Implanted body deployment device

Abstract

An implanted body deployment device according to the present disclosure comprises: an outer cylinder body that defines a hollow part in the interior thereof; and a shaft body capable of insertion in the axial direction of the outer cylinder body relative to the hollow part. The shaft body comprises a shaft groove part that can accommodate a thread-like implanted body that extends in the radial direction of the outer cylinder body. The shaft body is movable in the axial direction with respect to the outer cylinder body so that the shaft groove part can move between a second position and a first position where the shaft groove part is exposed to the outside of the outer cylinder body without being covered by the outer cylinder body.

Description

Implant placement device

[0001] The present disclosure relates to implant placement devices.

[0002] In order to treat tissues with reduced function in the living body, various treatment methods have been proposed in which an implant that promotes tissue regeneration is placed at a treatment site in the living body. Patent Document 1 discloses an implant placement device used to implant porous collagen fibers with countless pores formed therein at a damaged site. When the collagen fibers are implanted at a damaged site in the living body, cells gather around the collagen fibers, promoting the regeneration of the damaged tissue.

[0003] The implant placement device of Patent Document 1 comprises a tubular member having an internal space extending axially inside and a puncture portion formed at its tip that can puncture subcutaneous tissue, an engaging portion formed at the tip with a diameter approximately the same as the inner diameter of the internal space of the tubular member, and a main body portion extending thread-like from the engaging portion toward the base end, the implant being made of a material that has the ability to promote tissue regeneration when cells adhere to it, and a movement mechanism connected to the base end of the tubular member and that circulates liquid through the internal space to move the implant within the internal space of the tubular member.

[0004] Japanese Patent Application Laid-Open No. 2020-127607

[0005] According to the implant placement device described in Patent Document 1, the distal end of the tubular member is positioned inside the living body, and the implant can be protruded from the distal end of the tubular member by using a moving mechanism. The tubular member is then pulled out of the living body. In this way, the implant is placed so that one end is positioned inside the living body and the other end is positioned outside the living body.

[0006] In addition, a filamentous implant (hereinafter referred to as a "filamentous implant") may be placed in a state in which it penetrates a part of the living body so that both ends are exposed to the outside of the living body. Hereinafter, placement of such a filamentous implant is referred to as "through placement." The implant placement device described in Patent Document 1 still has room for improvement in terms of operability when penetrating and placing the filamentous implant.

[0007] An object of the present disclosure is to provide an implant placement device that can improve operability when penetrating and placing a filamentous implant.

[0008] An implant placement device according to a first aspect of the present disclosure is an implant placement device comprising: (1) an outer cylindrical body defining a hollow portion therein; and a shaft body that can be inserted axially through the hollow portion of the outer cylindrical body, wherein the shaft body has a shaft groove that can accommodate a filamentous implant extending radially of the outer cylindrical body, and the shaft body can be displaced in the axial direction relative to the outer cylindrical body between a first position and a second position where the shaft groove is exposed to the outside of the outer cylindrical body without being covered by the outer cylindrical body.

[0009] An implant placement device according to one embodiment of the present disclosure is the implant placement device described in (1) above, wherein: (2) the outer tube has an outer tube groove capable of accommodating the filamentous implant extending in the radial direction; in the first position, the shaft groove of the shaft is exposed to the outside of the outer tube through the outer tube groove of the outer tube; and in the second position, the shaft groove of the shaft is exposed to the outside of the outer tube distal to the distal end face of the outer tube.

[0010] An implant placement device according to one embodiment of the present disclosure is (3) the implant placement device described in (2) above, in which the outer tube comprises an outer tube main body and an outer tube hub connected to the proximal side of the outer tube main body, and the outer tube groove portion is provided in the outer tube hub.

[0011] An implant placement device according to one embodiment of the present disclosure is the implant placement device described in (3) above, wherein: (4) the outer tube hub comprises a cylindrical hub body and a protrusion protruding radially from the hub body, the outer tube groove is provided on the hub body, and the protrusion comprises a receiving surface for receiving a portion of the filamentous implant housed in the outer tube groove of the hub body that extends radially outward from the outer tube groove.

[0012] An implant placement device according to one embodiment of the present disclosure is (5) the implant placement device described in (4) above, in which the receiving surface of the protrusion is formed with a storage groove portion that stores the portion of the filamentous implant extending radially outward from the outer tube groove portion.

[0013] An implant placement device according to one embodiment of the present disclosure is (6) an implant placement device according to any one of (2) to (5) above, in which, in a side view of the outer tube along the extension direction of the outer tube groove portion, the groove wall on at least one of the distal and proximal sides of the outer tube groove portion in the axial direction has an inclined surface portion that inclines so as to extend to the other side in the axial direction as it approaches the groove bottom.

