Transfer equipment

Abstract

To provide transfer equipment for transferring a medical sheet to a treatment object part of a living body.SOLUTION: In transfer equipment 10, a first support part 26 includes a first support body 32 including a first support surface 261. The first support body 32 includes a pair of protrusions 37 protruding upward from the two sides in a width direction (arrow direction) of the first support body 32. The pair of protrusions 37 extend from the base end part of the first support body 32 to the tip.SELECTED DRAWING: Figure 1

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 area of ​​a living body, comprising a carrier member including a shaft and a support portion provided at the tip of the shaft and having a support surface for supporting the medical sheet, the support portion having a front surface on which the support surface is formed and a back surface which is the opposite side to the front surface, the support portion having a support body including the support surface, when the direction from the back surface to the front surface is defined as upward, the support body has a pair of protrusions protruding upward from both sides in a width direction perpendicular to the axial direction of the shaft, and the pair of protrusions extend from the base end to the tip end of the support body.

[0006] According to this configuration, when the medical sheet is transferred to a treatment target area covered with other biological tissue, the pair of protrusions lifts the other biological tissue relative to the treatment target area when the carrier member is inserted between the treatment target area and the other biological tissue. This allows an appropriate space to be formed between the medical sheet placed on the support section and the other biological tissue. This suppresses contact between the medical sheet placed on the support section and the other biological tissue, or reduces the contact area between the medical sheet placed on the support section and the other biological tissue, making it possible to easily transfer the medical sheet to a treatment target area covered with other biological tissue.

[0007] (2) In the transfer device described in (1) above, the support portion has a pair of extending portions extending in a tip direction from both sides in the width direction at the tip portion of the support body, and the pair of extending portions may have extended protrusions extending further in the tip direction from the pair of protrusions.

[0008] According to this configuration, since the extended protrusion is provided, other biological tissue present in the distal direction (forward) of the support part can be lifted to form a space, which makes it easier to transfer the medical sheet to the treatment target part covered with other biological tissue.

[0009] (3) In the transfer device described in (1) or (2) above, the tip edge of the support body may extend linearly along the width direction.

[0010] With this configuration, when placing the medical sheet on the support part from the tip side of the support part, it is easy to place the medical sheet on the support part.

[0011] (4) In the transfer device according to any one of (1) to (3) above, the width of the support surface may increase in the direction toward the tip.

[0012] With this configuration, the width of the tip of the support surface is the widest, which makes it easier to place the medical sheet on the support surface from the tip side of the support portion, and also makes it possible to prevent the medical sheet placed on the support surface from spilling out of the support surface.

[0013] (5) In the transfer device described in any one of (1) to (4) above, the carrier member is a first carrier member, the shaft is a first shaft, and the transfer device further includes 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 tip of the second shaft, and the pressing portion may be capable of pressing the medical sheet supported on the support surface in a tip direction.

[0014] According to this configuration, by moving the second shaft in the distal direction and pressing the medical sheet with the pressing portion, the medical sheet supported on the support surface can be efficiently transferred to the treatment target area.

[0015] (6) In the transfer device described in (5) above, the support portion is a first support portion, the support surface is a first support surface, the second carrier member further includes a second support portion provided on 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.

[0016] With this configuration, by moving the second shaft toward the tip and pressing the medical sheet with the pressing portion, the medical sheet supported on the first support surface and the second support surface can be efficiently transported to the treatment target area.

[0017] (7) The transfer device described in (6) above may further include an outer tube having a distal opening, wherein the first shaft and the second shaft are movable along the outer tube inside the outer tube, and at a first position where the first shaft and the second shaft are moved in a base end direction relative to the outer tube so that the first support portion and the second support portion are contained within the outer tube, the first support portion and the second support portion are contained within the outer tube in a curved and deformed state, and at a second position where the shaft and the second shaft are moved in the distal end direction relative to the outer tube so that the first support portion and the second support portion protrude from the distal opening, the first support portion and the second support portion may be deployed by being exposed in the distal direction from the outer tube.

