specifically, in the moving step, the user pushes the base end of the first shaft 24 in the direction of the arrow X1 at the protruding position. Since the interlocking member 104 is in a tensioned state at the protruding position, the interlocking member 104 pulls the second shaft 48 in the direction of the arrow X1. This transmits a force in the direction of the arrow X1 from the first shaft 24 to the second shaft 48 via the interlocking member 104. The second shaft 48 moves in the direction of the arrow X1 relative to the first shaft 24 due to the force transmitted from the interlocking member 104. That is, the second carrier member 20 moves in the direction of the arrow X1 relative to the first carrier member 18. At this time, the base end of the medical sheet 300 abuts against the pressing surface 58.

[0104] When the user further presses the base end of the first shaft 24 in the direction of arrow X1, the carrier holding part 54 presses the base end of the medical sheet 300 in the direction of arrow X1 via the pressing surface 58. As a result, the entire medical sheet 300 moves in the direction of arrow X1 together with the second carrier member 20.

[0105] In this moving step, the medical sheet 300 is moved above (transfer position) the transplantation target portion 402 of the heart 400 so that the protruding portions 302 of the medical sheet 300 come into contact with the transplantation target portion 402 (see FIG. 16).

[0106] Thereafter, in the removal step (step S7 in FIG. 6), as shown in FIG. 17, the second carrier member 20 is moved from the transfer position to the protruding position to remove the second support part 50 from between the transplantation target part 402 and the medical sheet 300. Specifically, when the user stops pushing the base end of the first shaft 24 in the direction of arrow X1, the second carrier member 20 returns from the transfer position (see FIG. 15) to the protruding position (see FIG. 14) by the biasing force of the elastic body 106 in the direction of arrow X2. 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.

[0107] Thereafter, when the user pulls the base end of the first shaft 24 in the direction of arrow X2, the first carrier member 18 and the second carrier member 20 return from the extended position (see FIG. 14) to the retracted position (see FIG. 10). The delivery device 10 is removed from the chest 408 with the first support part 26 and the second support part 50 still retracted within the outer tube 22.

[0108] The first embodiment provides the following advantages.

[0109] As shown in Figure 16, by moving the second shaft 48 in the direction of arrow X1 (towards the tip) from a state in which the medical sheet 300 is supported by the first support surface 261 and the second support surface 74 (see Figure 13), the medical sheet 300 can be efficiently transported to the transplant target portion 402 (treatment target portion) of the heart 400.

[0110] 10, the restricting portion 102 restricts the relative movement of the second shaft 48 in the direction of the arrow X2 (proximal direction) with respect to the first shaft 24, so that when a user pushes the proximal end of the first shaft 24 protruding from the proximal opening 100 of the outer tube 22 in the direction of the arrow X1, the first shaft 24 and the second shaft 48 can be moved integrally in the direction of the arrow X1 with respect to the outer tube 22. Therefore, the first carrier member 18 and the second carrier member 20 can be moved integrally from the housed position (first position) to the protruding position (second position) (see FIG. 14) simply by pushing the first shaft 24 in the direction of the arrow X1.

[0111] 14, when the user presses the base end of the first shaft 24 further in the direction of arrow X1 at the protruding position, the second shaft 48 moves in the direction of arrow X1 relative to the first shaft 24 by an interlocking member 104 connecting the outer tube 22 and the second shaft 48. Therefore, the second carrier member 20 can be moved from the protruding position to the transfer position (third position) (see FIG. 15) relative to the first carrier member 18 by the user simply pressing the first shaft 24 in the direction of arrow X1.

[0112] Thus, in the first embodiment, the user can easily unfold the first support part 26 at the protruding position and transfer the medical sheet 300 to the transplant target part 402 at the transfer position by simply pushing the first shaft 24 in the direction of arrow X1.

[0113] 14, when the user presses the base end of the first shaft 24 in the direction of the arrow X1 at the protruding position, the second shaft 48 moves in the direction of the arrow X1 due to a force in the direction of the arrow X1 transmitted from the first shaft 24 via the interlocking member 104. This allows the second shaft 48 to easily move relative to the first shaft 24 in the direction of the arrow X1.

[0114] As shown in Fig. 10, when the user pushes the base end of the first shaft 24 in the direction of arrow X1 at the stored position and the first shaft 24 and the second shaft 48 move together in the direction of arrow X1, the interlocking member 104 becomes tensed at the protruding position as shown in Fig. 14. As a result, when the user pushes the base end of the first shaft 24 in the direction of arrow X1 at the protruding position, the force in the direction of arrow X1 can be efficiently transmitted from the first shaft 24 to the second shaft 48 via the interlocking member 104. As a result, the second shaft 48 can be more easily moved relative to the first shaft 24 in the direction of arrow X1.