[0014] An implant placement device according to one embodiment of the present disclosure is (7) an implant placement device according to any one of (2) to (6) above, in which, when viewed from above the outer tube along a direction perpendicular to the extension direction of the outer tube groove, the groove wall on the distal side in the axial direction of the outer tube groove is formed in a concave shape.

[0015] An implant placement device according to one embodiment of the present disclosure is (8) an implant placement device according to any one of (1) to (7) above, in which, in a side view of the shaft body along the extension direction of the shaft groove portion, at least one of the groove walls on both sides of the axial direction of the shaft groove portion has an inclined surface portion that is inclined with respect to the axial direction.

[0016] An implant placement device according to one embodiment of the present disclosure is (9) the implant placement device described in any one of (1) to (8) above, wherein the shaft body comprises: a shaft main body; and a shaft hub connected to the proximal side of the shaft main body; and the shaft groove portion is provided in the shaft main body.

[0017] An implant placement device according to one embodiment of the present disclosure is: (10) the implant placement device according to (9) above, wherein the shaft body is a solid rod-shaped body.

[0018] According to the present disclosure, an implant placement device can be provided that can improve operability when penetrating and placing a filamentous implant.

[0019] 6 is a diagram showing some steps of the setting step of a filamentous implant performed using an implant placement device according to an embodiment of the present disclosure. FIG. 7 is a diagram showing other steps of the setting step of the filamentous implant shown in FIG. 1. FIG. 8 is a diagram showing a puncturing step of the implant placement device, which is performed after completion of the setting step shown in FIG. 2. FIG. 9 is a diagram showing an exposure step of exposing the shaft groove, which is performed after completion of the puncturing step shown in FIG. 3. FIG. 10 is a diagram showing a removal step of removing the filamentous implant from the shaft groove, which is performed after completion of the exposure step shown in FIG. 4. FIG. 5 is a diagram showing a shaft removal step of removing the shaft from the outer cylinder, which is performed after completion of the removal step shown in FIG. 6. FIG. 7 is a perspective view showing details of the implant placement device shown in FIG. 1. FIG. 8 is an exploded perspective view showing the implant placement device shown in FIG. 8 disassembled into the outer cylinder and the shaft. FIG. 9 is a perspective view showing the vicinity of the outer cylinder groove of the outer cylinder shown in FIG. 10. FIG. 11 is a diagram showing the vicinity of the outer cylinder groove in a side view of the outer cylinder seen along the extending direction of the outer cylinder groove shown in FIG. 10. FIG. 12 is a diagram showing a modified example of the outer cylinder groove shown in FIG. 10. 17A , 17B, 17C, 17D, 17E, 17F, 17G, 17G, 17H, 17I, 17J, 17K ...21 is a diagram showing a shaft removal step of removing the shaft body from the outer tube body, which is performed after completion of the removal step shown in Fig. 20. FIG. 22 is a diagram showing an outer tube removal step of removing the outer tube body outside the living body, which is performed after completion of the shaft removal step shown in Fig. 21. FIG. 23 is a diagram showing the vicinity of the outer tube groove in a side view of the outer tube body seen along the extending direction of the outer tube groove, which is a perspective view showing the vicinity of the outer tube hub of the outer tube body. FIG. 24 is a diagram showing the vicinity of the outer tube groove in a side view of the outer tube body seen along the extending direction of the shaft groove. FIG. 25 is a diagram showing a state in which a filamentary embedding body is placed in the shaft groove in the shaft body. FIG. 26 is a diagram showing the vicinity of the shaft groove in a side view of the shaft body seen along the extending direction of the shaft groove. FIG. 27 is a diagram showing an example of a depth marker provided on the outer tube body.

[0020] Hereinafter, an embodiment of an implant placement device according to the present disclosure will be illustrated and described with reference to the drawings. In each drawing, the same components are designated by the same reference numerals.

[0021] 1 to 7 are diagrams showing an example of a method for inserting a filamentous implant 500 into a patient using an implant placement device 1 as one embodiment of the implant placement device according to the present disclosure.

[0022] The implant placement device 1 may be used, for example, in a procedure for placing a threadlike implant 500 near a lymphatic vessel whose function has been impaired due to damage or other reasons. The impairment of lymphatic vessel function occurs due to lymph node dissection, radiation therapy, drug therapy, or the like during tumor treatment. Edema may occur when lymphatic fluid does not flow normally due to a functional impairment or dysfunction of the lymphatic vessel. To improve such a functional impairment or dysfunction, regeneration of the lymphatic vessel can be induced by placing a threadlike collagen as the threadlike implant 500 near a lymphatic vessel whose function has been impaired or which is dysfunctional.