[0018] According to this configuration, in the first position, the first support portion and the second support portion can be housed compactly within the outer cylinder. Effect of the Invention

[0019] According to the present invention, when the medical sheet is transferred to a treatment target area covered with other biological tissue, the carrier member is inserted between the treatment target area and the other biological tissue, and the pair of protrusions lifts the other biological tissue relative to the treatment target area. This allows an appropriate space to be formed between the medical sheet placed on the support section and the other biological tissue. This suppresses contact between the medical sheet placed on the support section and the other biological tissue, or reduces the contact area between the medical sheet placed on the support section and the other biological tissue, making it possible to easily transfer the medical sheet to the treatment target area covered with other biological tissue. [Brief description of the drawings]

[0020] [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 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 placement process. [Figure 12] FIG. 12 is a first explanatory diagram of the development process. [Figure 13] FIG. 13 is a second explanatory diagram of the unfolding step. [Figure 14] FIG. 14 is an explanatory diagram of the development process in the comparative example. [Figure 15] FIG. 15 is an explanatory diagram of the movement process. [Figure 16] FIG. 16 is an explanatory diagram of the removal step. [Figure 17] FIG. 17 is a plan view of the distal end of a transfer device according to a second embodiment of the invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] 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. 11 to 13, 15 and 16). The transfer device 10 allows multiple medical sheets 300 to be attached to the transplant target portion 402.

[0022] 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).

[0023] 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.

[0024] 1 and 2, the transport instrument 10 includes an instrument body 12, an endoscope 14, and a fixing member 16. The instrument body 12 includes a carrier member 18. Hereinafter, the carrier member 18 will be referred to as a "first carrier member 18." The instrument body 12 further includes a second carrier member 20 and an outer tube 22. Note that the transport instrument 10 is not limited to including the endoscope 14.

[0025] 2, the first carrier member 18 has a first shaft 24 and a first support portion 26. Hereinafter, the shaft 24 will be referred to as the "first shaft 24." The support portion 26 will be referred to as the "first support portion 26."

[0026] The first shaft 24 is a tubular body (a circular tube member in the first embodiment) having a first lumen 28. The first lumen 28 opens at the tip end (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.

[0027] 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.

[0028] 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.

[0029] As shown in Figs. 2 to 4, the first support part 26 is attached to the tip of the first shaft 24. The first support part 26 is made of, for example, a resin material. The first support part 26 can hold a medical sheet 300 (see Fig. 1). 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 support body 32. Hereinafter, the support body 32 will be referred to as the "first support body 32".

[0030] 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.

[0031] 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.

[0032] 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.

[0033] 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 of the base end support part 34 in the width direction (arrow W direction perpendicular to the arrow X1 direction, the arrow X2 direction, and the arrow Y direction) are tapered toward the first joint part 30 (see Fig. 2). The intermediate support part 36 is formed in a tapered shape whose width gradually decreases from the tip toward the base end (arrow X2 direction).

[0034] 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 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 connects the pair of second protrusions 40. The tip edge 43 of the tip support portion 42 extends linearly along the width direction (arrow W direction) of the tip support portion 42. The width of the first support surface 261 increases toward the tip direction. In addition, as shown by the two-dot chain line in FIG. 8, in the first support portion 26P in a planar state before the pair of protrusions 37 are formed (before bending), the corners 42C on both sides in the width direction of the tip support portion 42 may have a relatively large radius of curvature (see also FIG. 3 for comparison).

[0035] 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).

[0036] 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 (in the direction of arrow W) of the intermediate support part 36 that is 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.

[0037] As shown in Fig. 3, the pair of second protruding portions 40 are respectively connected to the tips of the pair of first protruding portions 38. The pair of second protruding portions 40 protrude upward from both sides in the width direction of the intermediate support portion 36. The second protruding portions 40 are formed with a smaller curvature than the first protruding portions 38. As shown in Fig. 4, the protruding height of the second protruding portions 40 is greater than the protruding height of the first protruding portions 38.

[0038] 3, 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 (intermediate supporting portion 36) of the first supporting portion 26 (see FIG. 5).

[0039] 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.

[0040] As shown in FIG. 2, the second carrier member 20 includes a second shaft 48 , a second support portion 50 , and a hub 52 .

[0041] 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 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.

[0042] 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.

[0043] 4, the second shaft 48 has a carrier holding portion 54 (pressing portion) 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.

[0044] 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.

[0045] 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. 15).

[0046] 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.

[0047] 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.

[0048] In FIG. 2, the hub 52 is attached to the second shaft 48 .

[0049] 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.

[0050] 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.

[0051] 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.

[0052] 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.

