Transfer device

Abstract

To provide a transfer device for transferring a medical sheet to a treatment object part of a living body.SOLUTION: A transfer device 10 includes an outer cylinder 22 and a carrier member 18 having a support 26. The support 26 is formed in a wave shape in a cross section along a width direction orthogonal to the axial direction of the outer cylinder 22. In a state where the support 26 is accommodated in the outer cylinder 22, both ends of a back surface, which are both ends of the back surface of the support 26 in the width direction, come into contact with an inner peripheral surface of the outer cylinder 22, and both ends of the back surface are not in contact with each other. As the support 26 protrudes from the outer cylinder 22, the support 26 is brought into a deployed state.SELECTED DRAWING: Figure 2

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 Art

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

Prior Art Document

Patent Document

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] It is desired to transfer the medical sheet to the treatment target part more efficiently.

Means for Solving the Problems

[0005] (1) One aspect of the present invention is a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: an outer cylinder; a shaft extending in the axial direction of the outer cylinder and arranged to be movable along the axial direction inside the outer cylinder; and a carrier member having a sheet-like support portion arranged at the tip of the shaft and including a support surface capable of holding the medical sheet. The support portion has a front surface including the support surface and a back surface opposite to the front surface. The support portion is formed in a wave shape in a cross section along the width direction orthogonal to the axial direction of the outer cylinder. In a housed state where the support portion is housed in the outer cylinder, both end portions of the back surface in the width direction of the support portion, which are both end portions of the back surface, are in contact with the inner peripheral surface of the outer cylinder and are non-contact with each other. As the support portion protrudes from the tip opening of the outer cylinder and is exposed from the outer cylinder, the support portion becomes a deployed state developed by the elastic restoring force of the support portion. The support portion in the deployed state is larger in the width direction than the support portion in the housed state, and is a transfer device.

[0006] According to the above configuration, since the support portion is formed in a wave shape, the support portion can be contracted in the width direction and housed in the outer cylinder. Therefore, a medical sheet wider than the inner peripheral length of the outer cylinder can be placed on the support portion, and the device (transfer device) can be made thinner and less invasive. Thus, according to this transfer device, the medical sheet can be efficiently transferred to the treatment target part.

[0007] (2) In the transfer device according to (1) above, the support portion may have at least one first curved convex portion curved to be convex in a first direction from the back surface toward the front surface and at least one second curved convex portion curved to be convex in a second direction opposite to the first direction.

[0008] (3) In the transfer device according to (2) above, in the housed state, at least one of both end portions of the back surface may be arranged between at least one of the first curved convex portions and the inner peripheral surface of the outer cylinder.

[0009] (4) In the transfer device according to (2) or (3) above, in the accommodated state, the second curved convex portion may be non-contact with the inner peripheral surface of the outer cylinder.

[0010] (5) In the transfer device according to (2) above, in the accommodated state, both end portions of the back surface may be located at positions closer to the second direction than the protruding ends of the first curved convex portions.

[0011] (6) In the transfer device according to any one of (2) to (5) above, the support portion may have two of the first curved convex portions and one of the second curved convex portions formed between the two first curved convex portions in the width direction.

[0012] (7) In the transfer device according to any one of (1) to (6) above, a second shaft extending along the shaft and provided so as to be movable along the shaft, and a pressing portion provided at the tip of the second shaft for pressing the medical sheet toward the tip direction. A second carrier member may be provided.

[0013] Since the transfer device includes the second carrier member, the medical sheet can be transferred from the support portion to the treatment target portion of the living body using the second carrier member without using other devices (such as forceps). Therefore, the medical sheet can be efficiently transferred to the treatment target portion.

Effect of the Invention

[0014] According to the moving device of the present invention, since the support portion is formed in a wave shape, the support portion can be contracted in the width direction and accommodated in the outer cylinder. Therefore, a medical sheet having a width larger than the inner peripheral length of the outer cylinder can be placed on the support portion, and the device (transfer device) can be thinned and minimally invasive. Therefore, according to this transfer device, the medical sheet can be efficiently transferred to the treatment target portion.

Brief Description of the Drawings

[0015]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Figure 14

Figure 15

DETAILED DESCRIPTION OF THE INVENTION

[0016] As shown in FIG. 1, the transfer device 10 according to the present embodiment is a medical device for transferring the medical sheet 300 to the treatment target part of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure due to ischemic heart disease. In this case, the medical sheet 300 is transplanted to the transplantation target part 402 (the treatment target part of the living body) of the heart 400 (see FIG. 12). With the transfer device 10, a plurality of medical sheets 300 can be attached to the transplantation target part 402.