[0023] The above-mentioned collagen threads may be formed, for example, by folding a very thin collagen sheet. The diameter of the collagen threads is not particularly limited, but may be, for example, 0.3 to 2.0 mm. The length of the collagen threads is also not particularly limited, but may be, for example, 50 to 250 mm.

[0024] The uses of the implant placement device 1 are not limited to those described above. The implant placement device 1 may be used, for example, to place a thread-like substance other than the above-described thread-like collagen in a patient as the thread-like implant 500. In the present embodiment, the procedure for penetrating and placing thread-like collagen as the thread-like implant 500 in a patient using the implant placement device 1 will be described below.

[0025] As shown in FIG. 1 and other figures, the implant placement device 1 includes an outer cylindrical body 2 and a shaft body 3. The outer cylindrical body 2 defines a hollow portion 2a therein. As shown in FIGS. 1 and 2 and other figures, the shaft body 3 can be inserted into the hollow portion 2a of the outer cylindrical body 2 in the axial direction A of the outer cylindrical body 2. The axial direction A of the outer cylindrical body 2 is a direction parallel to the central axis O1 of the outer cylindrical body 2. Hereinafter, the axial direction A of the outer cylindrical body 2 will be referred to as the "axial direction A of the implant placement device 1" or simply as the "axial direction A." Within the axial direction A, the direction from the base end operated by a user such as a surgeon toward the tip end inserted into the patient's body will be referred to as the "distal side A1 of the axial direction A." In contrast, within the axial direction A, the direction opposite to the distal side A1 will be referred to as the "proximal side A2 of the axial direction A." The circumferential direction of the outer cylinder 2 around the central axis O1 of the outer cylinder 2 is referred to as the "circumferential direction B of the implant placement device 1" or simply as the "circumferential direction B." Furthermore, the radial direction of the outer cylinder 2, which is the radial direction of an imaginary circle centered on the central axis O1 of the outer cylinder 2, is referred to as the "radial direction C of the implant placement device 1" or simply as the "radial direction C."

[0026] As shown in Fig. 1 and other figures, the shaft body 3 has a shaft groove 21 capable of accommodating the filamentary embedding body 500 extending in the radial direction C. Also, as shown in Fig. 1 and other figures, the outer cylinder body 2 of this embodiment has an outer cylinder groove 11 capable of accommodating the filamentary embedding body 500 extending in the radial direction C.

[0027] The shaft body 3 can be displaced between a first position (see FIG. 1 ) and a second position (see FIGS. 4 and 5 ) in which the shaft groove portion 21 is not covered by the outer cylindrical body 2 and is exposed to the outside of the outer cylindrical body 2 by moving in the axial direction A relative to the outer cylindrical body 2. Details of this will be described later.

[0028] Next, with reference to FIGS. 1 to 7, a procedure for inserting thread-like collagen as the thread-like implant 500 into a patient using the implant placement device 1 will be described.

[0029] 1 and 2 are diagrams showing the setting process for setting the filamentous implant 500 in the implant placement device 1. As shown in FIG. 1 , the shaft 3 is moved in the axial direction A relative to the outer cylinder 2, and the axial position of the shaft groove 21 of the shaft 3 is aligned with the axial position of the outer cylinder groove 11 of the outer cylinder 2. The shaft 3 is also rotated in the circumferential direction B relative to the outer cylinder 2, and the circumferential position of the shaft groove 21 of the shaft 3 is aligned with the circumferential position of the outer cylinder groove 11 of the outer cylinder 2. The alignment of the outer cylinder groove 11 and the shaft groove 21 in the circumferential direction B may be manually adjusted by a user such as a surgeon. In this state, the filamentous implant 500 is accommodated in the shaft groove 21 through the outer cylinder groove 11.

[0030] 2, the shaft body 3 is moved from the state shown in FIG. 1 to the distal side A1 in the axial direction A relative to the outer cylindrical body 2. In this embodiment, the shaft body 3 is moved to a position where the distal end surface 22a of the shaft body 3 is approximately flush with the distal end surface 12a of the outer cylindrical body 2. As a result, the filamentous implant 500 housed in the shaft groove 21 of the shaft body 3 is pressed toward the distal side A1 by the groove wall on the proximal side A2 of the shaft groove 21, and moves toward the distal side A1 together with the shaft body 3. In this embodiment, the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft body 3 are blade surfaces that are inclined with respect to the axial direction A. Therefore, by aligning the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft body 3 so that they are substantially flush with each other, it is possible to prevent biological tissue from becoming entangled in the outer cylindrical body 2 when the distal end of the implant placement device 1 is inserted into the living body from the biological surface BS, thereby reducing puncture resistance. This completes the setting step of setting the filamentous implant 500 in the implant placement device 1 of this embodiment.