[0115] As shown in FIG. 10, in the accommodated position, the interlocking member 104 contracts in a bellows shape, so that the interlocking member 104 can be accommodated compactly between the inside of the outer cylinder 22 and the first shaft 24.

[0116] Furthermore, since the second shaft 48 is not exposed from the first shaft 24 in the stored position, the user can operate the first shaft 24 without hesitation.

[0117] 14 and 15, when the user stops pushing the first shaft 24 in the direction of the arrow X1, the second shaft 48 moves in the direction of the arrow X2 relative to the first shaft 24 due to the biasing force of the elastic body 106. This makes it possible to easily return the second shaft 48 from the transport position to the protruding position.

[0118] 10, the restricting portion 102 is formed by the tip portion 94 of the first shaft 24 and the carrier holding portion 54, which engage with each other between the stored position and the protruding position. This allows the first shaft 24 and the second shaft 48 to be easily and integrally moved in the direction of the arrow X1 when the user presses the first shaft 24 in the direction of the arrow X1 at the stored position.

[0119] A transfer device 120 according to a second embodiment of the present invention will be described with reference to Figures 18 to 20. Note that in the transfer device 120 according to the second embodiment, the same components as those in the transfer device 10 according to the first embodiment (see Figures 1 to 17) are given the same reference symbols, and detailed descriptions of the same components will be omitted, and the same applies below.

[0120] Fig. 18 is an explanatory diagram of the storing step (see Fig. 6) of the conveying tool 120 according to the second embodiment. Fig. 18 illustrates the stored position in the second embodiment. The conveying tool 120 does not include the elastic body 106 (see Fig. 10).

[0121] In the delivery device 120, the first shaft 24 has a locking portion 122. The locking portion 122 is formed on the inside of the first shaft 24. The locking portion 122 is a ring-shaped protrusion that protrudes inwardly of the first shaft 24 from the inside of the first shaft 24.

[0122] The second shaft 48 has an engagement portion 124. The engagement portion 124 protrudes in a direction intersecting the axial direction (direction along the axis Ax) of the second shaft 48. In Fig. 18, the engagement portion 124 is a flange 126 provided at the base end of the second shaft 48. The flange 126 protrudes in the radial direction of the second shaft 48 at the base end of the second shaft 48.

[0123] Inside the first shaft 24, the base end of the second shaft 48 is located between the locking portion 122 and the base end of the first shaft 24. Therefore, the engagement portion 124 (flange 126) is located between the locking portion 122 and the base end of the first shaft 24.

[0124] In the transfer device 120, the locking portion 122 is provided with a groove (not shown) that penetrates in the axial direction (direction along the axis Ax) of the first shaft 24. The interlocking member 104 can be inserted into the groove of the locking portion 122. In the stored position, the other end side of the interlocking member 104 passes through the groove of the locking portion 122 and extends in the direction of the arrow X2. In the stored position, the other end of the interlocking member 104 is located (connected) at a position between the locking portion 122 and the engagement portion 124 on the second shaft 48.

[0125] Also in the second embodiment, when the user pushes the base end of the first shaft 24 in the direction of the arrow X1 in the stored position of Fig. 18, the first shaft 24 and the second shaft 48 move together in the direction of the arrow X1 by the restricting portion 102. As a result, the conveying device 120 moves from the stored position to the protruding position shown in Fig. 19, and the interlocking member 104 changes from the relaxed state to the tensed state.

[0126] In the extended position, when the user pushes the base end of the first shaft 24 in the direction of arrow X1, a force in the direction of arrow X1 is transmitted from the first shaft 24 to the second shaft 48 via the interlocking member 104, and the second shaft 48 moves in the direction of arrow X1 relative to the first shaft 24.

[0127] 20, the engagement portion 124 abuts against the locking portion 122. As a result, even if a user pushes the base end of the first shaft 24 in the direction of the arrow X1, the second shaft 48 does not move in the direction of the arrow X1. As the engagement portion 124 abuts against the locking portion 122, the movement of the second shaft 48 in the direction of the arrow X1 is restricted.

[0128] The effect of the second embodiment will be described. As shown in Fig. 20, when the second shaft 48 moves to the transfer position, the engaging portion 124 comes into contact with the locking portion 122, so that the second shaft 48 can be restricted from moving in the direction of the arrow X1 more than necessary. This makes it possible to prevent the second carrier member 20 from coming off the transfer instrument 120 in the direction of the arrow X1 while transferring the medical sheet 300 to the transplantation target site 402.