[0017] Such medical sheets 300 include medical-use pharmaceuticals, products such as regenerative medicine, and medical devices. The medical sheet 300 is formed in a sheet shape such as a film shape or a membrane shape (gel-like object). The medical sheet 300 may be reinforced by applying fibrin or the like. Products such as regenerative medicine containing cells include, for example, cell sheets (sheet-like cell cultures), spheroids, and the like. 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). Somatic stem cells preferably include skeletal myoblasts (myoblast cells).

[0018] The medical sheet 300 may contain a tissue adhesive, a local anesthetic, and the like. 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 40 mm. However, the thickness and diameter (size) of the medical sheet 300 can be set as appropriate.

[0019] The medical sheet 300 may be a sheet transplanted to organs other than the heart 400 (for example, the lungs, liver, pancreas, kidneys, small intestine, esophagus, etc.). Also, the medical sheet 300 may be a sheet for preventing adhesions, for example, as long as it is for medical use.

[0020] As shown in FIGS. 1 and 2, the transfer device 10 includes an instrument body 12, an endoscope 14, and a fixing member 16. The instrument body 12 has a carrier member 18, a carrier member 20, and an outer cylinder 22. Hereinafter, one carrier member 18 is referred to as the "first carrier member 18", and the other carrier member 20 is referred to as the "second carrier member 20". Note that the transfer device 10 is not limited to the case where it includes an endoscope 14.

[0021] In FIG. 2, the first carrier member 18 has a shaft 24 (hereinafter referred to as the "first shaft 24") and a support portion 26 (hereinafter referred to as the "first support portion 26").

[0022] The first shaft 24 is a tubular body (a circular tube member in this embodiment) having a first inner cavity 28. The first inner cavity 28 opens at the tip (the end in the direction of arrow X1) of the first shaft 24 and also opens at the base end (the end in the direction of arrow X2) of the first shaft 24. An airtight valve body 55 that is in close contact with the outer peripheral 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 peripheral surface of the valve body 55. When the transfer device 10 is used, the user can visually recognize the marker 551. Note that the first shaft 24 is not limited to a tubular body and may not be a tubular body.

[0023] The first shaft 24 extends in the axial direction of the outer cylinder 22 and is disposed inside the outer cylinder 22 so as to be movable along the axial direction. The first shaft 24 is made of, for example, a resin material. The constituent material of the first shaft 24 is not particularly limited, and examples include polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyetheretherketone, polyvinyl chloride, ABS resin, polyamide elastomer, polyester elastomer, etc. The first shaft 24 may be made of a metal material.

[0024] The first shaft 24 may have flexibility. The first shaft 24 may have a flexible tube portion capable of holding a bent shape. In this case, the first shaft 24 can be bent into an appropriate shape within the body cavity and the bent shape can be maintained. As shown in FIGS. 2 to 4, the first support portion 26 is attached to the tip of the first shaft 24. The first support portion 26 is made of, for example, a resin material. The first support portion 26 can hold the medical sheet 300. The first support portion 26 is formed by bending a resin sheet material (film material) having flexibility into a predetermined shape. The first support portion 26 is formed, for example, by molding a sheet material into a predetermined shape using a sheet molding die. The thickness of the sheet material is not particularly limited, but is preferably set to, for example, 100 μm or more and 200 μm or less. The first support portion 26 has a first joint portion 30 and a first support body 32.

[0025] The constituent material of the first support portion 26 is not particularly limited, but it is preferably transparent, and examples thereof include polyethylene, polycarbonate, polyamide, polystyrene, polypropylene, polyacetal resin, polyimide, polyetherimide, polyetheretherketone, polyethylene terephthalate, fluororesin, etc. Further, the first support portion 26 may be mesh-shaped.

[0026] In FIG. 4, the first joint portion 30 is adhered to the inner peripheral surface of the tip of the first shaft 24 with an adhesive. The adhesive is not particularly limited, and examples thereof include UV adhesives, hot melt adhesives, instant adhesives (for example, cyanoacrylate-based instant adhesives), etc. The first joint portion 30 may be heat-sealed to the inner peripheral surface of the first shaft 24. Note that the first support portion 26 may be detachable from the tip of the first shaft 24.

[0027] As shown in FIG. 2, the first support body 32 extends from the first joint portion 30 in the distal direction. The first support body 32 has a proximal 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 of the first shaft 24 is arranged such that when the first support surface 261 faces upward, the marker 551 faces upward. That is, the user can confirm the direction of the first support surface 261 in the first support portion 26 by the marker 551.

[0028] As shown in FIG. 3, the proximal support portion 34 is formed wider in its extending direction. In other words, both side portions in the width direction of the proximal support portion 34 are inclined in a tapered shape toward the first joint portion 30 (see FIG. 2). The intermediate support portion 36 is formed in a tapered shape whose width gradually decreases from the distal end toward the proximal end direction (arrow X2 direction). The distal support portion 42 is connected to the distal ends of the intermediate support portion 36 and the pair of second protrusions 40.