[0031] 3 is a diagram showing a puncturing step in which the distal end of the implant placement device 1, to which the filamentous implant 500 is set, is inserted into the living body from the living body surface BS so as to pass through the subcutaneous tissue ST, and then protrudes again from the living body surface BS. As shown in Fig. 3, in the puncturing step, the implant placement device 1 is inserted so as to penetrate a part of the patient's living body. The implant placement device 1 is inserted into the living body near the target site where the filamentous implant 500 is to be placed.

[0032] Fig. 4 is a diagram showing an exposing step of exposing the shaft groove 21 of the shaft body 3 from the outer tube body 2. As shown in Fig. 4, in the exposing step, the shaft body 3 is moved from the state shown in Fig. 3 to the distal side A1 in the axial direction A. As a result, the shaft groove 21 of the shaft body 3 moves further to the distal side A1 from the distal end surface 12a of the outer tube body 2, and is exposed to the outside of the outer tube body 2 from the hollow portion 2a inside the outer tube body 2.

[0033] 5 is a diagram showing a removal step in which the filamentary embedding body 500 is removed from the shaft groove 21. As a result, one end 500a of the filamentary embedding body 500 is exposed on the distal side A1 beyond the distal end surface 12a of the outer cylindrical body 2. As shown in FIG. 5, the filamentary embedding body 500 has one end 500a exposed to the outside of the outer cylindrical body 2 from the distal end surface 12a of the outer cylindrical body 2, and the other end 500b that is drawn into the inside of the outer cylindrical body 2 through the outer cylindrical groove 11 in the setting step (see FIG. 2) and is positioned inside the outer cylindrical body 2. The portion of the filamentary embedding body 500 between the one end 500a and the other end 500b extends along the axial direction A into the hollow portion 2a of the outer cylindrical body 2.

[0034] Fig. 6 is a diagram showing a shaft removal step for the shaft body 3. As shown in Fig. 6, in the shaft removal step, the shaft body 3 is removed from the outer cylinder body 2 toward the proximal side A2 while maintaining the position of the filamentous embedding body 500. The position of the filamentous embedding body 500 may be maintained by, for example, holding one end portion 500a with a holder 600.

[0035] 7 is a diagram showing the outer tube removal step of the outer tube body 2. As shown in Fig. 7, in the outer tube removal step, the outer tube body 2 is moved to the proximal side A2 (see Fig. 6) while maintaining the position of the filamentous implant 500, and the outer tube body 2 is removed from inside the living body to outside the living body. As in the shaft removal step described above, the position of the filamentous implant 500 may be maintained by, for example, holding one end 500a with a holder 600.

[0036] In this way, by using the implant placement device 1, the filamentous implant 500 can be easily placed through a part of the patient's body.

[0037] Here, the shaft body 3 can be displaced between a first position and a second position, where the shaft groove 21 is not covered by the outer cylindrical body 2 but is exposed to the outside of the outer cylindrical body 2, by moving in the axial direction A relative to the outer cylindrical body 2. Specifically, at the first position, the shaft groove 21 of the shaft body 3 is exposed to the outside of the outer cylindrical body 2 through the outer cylindrical groove 11 of the outer cylindrical body 2. That is, the first position of the shaft body 3 in this embodiment is the position shown in FIG. 1 . Also, at the second position, the shaft groove 21 of the shaft body 3 is exposed to the outside of the outer cylindrical body 2 at a position A1 distal to the distal end surface 12 a of the outer cylindrical body 2. That is, the second position of the shaft body 3 in this embodiment is the position shown in FIGS. 4 and 5 .

[0038] As described above, in the implant placement device 1, the shaft 3 is movable relative to the outer cylindrical body 2 between the first position (see FIG. 1 ) and the second position (see FIGS. 4 and 5 ). Therefore, according to the implant placement device 1 of this embodiment, by hooking the filamentous implant 500 into the shaft groove 21 while the shaft 3 is in the first position (see FIG. 1 ) and then moving the shaft 3 to the second position (see FIGS. 4 and 5 ), the filamentous implant 500 can be easily inserted into the outer cylindrical body 2, i.e., the filamentous implant 500 can be easily threaded into the hollow portion 2 a of the outer cylindrical body 2. This allows even a flexible and pliable filamentous implant 500 to be easily inserted into the outer cylindrical body 2. Therefore, with the implant placement device 1, the outer cylinder 2 is placed in a state in which it penetrates a part of the patient's living body (see FIGS. 3 to 6), and by using this outer cylinder 2, the filamentous implant 500 can be easily passed through and placed (see FIG. 7). In other words, with the implant placement device 1, the operability when passing through and placing the filamentous implant 500 can be improved.