[0053] 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.

[0054] 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. 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.

[0055] 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.

[0056] 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.

[0057] 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.

[0058] As shown in FIG. 1 to FIG. 4, the pair of protrusions 37 extend from the base end (base end support portion 34) of the first support body 32 to the tip end (tip end of tip support portion 42) of the first support body 32. That is, the first protrusion 38 extends from the base end support portion 34 to the intermediate support portion 36. The second protrusion 40 is connected to the tip of the first protrusion 38 and extends from the intermediate support portion 36 to the tip end of the tip support portion 42. Therefore, the pair of protrusions 37 face each other in the width direction of the first support portion 26 from the base end to the tip end of the first support body 32. The "tip end of the first support body 32" refers to, for example, at least a range of 10 mm from the tip end (tip edge 43) of the first support body 32 in the base end direction. Therefore, in the longitudinal direction of the first support portion 26, the tip end of the protrusion 37 does not necessarily have to coincide with the tip end (tip edge 43) of the first support body 32. Even if the tip of the protrusion 37 is located slightly shifted toward the base end from the tip of the first support body 32, this still falls under the configuration in which "the protrusion 37 extends to the tip of the first support body 32."

[0059] As shown in Figs. 1 to 3, the second support part 50 has a shape tapered toward the tip. More specifically, the second support part 50 has a shape that expands in the width direction (arrow W direction) from the second joint part 70 toward the tip, and tapers from the maximum width of the second support part 50 toward the tip. The tapered part of the second support part 50 is formed in a triangular shape. The tip edge of the second support part 50 is formed in an arc shape. Note that the tip edge of the second support part 50 may have any shape that does not damage the medical sheet 300. The second support part 50 is not limited to the shape shown in the drawings, and may have, for example, a pair of edges extending parallel to each other along the longitudinal direction of the second support part 50 on both sides in the width direction, and the tip side of the second support part 50 may be formed in an arc shape so as to connect the tips of the pair of edges.

[0060] 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 Figures 11 to 13, 15 and 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 Figure 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.

[0061] 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.

[0062] 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.

[0063] 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 (see FIG. 8) to a accommodated position (first position) as shown in FIG. 9. Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the base end direction (arrow X2 direction) relative to the outer cylinder 22.

[0064] 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.

[0065] 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. 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 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).

[0066] 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.

[0067] 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).

[0068] 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.

[0069] 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.

[0070] 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 an incision 409 in the chest 408. The heart 400 is covered with the pericardium 404. In the placement step, a part of the pericardium 404 is incised to form an opening 406, and the tip of the transfer instrument 10 is inserted between the pericardium 404 and the heart 400 through the opening 406. At this time, the tip of the endoscope 14 is positioned within 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 a connection port of the hub 52 to introduce liquid (e.g., physiological saline).

[0071] Subsequently, 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, with the tip of the transport instrument 10 inserted between the pericardium 404 and the heart 400, the first shaft 24 is grasped and moved in the tip 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 tip direction (arrow X1 direction). Then, the first support part 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. In the second position where the first support part 26 is unfolded, the second support part 50 spreads out in a planar shape.

[0072] 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.

[0073] In the deployment step, at the tip of the transport instrument 10, the back surface 462 of the first support part 26 comes into contact with the heart 400 (the transplantation target part 402), and the front surface 461 of the first support part 26 faces the inner surface of the pericardium 404. Therefore, the pair of protrusions 37 protrude from the first support body 32 and come into contact with the inner surface of the pericardium 404. In this case, the pair of protrusions 37 lift the pericardium 404 relative to the transplantation target part 402. That is, as shown in FIG. 13, in a state where the back surface 462 (see FIG. 4) of the first support part 26 and the transplantation target part 402 of the heart 400 are in contact with each other, the pair of protrusions 37 lift the pericardium 404 relative to the transplantation target part 402. As a result, a space 407 of an appropriate size is formed between the medical sheet 300 and the pericardium 404. As shown in FIG. 13, the space 407 is formed from the position of the opening 406 to the tip edge 43 of the first support body 32. Therefore, the pericardium 404 does not come into contact with the medical sheet 300 placed on the first support section 26, or the contact area with the medical sheet 300 is small.