[0029] As shown in FIG. 4, the proximal support portion 34 extends from the distal end of the first joint portion 30 in the distal direction (arrow X1 direction) generally along the axis Ax of the first shaft 24. The intermediate support portion 36 intersects the axis Ax of the first shaft 24 from the distal end of the proximal support portion 34 in the distal direction (arrow X1 direction) and extends in the distal direction (arrow X1 direction) of the first support portion 26.

[0030] In FIG. 3, the direction (W direction) orthogonal to the axial direction of the first shaft 24 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 cylinder 22).

[0031] In FIGS. 2 and 3, the pair of first protrusions 38 protrude upward (arrow Y direction) and inward in the width direction of the intermediate support portion 36 from both side portions in the width direction of the intermediate support portion 36 orthogonal to the moving direction of the first shaft 24. The pair of first protrusions 38 are connected to the proximal support portion 34. The first protrusion 38 has an arc shape that bulges convexly in the direction away from the first support surface 261.

[0032] As shown in FIG. 3, a 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 and outward in the width direction of the intermediate support portion 36 from both side portions in the width direction of the intermediate support portion 36. The second protruding portion 40 is formed with a smaller curvature than the first protruding portion 38. The second protruding portion 40 has a lower protruding height with respect to the first support surface 261 than the first protruding portion 38.

[0033] 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 with respect to the first support surface 261 (intermediate support portion 36) of the first support portion 26 (see FIG. 5).

[0034] Hereinafter, the portion combining the first protruding portion 38 and the second protruding portion 40 of the first support portion 26 is referred to as a "protruding portion 37". Therefore, a pair of protruding portions 37 are provided on both sides in the width direction of the first support portion 26.

[0035] The first support main body 32 has a surface 461 including the first support surface 261 facing upward (in the direction of arrow Y), and a back surface 462 which is the surface opposite to the surface 461. The first support surface 261 is a surface continuous with the upper surface of the base end support portion 34, the upper surfaces of the intermediate support portion 36 and the tip support portion 42. A lubricant may be applied to the first support surface 261 so that a second support portion 50, which will be described later, of the second carrier member 20 can slide smoothly with respect to the first support surface 261.

[0036] Since the first support portion 26 is a sheet-like member, it is elastically deformable and can be accommodated in the outer cylinder 22. As shown in FIG. 3, in a state where the first support portion 26 protrudes from the tip opening 80 of the outer cylinder 22, the first support portion 26 is in a deployed state because it is not restricted by the outer cylinder 22. The width Wp of the first support portion 26 in the deployed state is larger than the outer diameter D of the outer cylinder 22.

[0037] As shown in FIG. 5, the first support portion 26 is formed in a wave shape (wave-shaped, wavy, undulated, Corrugated) in a cross section along the width direction (W direction) of the first support portion 26. The wave shape of the first support portion 26 can also be expressed as a bellow folding or a zigzag.

[0038] The first support portion 26 has at least one first curved convex portion 271 that is curved so as to be convex in a first direction (T1 direction) from the back surface 462 toward the front surface 461, and at least one second curved convex portion 272 that is curved so as to be convex in a second direction (T2 direction) that is opposite to the first direction. The first direction is a direction along the thickness direction (T direction) of the first support portion 26. The second direction is the other direction along the thickness direction (T direction) of the first support portion 26. The thickness direction of the first support portion 26 is a direction orthogonal to the width direction (W direction) of the first support portion 26. Hereinafter, when the first curved convex portion 271 and the second curved convex portion 272 are not distinguished from each other for explanation, they are simply referred to as "curved convex portion 270". Therefore, the first support portion 26 has a plurality of curved convex portions 270. The bending angle θ of the first curved convex portion 271 in the unfolded state of the first support portion 26 is, for example, 30° to 150°, preferably 60° to 120°. The bending angle θ is an angle formed by a virtual straight line LS1 parallel to one end of the first curved convex portion 271 and a virtual straight line LS2 parallel to the other end of the first curved convex portion 271.

[0039] As shown in FIG. 3, each of the plurality of curved convex portions 270 extends along the extending direction (X1 direction and X2 direction) of the first support portion 26. Each of the plurality of curved convex portions 270 does not necessarily extend parallel to the extending direction of the first support portion 26, and may extend in a direction slightly inclined with respect to the extending direction of the first support portion 26. The wave shape of the first support portion 26 is provided from the base end side to the tip end side of the first support portion 26. That is, the wave shape of the first support portion 26 is provided on the base end support portion 34, the intermediate support portion 36, and the tip end support portion 42. The plurality of curved convex portions 270 reach the tip edge of the tip end support portion 42.