[0039] In this embodiment, the so-called "push-out method" is shown in which the filamentary implant 500 is housed in the shaft groove 21 in the state shown in Fig. 1 , the shaft body 3 is moved to the distal side A1, and then the filamentary implant 500 is removed from the shaft groove 21 in the state shown in Fig. 5 , but the method is not limited to this push-out method. That is, the so-called "pull-back method" may also be used in which the filamentary implant 500 is housed in the shaft groove 21 in the state shown in Fig. 5 , the shaft body 3 is moved to the proximal side A2, and then the filamentary implant 500 is removed from the shaft groove 21 in the state shown in Fig. 1 . Specific examples of this "pull-back method" will be described later (see Figs. 18 to 22 ).

[0040] Next, the implant placement device 1 of this embodiment will be described in detail with reference to FIGS. 8 to 16B.

[0041] FIG. 8 is a perspective view of the implant placement device 1. FIG. 9 is an exploded perspective view showing the implant placement device 1 disassembled into the outer cylinder 2 and the shaft 3. FIG. 10 is a perspective view showing the vicinity of the outer cylinder groove 11 of the outer cylinder 2. FIG. 11 is a side view of the outer cylinder 2 seen along the extending direction D of the outer cylinder groove 11, showing the vicinity of the outer cylinder groove 11. FIG. 12 is a view showing a modified example of the outer cylinder groove 11. FIG. 13 is a side view of the shaft 3 seen along the extending direction E of the shaft groove 21, showing the vicinity of the shaft groove 21. FIGS. 14 to 16 are cross-sectional views of the implant placement device 1 taken along the axial direction A. Specifically, FIG. 14 is a cross-sectional view of the implant placement device 1 with the shaft 3 in the first position (see FIG. 1). FIG. 15 is a cross-sectional view of the implant placement device 1 with the shaft 3 in a position between the first position and the second position (see FIGS. 2 and 3). More specifically, Fig. 15 is a cross-sectional view of the implant placement device 1 in a state in which the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft body 3 are aligned so as to be substantially flush (see Figs. 2 and 3). Fig. 16 is a cross-sectional view of the implant placement device 1 in a state in which the shaft body 3 is in the second position (see Figs. 4 and 5). Figs. 17A and 17B are views showing a movement restriction mechanism 8 that restricts movement of the shaft body 3 in the axial direction A relative to the outer cylindrical body 2. Specifically, Fig. 17A is a view showing a movement restriction state in which movement of the shaft body 3 in the axial direction A relative to the outer cylindrical body 2 is restricted by the movement restriction mechanism 8. Fig. 17B is a view showing a movement permitted state in which movement of the shaft body 3 in the axial direction A relative to the outer cylindrical body 2 is not restricted by the movement restriction mechanism 8.

[0042] As described above, the implant placement device 1 of this embodiment includes the outer cylinder body 2 and the shaft body 3 .

[0043] 9 and other figures, the outer cylinder body 2 of this embodiment includes an outer cylinder main body 4 and an outer cylinder hub 5. The outer cylinder hub 5 is connected to the proximal side A2 of the outer cylinder main body 4.

[0044] The sheath tube body 4 is a cylindrical member made of a metal such as stainless steel or a hard resin. The sheath tube body 4 defines an internal lumen 4a that penetrates in the axial direction A. The lumen 4a of the sheath tube body 4 opens to the proximal side A2 and communicates with the lumen 5a of the sheath tube hub 5. The lumen 5a of the sheath tube hub 5 penetrates the sheath tube hub 5 in the axial direction A. The hollow portion 2a of the sheath tube body 2 of this embodiment is formed by the lumen 4a of the sheath tube body 4 and the lumen 5a of the sheath tube hub 5. The sheath tube hub 5 may be made of a hard resin material such as polycarbonate resin, for example.