[0074] 14 shows a comparative example in which a pair of protrusions 37 are formed only on the base end side of the first support body 32. In the comparative example, the pair of protrusions 37 do not extend to the tip edge 43 of the first support body 32, so the space 407 formed between the medical sheet 300 and the pericardium 404 is small. For this reason, the pericardium 404 easily comes into contact with the medical sheet 300 placed on the first support part 26.

[0075] 15, in the movement step (step S6 in FIG. 6), 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 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 movement step, the second shaft 48 is moved in the distal direction relative to the first shaft 24.

[0076] 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 (pressing surface 58) 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 transplantation target part 402 of the heart 400, and the overhanging part 302 of the medical sheet 300 is brought into contact with the transplantation target part 402.

[0077] As described above, an appropriate size of space 407 is formed. Therefore, contact between the medical sheet 300 placed on the first support part 26 and the pericardium 404 is suppressed, or the contact area between the medical sheet 300 placed on the first support part 26 and the pericardium 404 is reduced. This makes it easier to transfer the medical sheet 300 placed on the first support part 26 to the transplantation target part 402. In the comparative example of FIG. 14, since the space 407 formed between the medical sheet 300 and the pericardium 404 is small, the contact area between the medical sheet 300 placed on the first support part 26 and the pericardium 404 becomes large, making it difficult to transfer the medical sheet 300 placed on the first support part 26 to the transplantation target part 402.

[0078] Thereafter, in the removal step (step S7 in FIG. 6), the second carrier member 20 is moved from the second position to the first position as shown in FIG. 16. Since the second support part 50 has a shape tapered toward the tip, the contact area of ​​the second support surface 74 with the medical sheet 300 becomes smaller toward the tip. This reduces the frictional resistance between the medical sheet 300 and the second support surface 74. Therefore, when the second carrier member 20 is moved from the second position to the first position, the second support part 50 can be easily pulled out from between the transplantation target part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation target part 402. As a result, the transfer of the medical sheet 300 to the transplantation target part 402 is completed. Thereafter, the transfer instrument 10 is removed from the chest 408 with the first support part 26 and the second support part 50 housed in the outer cylinder 22.

[0079] The first embodiment provides the following advantages.

[0080] 13, when the medical sheet 300 is transferred to a transplantation target portion 402 (a treatment target portion of a living organism) covered with a pericardium 404 (another living tissue), if the first carrier member 18 is inserted between the transplantation target portion 402 and the pericardium 404, the pair of protrusions 37 lift the pericardium 404 relative to the transplantation target portion 402. This allows an appropriate space 407 to be formed between the medical sheet 300 placed on the first support portion 26 and the pericardium 404. This prevents contact between the medical sheet 300 placed on the first support portion 26 and the pericardium 404, or reduces the contact area between the medical sheet 300 placed on the first support portion 26 and the pericardium 404, making it possible to easily transfer the medical sheet 300 to the transplantation target portion 402 covered with the pericardium 404.

[0081] As shown in FIG. 3, the tip edge 43 of the first support body 32 extends linearly along the direction of arrow W (the width direction of the first support body 32), making it easy to place the medical sheet 300 on the first support part 26 from the tip side of the first support part 26.

[0082] The width of the first supporting surface 261 increases in the direction of arrow X1 (toward the tip). Therefore, the width of the tip of the first supporting surface 261 is the widest. This makes it easier to place the medical sheet 300 on the first supporting surface 261 from the tip side of the first supporting part 26. In addition, it is possible to prevent the medical sheet 300 placed on the first supporting surface 261 from spilling out of the first supporting surface 261.

[0083] As shown in Figure 15, by moving the second shaft 48 in the direction of arrow X1 and pressing the medical sheet 300 with the carrier holding portion 54 (pressing portion), the medical sheet 300 supported by the first support surface 261 can be efficiently transported to the transplant target area 402.

[0084] By moving the second shaft 48 in the direction of arrow X1 and pressing the medical sheet 300 with the carrier holding portion 54, the medical sheet 300 supported by the first support surface 261 and the second support surface 74 can be efficiently transported to the transplant target area 402.

[0085] At the stored position (first position) shown in Fig. 9, the first support part 26 and the second support part 50 are stored in the outer tube 22 in a curved and deformed state (see Fig. 10). At the protruding position (second position) shown in Fig. 12, the first support part 26 and the second support part 50 are exposed in the direction of the arrow X1 from the outer tube 22 and deployed. This allows the first support part 26 and the second support part 50 to be stored compactly in the outer tube 22 at the first position.