[0040] In this embodiment, the first support portion 26 has two first curved convex portions 271 and one second curved convex portion 272. The second curved convex portion 272 is formed between the two first curved convex portions 271 in the width direction of the first support portion 26. For this reason, the second curved convex portion 272 is formed at the center in the width direction of the first support portion 26. A pair of protruding portions 37 are provided further outside in the width direction of the two first curved convex portions 271.

[0041] The waveform of the first support portion 26 (the respective numbers of the first curved convex portions 271 and the second curved convex portions 272) is not limited to the above-described aspect. The first support portion 26 may have three or more first curved convex portions 271, or may have two or more second curved convex portions 272.

[0042] As shown in FIG. 2, the second carrier member 20 has a second shaft 48, a second support portion 50, and a hub 52.

[0043] The second shaft 48 is a tubular body (a circular tube member in this embodiment) having a second inner cavity 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 inner cavity 28 of the first shaft 24 (see FIGS. 1 and 4). In other words, the tip portion of the second shaft 48 protrudes in the tip direction (arrow X1 direction) from the tip opening of the first shaft 24. The base end portion of the second shaft 48 protrudes in the base end direction (arrow X2 direction) from the base end opening of the first shaft 24 (see FIG. 1). The second shaft 48 extends along the first shaft 24 and is provided so as to be movable along the first shaft 24. Note that the second shaft 48 is not limited to a tubular body and may not be a tubular body.

[0044] The second shaft 48 is configured to follow the shape of the first support portion 26. As the constituent material of the second shaft 48, for example, a material having higher flexibility 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. may be mentioned. The second shaft 48 has flexibility.

[0045] As shown in FIG. 4, the second shaft 48 has a carrier holding portion 54 and a pressing portion 56 formed by the tip end portion of the second shaft 48. The pressing portion 56 is formed of 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 cylinder 22 in a state where the first support portion 26 is accommodated in the outer cylinder 22.

[0046] The tip end of the carrier holding portion 54 has a pressing surface 58. The carrier holding portion 54 can press the outer peripheral end surface of the medical sheet 300 supported by the first support portion 26 in the tip end direction (arrow X1 direction) by the pressing surface 58. In the present embodiment, the pressing portion 56 is provided with a carrier holding portion 54 that supports the second support portion 50. The carrier holding portion 54 includes a pressing surface 58 and a mounting hole 60.

[0047] In FIG. 4, the pressing surface 58 is provided on the tip end surface of the carrier holding portion 54. The mounting hole 60 opens in the pressing surface 58. The second support portion 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 end direction (arrow X1 direction) (see FIG. 12).

[0048] In FIGS. 2 to 4, the second support portion 50 is configured in a flexible sheet shape. The second support portion 50 has a second joint portion 70 and a second support body 72. The second joint portion 70 is provided at the proximal end of the second support portion 50. The second joint portion 70 is provided at the proximal end of the second support body 72. The second joint portion 70 is inserted into the mounting hole 60 of the carrier holding portion 54 and is, for example, adhered. The second joint portion 70 may be joined to the mounting hole 60 of the carrier holding portion 54 by an appropriate joining method other than adhesion. Further, the second support portion 50 may be integrally formed with the carrier holding portion 54.

[0049] The second support body 72 extends from the second joint portion 70 in the distal direction (arrow X1 direction). The length of the second support body 72 extending from the second joint portion 70 in the extending direction is shorter than the length of the first support body 32 extending from the first joint portion 30 in the extending direction. On the upper surface of the second support body 72, a second support surface 74 for placing the medical sheet 300 is provided. The second support surface 74 is a flat surface. The second support body 72 is smaller than the first support body 32. That is, the area of the second support surface 74 is smaller than the area of the first support surface 261. The second support portion 50 (second support body 72) may be in contact with only the first curved convex portion 271 of the first support portion 26. The second support portion 50 may be in contact with the first support surface 261 along the curved shape of the first support surface 261.

[0050] In FIG. 2, the hub 52 is attached to the proximal end portion of the second shaft 48. The second carrier member 20 further includes a stopper 49. The stopper 49 is disposed at a distance from the hub 52 in the distal direction (arrow X1 direction). The stopper 49 has a larger diameter than the second shaft 48. As shown in the cross-sectional view in FIG. 1, the stopper 49 is inserted into the first inner cavity 28 of the first shaft 24. When the second shaft 48 is pulled in the proximal direction with respect to the first shaft 24, the stopper 49 abuts against and is locked to the valve body 55.