[0045] The distal end surface 12a of the outer cylindrical body 2 in this embodiment is formed by the distal end surface of the outer cylindrical main body 4. As described above, the distal end surface 12a of the outer cylindrical body 2 in this embodiment is a blade surface inclined with respect to the axial direction A, and the distal end 13 of the outer cylindrical body 2 is formed by a sharp cutting edge. By forming the distal end surface 12a of the outer cylindrical body 2 as a blade surface, the outer cylindrical body 2 can be inserted into a living body so as to penetrate a part of the living body. However, the distal end surface 12a of the outer cylindrical body 2 does not have to be a blade surface inclined with respect to the axial direction A. In other words, the outer cylindrical body 2 does not need to have a puncturing function. In such a case, for example, a through-hole penetrating a part of the living body is formed in advance using a needle member separate from the implant placement device 1. As a result, even if the outer cylindrical body 2 does not have a puncturing function, the outer cylindrical body 2 can be inserted into a part of the living body by being inserted into a pre-formed through-hole in the living body. Alternatively, an incision may be made in the skin of the living body using a needle member separate from the implant placement device 1, and the incision may be used as an entrance into the living body to insert the implant placement device 1 having an outer cylindrical body 2 that does not have a puncture function into the living body, thereby penetrating a part of the living body.

[0046] The outer cylinder groove 11 of this embodiment is provided in the outer cylinder hub 5. More specifically, the outer cylinder hub 5 of this embodiment includes a cylindrical hub body 14 and a protrusion 15 that protrudes from the hub body 14 in the radial direction C. The outer cylinder groove 11 of this embodiment is provided in the hub body 14.

[0047] The inner cavity 5a of the sheath tube hub 5 described above is defined inside the cylindrical hub body 14. The proximal end of the sheath tube body 4 is fitted into the inner cavity 5a of the sheath tube hub 5. This allows communication between the inner cavity 4a of the sheath tube body 4 and the inner cavity 5a of the sheath tube hub 5. The sheath tube body 4 may be joined to the sheath tube hub 5 by adhesive or the like, with its proximal end inserted into the inner cavity 5a of the sheath tube hub 5.

[0048] As shown in Figure 10, the protrusion 15 has a receiving surface 15a that receives a portion of the filamentary embedding body 500 housed in the outer cylinder groove 11 of the hub body 14, the portion extending outward in the radial direction C from the outer cylinder groove 11 (hereinafter, for convenience of explanation, referred to as the "extended portion 501 of the filamentary embedding body 500"). A user, such as a surgeon, can hold the filamentary embedding body 500 by pressing the extended portion 501 of the filamentary embedding body 500 against the receiving surface 15a and gripping the extended portion 501 of the filamentary embedding body 500 between the receiving surface 15a and the protrusion 15. In other words, the provision of the receiving surface 15a allows the user to easily maintain the state in which the filamentary embedding body 500 is housed in the outer cylinder groove 11.

[0049] More specifically, the protrusion 15 of this embodiment includes a first plate-shaped portion 16a. The first plate-shaped portion 16a is a plate-shaped portion in which the axial direction A is the in-plane direction and the direction perpendicular to the axial direction A is the thickness direction. An upper surface 16a1, which is the surface on one side of the thickness direction of the first plate-shaped portion 16a, extends in the radial direction C so as to be continuous with the groove bottom 11a of the outer cylinder groove portion 11. The upper surface 16a1 of the first plate-shaped portion 16a constitutes the receiving surface 15a of this embodiment.

[0050] 11 , the maximum length L1 in the axial direction A of the upper surface 16a1 serving as the receiving surface 15a is longer than the maximum length L2 in the axial direction A of the outer tube groove portion 11. Furthermore, the upper surface 16a1 serving as the receiving surface 15a is provided over the entire area in the axial direction A where the groove bottom 11a of the outer tube groove portion 11 is located. In this embodiment, the proximal end of the upper surface 16a1 serving as the receiving surface 15a is located on the proximal side A2 further proximal than the proximal end of the groove bottom 11a of the outer tube groove portion 11.

[0051] The receiving surface 15a of the protrusion 15 is formed with a storage groove 15a1 that stores the portion of the filamentary embedding body 500 that extends outward in the radial direction C from the outer tube groove 11. More specifically, in this embodiment, the storage groove 15a1 extending in the radial direction C is formed on the upper surface 16a1 of the first plate-shaped portion 16a. In this embodiment, the storage groove 15a1 has an arc-shaped outer shape in a cross section perpendicular to its extension direction, but the cross-sectional shape of the storage groove 15a1 is not limited to this shape. By providing such a storage groove 15a1, the filamentary embedding body 500 can be prevented from moving on the receiving surface 15a. Therefore, the state in which the filamentary embedding body 500 is stored in the outer tube groove 11 can be more stably maintained.