[0086] In the first embodiment, the medical sheet 300 may be transferred to an organ other than the heart 400 as the transplantation target portion 402. Even in the case of an organ other than the heart 400, other biological tissues (e.g., the peritoneum) may face the organ relatively close to the organ. Therefore, even when an organ other than the heart 400 is the target, the medical sheet 300 can be easily transferred to the transplantation target portion 402 using the transfer device 10 described above.

[0087] A transfer device 120 according to a second embodiment of the present invention will be described with reference to Fig. 17. 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 Figs. 1 to 16) are given the same reference symbols, and detailed descriptions of the same components will be omitted, as in the following description.

[0088] FIG. 17 is a plan view of the tip of the transfer device 120 according to the second embodiment. In the transfer device 120, the first support portion 26 has a pair of extending portions 122. The pair of extending portions 122 protrude in the direction of the arrow X1 (tip direction) from the tip of the first support body 32. More specifically, the pair of extending portions 122 extend in the direction of the arrow X1 from both sides in the direction of the arrow W (width direction) of the tip support portion 42 of the first support body 32. Therefore, the first support portion 26 has a recess 126 recessed in the base end direction between the pair of extending portions 122. The pair of extending portions 122 has a pair of extending base portions 123 extending in the tip direction from both sides in the width direction of the first support surface 261. The pair of extending portions 122 has an extending protruding portion 124 further extending in the direction of the arrow X1 from the pair of protruding portions 37. The pair of extending protruding portions 124 protrude upward from the pair of extending base portions 123, respectively.

[0089] The effects of the second embodiment will be described. In the second embodiment, since a pair of extended protrusions 124 is provided, the pericardium 404 existing in the distal direction (forward) of the first support part 26 can be lifted to form a space 407. This makes it possible to more easily transfer the medical sheet 300 to the transplantation target part 402 covered with the pericardium 404.

[0090] 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]

[0091] 10, 120...transfer equipment 18...First carrier member (carrier member) 24…First shaft (shaft) 26...First support part (support part) 32...First support body (support body) 37...Protruding part 261...First support surface (support surface) 300…Medical sheets 402... Transplant target part (treatment target part of living body) 461...Surface 462...Back side

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, a carrier member including a shaft and a support portion provided at a tip portion of the shaft and having a support surface for supporting the medical sheet; The support portion has a front surface on which the support surface is formed and a back surface that is the opposite surface to the front surface, The support portion has a support body including the support surface, When the direction from the back surface to the front surface is defined as an upward direction, the support body has a pair of protruding portions protruding upward from both sides in a width direction perpendicular to the axial direction of the shaft, A pair of said projections extend from a proximal end to a distal end of said support body.

2. 2. The transfer device of claim 1, The support portion has a pair of extension portions extending in a tip direction from both sides in the width direction of the tip portion of the support body, A transfer device, wherein the pair of extensions includes an extension protrusion further extending in the distal direction from the pair of protrusions.

3. 3. The transfer device according to claim 1 or 2, A transfer device, wherein a leading edge of the support body extends linearly along the width direction.

4. 3. The transfer device according to claim 1 or 2, A delivery device, wherein the support surface has a width that increases distally.

5. 3. The transfer device according to claim 1 or 2, the carrier member is a first carrier member; the shaft is a first shaft, 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 tip end of the second shaft; The pressing portion is capable of pressing the medical sheet supported on the support surface in a distal direction.

6. 6. The transfer device of claim 5, The support portion is a first support portion, the support surface is a first support surface; the second carrier member further includes a second support portion provided on 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.

7. 7. The transfer device of claim 6, Further comprising an outer cylinder having a tip opening; the first shaft and the second shaft are movable along the outer cylinder within the outer cylinder, at a first position obtained by moving the first shaft and the second shaft in a proximal direction relative to the outer cylinder so that the first support portion and the second support portion are accommodated in the outer cylinder, the first support portion and the second support portion are accommodated in the outer cylinder in a curved and deformed state, A delivery device in which, at a second position where the shaft and the second shaft are moved in the distal direction relative to the outer tube so that the first support portion and the second support portion protrude from the distal opening, the first support portion and the second support portion are exposed in the distal direction from the outer tube, thereby deploying.

Images