[0051] In FIGS. 1 and 2, the outer cylinder 22 is a cylindrical member having an inner cavity 78. The inner cavity 78 has a tip opening 80 that opens at the tip of the outer cylinder 22 (the end in the direction of arrow X1). The inner cavity 78 opens at the base end of the outer cylinder 22 (the end in the direction of arrow X2). The outer cylinder 22 is flexible. The constituent material of the outer cylinder 22 may be the same material as that of the first shaft 24 described above. The first shaft 24 is inserted into the inner cavity 78 of the outer cylinder 22. The length of the outer cylinder 22 along the axial direction is shorter than the length of the first shaft 24 along the axial direction. An airtight valve body 84 that adheres to the outer peripheral surface of the first shaft 24 is provided at the base end of the outer cylinder 22.

[0052] In FIGS. 2 and 4, the tip surface of the outer cylinder 22 extends along a direction orthogonal to the axial direction of the outer cylinder 22.

[0053] As shown in FIG. 2, the endoscope 14 has a long endoscope body 86. The tip portion of the endoscope body 86 is fixed to the outer peripheral surface of the outer cylinder 22 by a fixing member 16 (see FIG. 1). The objective lens 88 provided on the tip surface of the endoscope body 86 faces the tip direction of the outer cylinder 22 (the direction of arrow X1). The tip portion of the endoscope body 86 is fixed to the middle portion in the axial direction of the outer cylinder 22. However, the tip portion of the endoscope body 86 may be fixed to the tip portion of the outer cylinder 22.

[0054] The fixing member 16 includes, for example, a fixing cylinder 90 and a fixing tube 92. The fixing cylinder 90 is made of, for example, a rigid resin material. The inner cavity of the fixing cylinder 90 is capable of inserting the endoscope body 86. The fixing cylinder 90 is arranged along the longitudinal direction of the outer cylinder 22. The fixing tube 92 is a tube for fixing the fixing cylinder 90 to a predetermined position of the outer cylinder 22. The fixing tube 92 is, for example, a heat-shrinkable tube. Note that the method of fixing the tip portion of the endoscope body 86 to the outer cylinder 22 can be set as appropriate.

[0055] As shown in FIG. 3, in the present embodiment, the first support portion 26 has a pair of protruding portions 37. In FIG. 3, W1 is the width at the location where the width of the first support portion 26 is maximized when the first support portion 26 is developed in a planar shape. That is, the width W1 of the first support portion 26 is the maximum width of the first support portion 26P in the planar state before (before bending) the pair of protruding portions 37 are formed. The width W1 of the first support portion 26 is larger than the inner peripheral length L of the outer cylinder 22 (see FIG. 9). In FIG. 9, the inner peripheral length L of the outer cylinder 22 is the length of the inner peripheral surface 221 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. In FIG. 1, the width W2 of the medical sheet 300 in the width direction (W direction) orthogonal to the axial direction of the outer cylinder 22 is larger than the inner peripheral length L of the outer cylinder 22. The first support portion 26 can hold the medical sheet 300 having a width larger than the inner peripheral length L of the outer cylinder 22. When the medical sheet 300 is circular, the width W2 is the diameter of the medical sheet 300.

[0056] Next, a transfer method for transferring the medical sheet 300 to the treatment target part of the living body will be described. Specifically, as shown in FIGS. 10 to 13, a transfer method for transferring the medical sheet 300 to the transplantation target part 402 (treatment target part of the living body) of the heart 400 by thoracoscopic surgery will be described. As shown in FIG. 6, the transfer method according to the present embodiment includes a preparation step, a sheet placement step, a housing step, an arrangement step, a deployment step, a movement step, and a removal step.

[0057] First, in the preparation step (step S1), the transfer device 10 according to the above-described embodiment is prepared. Hereinafter, a state as 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) with respect to the outer cylinder 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 cylinder 22. Each of the first support portion 26 and the second support portion 50 is deployed by being exposed in the distal direction from the outer cylinder 22, 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 at a retracted position overlapping the first support surface 261 of the first support portion 26. At this time, the proximal end portion of the carrier holding portion 54 is inserted into the first inner cavity 28 of the first shaft 24.

[0058] Subsequently, in the sheet placement step (step S2), as shown in FIG. 7, the medical sheet 300 disposed 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 in a state of being placed on the second support surface 74. The first support surface 261 supports the overhanging portion 302 that protrudes outward from the second support portion 50 of the medical sheet 300. Since the width W2 of the medical sheet 300 is larger than the width W1 of the first support portion 26 (see FIG. 1), as shown in FIG. 7, in a state where the medical sheet 300 is placed on the first support portion 26, both end portions in the width direction of the medical sheet 300 protrude from both end portions of the first support portion 26.

[0059] Thereafter, in the accommodation step (step S3 in FIG. 6), as shown in FIG. 8, the medical sheet 300 is placed in the accommodation position (first position) in the outer cylinder 22 together with the first support portion 26 and the second support portion 50. Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the proximal direction (arrow X2 direction) with respect to the outer cylinder 22.