[0052] Furthermore, the protruding portion 15 of this embodiment has a proximal surface 16b1 that rises from the upper surface 16a1 and faces the proximal side A2. The proximal surface 16b1 extends in the radial direction C so as to be continuous with the groove wall 11b on the distal side A1 of the outer tube groove portion 11. As in this embodiment, the proximal surface 16b1 may have a plurality of convex ribs 16b2 formed at intervals in the radial direction C. The protruding portion 15 does not necessarily have to have the proximal surface 16b1, but it is preferable that the protruding portion 15 has the proximal surface 16b1 as in this embodiment. By providing the proximal surface 16b1 on the protruding portion 15, it is possible to prevent the filamentous implant 500 from extending in a curved manner so as to form a convex shape toward the proximal side A2. This configuration can prevent the thread-like embedding body 500 from being locally deformed significantly during the setting step (see FIGS. 1 and 2 ) in which the shaft body 3 is moved toward the distal side A1 relative to the outer cylinder body 2 to draw the thread-like embedding body 500 from the outer cylinder groove portion 11 into the hollow portion 2 a of the outer cylinder body 2. This prevents the thread-like embedding body 500 from being damaged, broken, or the like during the setting step (see FIGS. 1 and 2 ).

[0053] More specifically, the protrusion 15 of this embodiment includes a second plate-shaped portion 16b rising from the upper surface 16a1 of the first plate-shaped portion 16a. The second plate-shaped portion 16b rises from the edge of the distal side A1 of the first plate-shaped portion 16a. The second plate-shaped portion 16b is a plate-shaped portion in which the axial direction A is the thickness direction and the direction perpendicular to the axial direction A is the in-plane direction. In other words, the first plate-shaped portion 16a and the second plate-shaped portion 16b of this embodiment form a substantially L-shaped outer shape in a cross-sectional view along the axial direction A. The proximal surface 16b1 of this embodiment is formed by the surface of the proximal side A2 of the second plate-shaped portion 16b.

[0054] The outer cylindrical hub 5 of this embodiment also includes two protrusions 15. The two protrusions 15 protrude toward opposite sides from opposing positions in the radial direction C of the cylindrical hub body 14. The two protrusions 15 are also arranged on both sides of the outer cylindrical groove 11 in the extending direction D of the outer cylindrical groove 11. The provision of these two protrusions 15 makes it easier for the extension portion 501 of the filamentous embedding body 500 to be held on both sides of the outer cylindrical groove 11. In other words, by using the two protrusions 15, a user such as a surgeon can easily maintain the state in which the filamentous embedding body 500 is housed in the outer cylindrical groove 11.

[0055] 11 , in a side view of the outer tube body 2 taken along the extension direction D of the outer tube groove 11, the groove wall on at least one side of the distal side A1 and the proximal side A2 in the axial direction A of the outer tube groove 11 (in this embodiment, the groove wall 11c on the proximal side A2) has a guide surface portion 17 as an inclined surface portion that slopes toward the other side in the axial direction A (in this embodiment, the distal side A1) as it approaches the groove bottom 11a. The provision of such a guide surface portion 17 makes it easier for the filamentous embedding body 500 to be guided toward the groove bottom 11a while abutting against the guide surface portion 17 when inserting the filamentous embedding body 500 into the outer tube groove 11. In other words, the provision of the guide surface portion 17 improves the operability of inserting the filamentous embedding body 500 into the outer tube groove 11.

[0056] In this embodiment, the groove wall 11b on the distal side A1 is configured by a vertical surface extending in a direction substantially perpendicular to the axial direction A, but is not limited to this configuration. For example, the groove wall 11b on the distal side A1 may have a guide surface portion as an inclined surface portion that inclines so as to extend toward the proximal side A2 in the axial direction A as it approaches the groove bottom 11a, in addition to or instead of the guide surface portion 17 of the groove wall 11c on the proximal side A2.

[0057] 12 , the groove wall 11b on the distal side A1 may be formed in a concave shape when viewed from above the outer tube body 2 along a direction perpendicular to the extending direction D of the outer tube groove 11. In the top view shown in FIG. 12 , the hollow portion 2a of the outer tube body 2 extends from the bottom of the concave groove wall 11b toward the distal side A1. By forming the groove wall 11b on the distal side A1 in such a concave shape, during the setting step (see FIGS. 1 and 2 ) in which the shaft body 3 is moved toward the distal side A1 relative to the outer tube body 2 to draw the filamentous embedding body 500 from the outer tube groove 11 into the hollow portion 2a of the outer tube body 2, the filamentous embedding body 500 is drawn into the hollow portion 2a in a state curved convexly toward the distal side A1 along the concave shape of the groove wall 11b. Therefore, damage, breakage, etc. of the thread-shaped embedding body 500 can be suppressed during the setting step (see FIGS. 1 and 2).