[0129] 21 is a perspective view of a transfer device 140 according to a third embodiment of the present invention. The transfer device 140 does not have the second support part 50 (see FIG. 1). In the transfer device 140, as the second shaft 48 moves in the direction of arrow X1, the carrier holding part 54 presses the medical sheet 300 in the direction of arrow X1 via the pressing surface 58, thereby transferring the medical sheet 300 to the transplantation target site 402.

[0130] The effects of the third embodiment will be described. In the third embodiment, by moving the second shaft 48 in the direction of the arrow X1 from a state in which the medical sheet 300 is supported by the first support surface 261, the medical sheet 300 can be efficiently transferred to the transplantation target site 402.

[0131] 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]

[0132] 10, 120, 140…transfer equipment 18...First carrier member 20...Second carrier member 22…Outer cylinder 24…First shaft 26…First support part 48…Second shaft 54...Carrier holding portion (pressing portion) 80…Tip opening 100...Proximal opening 102…Regulation Department 104...Interlocking member 261...1st support surface 300…Medical sheets 402... Transplant target part (part of living body to be treated)

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, an outer cylinder having a distal end opening which is an opening in a distal direction and a proximal end opening which is an opening in a proximal direction; a first carrier member including a first shaft movable along the outer cylinder inside the outer cylinder, and a first support portion provided at a tip end of the first shaft and having a first support surface for supporting the medical sheet; a second carrier member including a second shaft extending along the first shaft and movable along the first shaft, and a pressing portion provided at a distal end of the second shaft and pressing the medical sheet supported on the first support surface in the distal direction; Equipped with a proximal end portion of the first shaft protruding in the proximal direction from the proximal end opening, at a first position obtained by moving the first shaft and the second shaft in the base end direction relative to the outer cylinder so that the first support portion and the pressing portion are housed in the outer cylinder, the first support portion is housed in the outer cylinder in a curved and deformed state, At a second position where the first shaft and the second shaft are moved in the distal direction relative to the outer tube so that the first support portion and the pressing portion protrude from the distal opening, the first support portion is exposed in the distal direction from the outer tube to be deployed, At a third position where the second shaft is moved in the distal direction relative to the outer tube and the first shaft so that the pressing portion pushes the medical sheet out of the first support portion, the medical sheet is transferred to the treatment target area. The transfer device includes: a restricting portion that restricts relative movement of the second shaft in the base end direction with respect to the first shaft between the first position and the second position; an interlocking member that connects the outer cylinder and the second shaft and moves the second shaft in the distal direction relative to the first shaft in conjunction with movement of the first shaft in the distal direction between the second position and the third position; The transfer device further comprises:

2. 2. The transfer device of claim 1, The first shaft is a tubular body having an inner lumen, The second shaft is inserted into the first shaft, One end of the interlocking member is connected to the outer cylinder, The other end of the interlocking member is connected to the second shaft, A transfer device, wherein a portion of the interlocking member between one end and the other end is inserted into an opening provided in the first shaft.

3. 3. The transfer device of claim 2, The interlocking member has flexibility, In the first position, at least a portion of the linkage member is relaxed; In the second position, the linkage member is tensioned.

4. 4. The transfer device of claim 3, A transfer device, wherein in the first position, a portion of the interlocking member between the outer cylinder and the opening of the first shaft contracts like a bellows.

5. A transfer device according to any one of claims 2 to 4, In the first position, a proximal end of the second shaft is received within the first shaft.

6. A transfer device according to any one of claims 2 to 4, The delivery instrument further comprising a resilient body connecting the first shaft and the second shaft and biasing the second shaft in the proximal direction between the second position and the third position.

7. 2. The transfer device of claim 1, The first shaft is a tubular body having an inner lumen, The second shaft is inserted into the first shaft, A transfer device, wherein the regulating portion is constituted by the tip portion of the first shaft and the pressing portion which engage with each other between the first position and the second position.

8. A transfer device according to any one of claims 2 to 4, The first shaft has a locking portion formed on an inner side of the first shaft, The second shaft has an engagement portion protruding in a direction intersecting an axial direction of the second shaft, A delivery instrument, wherein the engagement portion abuts the locking portion when the second shaft moves relative to the first shaft in the distal direction between the second position and the third position.

9. A transfer device according to any one of claims 1 to 4, the second carrier member further includes a second support portion provided at a tip portion of the pressing portion and having a second support surface smaller than the first support surface, The medical sheet is supported by the first support surface and the second support surface.

Images