[0060] Then, the proximal support portion 34 (see FIG. 2) of the first support portion 26 is drawn proximally from the distal opening 80 of the outer cylinder 22. At this time, when both tapered side portions of the proximal support portion 34 come into contact with the distal opening 80 of the outer cylinder 22, the proximal support portion 34 is smoothly drawn into the outer cylinder 22 while contracting in the width direction. At this time, the first support portion 26 is accommodated in the outer cylinder 22 while contracting in the width direction so that the width on the distal side is relatively large and the width on the proximal side is relatively small.

[0061] When the proximal support portion 34 of the first support portion 26 contracts and deforms in the width direction, a force that causes the intermediate support portion 36 of the first support portion 26 to also contract and deform in the width direction acts thereon. Therefore, the intermediate support portion 36 (see FIG. 2) is drawn into the outer cylinder 22 while contracting in the width direction. Each of the pair of first protrusions 38 is curved such that the surface 461 of the first support portion 26 is on the inner side and the back surface 462 of the first support portion 26 is on the outer side.

[0062] As shown in FIG. 9, in a state where the first support portion 26 is accommodated in the outer cylinder 22 (hereinafter, also referred to as "the accommodation state of the first support portion 26"), the wavy first support portion 26 is folded in the width direction (W direction). For this reason, the distance between the two first curved convex portions 271 in the accommodation state of the first support portion 26 is smaller than the distance between the two first curved convex portions 271 in the unfolded state of the first support portion 26 (see FIG. 5).

[0063] In the aspect shown in FIG. 9, the two first curved convex portions 271 are curved so as to bulge toward the inside of the outer cylinder 22. The central portion in the width direction of the medical sheet 300 is supported by the second curved convex portion 272 of the first support portion 26 via the second support portion 50.

[0064] In the accommodated state of the first support portion 26, both end portions 465 in the width direction on the back surface 462 of the first support portion 26, i.e., the both end portions 465 of the back surface, are in contact with the inner peripheral surface 221 of the outer cylinder 22, and the both end portions 465 of the back surface of the first support portion 26 are not in contact with each other. In the accommodated state of the first support portion 26, the both end portions 465 of the back surface of the first support portion 26 are disposed between the two first curved convex portions 271 and the inner peripheral surface 221 of the outer cylinder 22. In the accommodated state of the first support portion 26, only one of the both end portions 465 of the back surface of the first support portion 26 may be disposed between one of the first curved convex portions 271 and the inner peripheral surface 221 of the outer cylinder 22.

[0065] In the aspect shown in FIG. 9, the portion of the medical sheet 300 supported by the two first curved convex portions 271 is in contact with other portions of the medical sheet 300. In other aspects, one or both of the portions of the medical sheet 300 supported by the two first curved convex portions 271 may be spaced apart from other portions of the medical sheet 300.

[0066] In the accommodated state of the first support portion 26, the second curved convex portion 272 projects in the second direction (T2 direction) from between the two first curved convex portions 271 toward the inner peripheral surface 221 of the outer cylinder 22. In the accommodated state of the first support portion 26, the second curved convex portion 272 is not in contact with the inner peripheral surface 221 of the outer cylinder 22. In the accommodated state of the first support portion 26, the second curved convex portion 272 may be in contact with the back surface 462 of other portions of the first support portion 26 (the portions of the first support portion 26 on both sides of the second curved convex portion 272 and facing the second curved convex portion 272), or may not be in contact with the back surface 462 of other portions of the first support portion 26.

[0067] As the first support portion 26 deforms, the second support portion 50 also similarly deforms in a curved manner along the first support portion 26 on the inner side (the surface 461 side) of the first support portion 26. Along with the curved deformation of the first support portion 26 and the second support portion 50, the medical sheet 300 deforms into a waveform corresponding to the waveform of the first support body 32, and the medical sheet 300 is accommodated within the outer cylinder 22. In the aspect shown in FIG. 9, in a state where the medical sheet 300 is accommodated within the outer cylinder 22 and supported by the first support portion 26 (hereinafter, also referred to as the "sheet accommodation state"), both end portions in the width direction of the medical sheet 300 do not protrude from both end portions 269 in the width direction of the first support portion 26. In other aspects, as shown by the phantom line in FIG. 9, in the sheet accommodation state, one or both of the end portions in the width direction of the medical sheet 300 may protrude from one or both of the end portions 269 in the width direction of the first support portion 26. In this case, the end portions in the width direction of the medical sheet 300 may or may not contact each other.

[0068] Note that, when the medical sheet 300 is placed on the first support portion 26, the center in the width direction of the first support portion 26 and the center in the width direction of the medical sheet 300 do not necessarily coincide. That is, the center in the width direction of the medical sheet 300 may be displaced in the width direction (left - right direction) from the center in the width direction of the first support portion 26.

[0069] As shown in FIG. 8, the accommodation process is completed when the entire first support portion 26 is completely inserted into the outer cylinder 22. At this time, as shown in the cross - sectional view in FIG. 1, the stopper 49 provided on the second shaft 48 is locked to the valve body 55 of the first shaft 24, thereby preventing the relative movement of the second shaft 48 with respect to the first shaft 24 in the proximal - end direction (arrow X2 direction). When the accommodation process is completed, a part of the first support portion 26 may protrude from the distal - end opening 80 of the outer cylinder 22. In this case, the state where a part of the first support portion 26 protrudes from the distal - end opening 80 of the outer cylinder 22 is the first position of the first support portion 26.

[0070] Thereafter, in the placement step (step S4 in FIG. 6), as shown in FIG. 10, the transfer instrument 10 is inserted into the thoracic cavity 410 through the incision 409 in the chest 408. At this time, the tip of the transfer instrument 10 is positioned near the transplantation target portion 402 of the heart 400, and the tip of the endoscope 14 is positioned within the thoracic cavity 410. Before inserting the transfer instrument 10 into the thoracic cavity 410, a liquid supply instrument (not shown) may be connected to the connection port portion of the hub 52 to introduce a liquid (e.g., physiological saline).

[0071] Subsequently, in the deployment step (step S5 in FIG. 6), as shown in FIG. 11, the first support portion 26, the second support portion 50, and the medical sheet 300 are deployed. Specifically, in the deployment step, the first shaft 24 is gripped and the first shaft 24 is moved in the distal direction (arrow X1 direction) with respect to the outer cylinder 22. Thereby, by the valve body 55 of the first shaft 24, the second shaft 48 moves integrally with the first shaft 24 in the distal direction (arrow X1 direction). Then, the first support portion 26 exposed from the distal opening 80 of the outer cylinder 22 returns to its original shape by the restoring force. That is, as the first support portion 26 protrudes from the distal opening 80 of the outer cylinder 22 and is exposed from the outer cylinder 22, the first support portion 26 assumes a deployed state deployed by the elastic restoring force of the first support portion 26. The first support portion 26 in the deployed state is larger in the width direction than the first support portion 26 in the accommodated state.

[0072] In the deployment step, the second carrier member 20 is such that the entire second support surface 74 on which the medical sheet 300 is placed is positioned on the first support surface 261. At this time, the medical sheet 300 is supported by the first support surface 261 and the second support surface 74. Thereby, it is possible to suppress the occurrence of wrinkles in the overhanging portion 302 of the medical sheet 300 in the state before the medical sheet 300 is transferred to the transplantation target portion 402 of the heart 400.

[0073] Next, in the moving step (step S6 in FIG. 6), as shown in FIG. 12, by moving the second carrier member 20 in the tip direction (arrow X1 direction) with respect to the first carrier member 18, the second support portion 50 on which the medical sheet 300 is placed moves from the retracted position to the advanced position, and the second support portion 50 protrudes in the tip direction (arrow X1 direction) beyond the tip of the first support portion 26. Specifically, in the moving step, the second shaft 48 is moved in the tip direction with respect to the first shaft 24.

[0074] As a result, the second support portion 50 moves in the tip direction (arrow X1 direction) with respect to the first support portion 26. At this time, when the tip surface of the carrier holding portion 54 (pressing portion 56) presses the outer peripheral end surface of the medical sheet 300 in the tip direction, the entire medical sheet 300 is positioned in the tip direction beyond the first support portion 26. In this moving step, the medical sheet 300 is moved above the transplantation target portion 402 of the heart 400 to bring the overhanging portion 302 of the medical sheet 300 into contact with the transplantation target portion 402.

[0075] Thereafter, in the removing step (step S7 in FIG. 6), as shown in FIG. 13, by moving the second carrier member 20 from the second position to the first position, the second support portion 50 is pulled out from between the transplantation target portion 402 and the medical sheet 300. Then, the entire medical sheet 300 comes into contact with the surface of the transplantation target portion 402. As a result, the transfer of the medical sheet 300 to the transplantation target portion 402 is completed. Thereafter, the transfer device 10 is removed from the chest 408 with the first support portion 26 and the second support portion 50 housed in the outer cylinder 22.

[0076] This embodiment has the following effects.

[0077] Since the transfer device 10 includes the second carrier member 20 that is axially relatively movable with respect to the first carrier member 18, the medical sheet 300 can be transferred from above the first support portion 26 to the transplantation target portion 402 of the living body using the second carrier member 20 without using other devices (such as forceps). Therefore, the medical sheet 300 can be efficiently transferred to the transplantation target portion 402.

[0078] As shown in FIG. 1, at the tip of the second shaft 48, a sheet-like second support portion 50 including a second support surface 74 capable of holding the medical sheet 300 is provided. The second support portion 50 is relatively movable with respect to the first support portion 26 between a retracted position overlapping the first support surface 261 and an advanced position located in the distal direction (arrow X1 direction) from the first support surface 261. With this configuration, the medical sheet 300 can be moved along the first support surface 261 of the first support portion 26 by the second support portion 50 having the second support surface 74.

[0079] Since the first support portion 26 is formed in a wave shape, the first support portion 26 can be contracted in the width direction and accommodated in the outer cylinder 22. For this reason, the medical sheet 300 having a width larger than the inner peripheral length of the outer cylinder 22 can be placed on the first support portion 26, and the device (transfer instrument 10) can be made thinner and less invasive. Therefore, according to this transfer instrument 10, the medical sheet 300 can be efficiently transferred to the treatment target site.

[0080] Instead of the first support portion 26 described above, the first support portion 26A shown in FIG. 14 or the first support portion 26B shown in FIG. 15 may be adopted.

[0081] In FIG. 14, the first support portion 26A is accommodated in the outer cylinder 22. In the accommodated state of the first support portion 26A, the both end portions 465 in the width direction on the back surface 462 of the first support portion 26A are located closer to the second direction (T2 direction) than the protruding ends 271p of the first curved convex portions 271. In the aspect shown in FIG. 14, the two first curved convex portions 271 are in contact with the inner peripheral surface 221 of the outer cylinder 22. In other aspects, one or both of the two first curved convex portions 271 may be non-contact with the inner peripheral surface 221 of the outer cylinder 22.

[0082] In FIG. 15, the first support portion 26B is housed inside the outer cylinder 22. In the housed state of the first support portion 26B, the second curved convex portion 272 is in contact with the inner peripheral surface 221 of the outer cylinder 22. In the housed state of the first support portion 26B, the second curved convex portion 272 may be non-contact with the inner peripheral surface 221 of the outer cylinder 22. In the housed state of the first support portion 26B, both end portions 269 in the width direction of the first support portion 26B overlap so that the front surface 461 and the back surface 462 face each other. Even in this case, both end portions 465 of the back surface of the first support portion 26B are non-contact with each other.

[0083] Note that the present invention is not limited to the above-described disclosure, and various configurations can be adopted without departing from the gist of the present invention.

Explanation of Reference Numerals

[0084] 10... Transfer device 18... First carrier member 20... Second carrier member 22... Outer cylinder 24... First shaft 26, 26A, 26B... First support portion 48... Second shaft 261... First support surface 300... Medical sheet 465... Both end portions of the back surface

Claims

1. A transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: an outer cylinder, a shaft extending in the axial direction of the outer cylinder and arranged to be movable along the axial direction inside the outer cylinder, and a sheet-shaped support part arranged at the tip of the shaft and including a support surface capable of holding the medical sheet, and a carrier member having the above, the support part has a front surface including the support surface and a back surface which is the surface opposite to the front surface, the support part is formed in a wave shape in a cross section along the width direction orthogonal to the axial direction of the outer cylinder, in a housed state where the support part is housed in the outer cylinder, both end parts in the width direction on the back surface of the support part are in contact with the inner peripheral surface of the outer cylinder, and both end parts of the back surface are not in contact with each other, as the support part protrudes from the tip opening of the outer cylinder and is exposed from the outer cylinder, the support part becomes a deployed state developed by the elastic restoring force of the support part, and the support part in the deployed state is larger in the width direction than the support part in the housed state, the transfer device.

2. In the transfer device according to Claim 1, the support part has at least one first curved convex part curved to be convex in a first direction from the back surface toward the front surface, and at least one second curved convex part curved to be convex in a second direction which is the opposite direction to the first direction, the transfer device.

3. In the transfer device according to Claim 2, in the housed state, at least one of both end parts of the back surface is arranged between at least one of the first curved convex parts and the inner peripheral surface of the outer cylinder, the transfer device.

4. In the transfer device according to Claim 2, in the housed state, the second curved convex part is not in contact with the inner peripheral surface of the outer cylinder, the transfer device.

5. In the transfer device according to Claim 2, in the housed state, both end parts of the back surface are located at positions closer to the second direction than the protruding ends of the first curved convex parts, the transfer device.

6. In the transfer device according to Claim 2, the support part has two of the first curved convex parts and one of the second curved convex parts formed between the two first curved convex parts in the width direction, the transfer device.

7. In the transfer device according to any one of Claims 1 to 6, A transfer device comprising: a second shaft extending along the shaft and provided so as to be movable along the shaft; and a second carrier member having a pressing portion provided at a tip end portion of the second shaft for pressing the medical sheet toward the tip end direction.

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