[0058] When the groove wall 11b on the distal side A1 is formed in a concave shape when viewed from above as shown in Figure 12, the proximal surface 16b1 of the protrusion 15 may have an inclined surface portion 18 that is continuous with the concave groove wall 11b when viewed from above (see Figure 12).

[0059] 11 , a receiving groove 11a1 extending in the radial direction C is formed in the groove bottom 11a of the outer tube groove 11 of this embodiment. The receiving groove 11a1 is continuous with the receiving groove 15a1 of the receiving surface 15a. As shown in FIG. 11 , the receiving groove 11a1 can receive the filamentary embedding body 500 received in the outer tube groove 11. The provision of this receiving groove 11a1 allows the filamentary embedding body 500 to be held in a stable position within the outer tube groove 11.

[0060] Furthermore, in the side view shown in Fig. 11 , the receiving groove 11a1 of this embodiment is recessed so as to be inclined relative to a direction perpendicular to the axial direction A (the up-down direction in Fig. 11 ). Therefore, as shown in Fig. 11 , when the receiving groove 11a1 receives the filamentary embedding body 500, one groove wall of the receiving groove 11a1 covers the filamentary embedding body 500. This prevents the embedding body 500 from moving in a direction perpendicular to the axial direction A from the receiving groove 11a1, and more stably holds the filamentary embedding body 500 in the outer tube groove 11.

[0061] 9 , the shaft body 3 of this embodiment includes a shaft main body 6 and a shaft hub 7 connected to the proximal side A2 of the shaft main body 6. The shaft main body 6 of this embodiment is a solid rod-shaped body having an outer diameter that allows it to be inserted into the hollow portion 2a of the outer cylinder body 2. The shaft main body 6 may be made of a metal such as stainless steel. The shaft hub 7 may be made of a hard resin material such as polycarbonate resin.

[0062] 14 to 16, the shaft body 6 can be inserted in the axial direction A within the hollow portion 2a of the outer cylindrical body 2. The shaft body 6 can also rotate in the circumferential direction B within the hollow portion 2a of the outer cylindrical body 2. As shown in FIG. 13, the shaft groove 21 of this embodiment is provided in the shaft body 6.

[0063] As shown in Fig. 13 , in a side view of the shaft body 3 taken along the extending direction E of the shaft groove 21, at least one of the groove walls 21b, 21c on both sides of the shaft groove 21 in the axial direction A has an inclined surface portion inclined with respect to the axial direction A. More specifically, in this embodiment, the groove wall 21c on the proximal side A2 has a return surface portion 25 as an inclined surface portion that is inclined so as to extend toward the proximal side A2 as it approaches the groove bottom 21a in the side view shown in Fig. 13 . As shown in Figs. 14 to 16 , the filamentary embedding body 500 is pressed toward the distal side A1 by the groove wall 21c, thereby moving toward the distal side A1 within the hollow portion 2a of the outer cylindrical body 2. Therefore, the provision of the return surface portion 25 on the groove wall 21c can prevent the filamentary embedding body 500 from slipping out of the shaft groove 21 while being pressed by the groove wall 21c and moving toward the distal side A1.

[0064] In addition to the return surface portion 25 of the groove wall 21c, the groove wall 21b on the distal side A1 may have a return surface portion as an inclined surface portion that is inclined so as to extend toward the distal side A1 as it approaches the groove bottom 21a in the side view shown in Figure 13.

[0065] Furthermore, at least one of the groove walls 21b, 21c on both sides may have a guide surface portion as an inclined surface portion, a specific example of which will be described later (see FIGS. 25 and 26).

[0066] 13 , the distal end surface 22 a of the shaft body 3 of this embodiment is formed by the distal end surface of the shaft main body 6. As described above, the distal end surface 22 a of the shaft body 3 of this embodiment is a blade surface that is inclined with respect to the axial direction A, and the distal end 23 of the shaft body 3 is formed by a sharp cutting edge. By forming the distal end surface 22 a of the shaft body 3 as a blade surface in this manner, the shaft body 3 can be inserted into a living organism so as to penetrate a part of the living organism.

[0067] However, the distal end surface 22a of the shaft body 3 may have a blade surface inclined with respect to the axial direction A, while the outer edge of the distal end surface 22a may be curved by, for example, chamfering to reduce the ability to puncture into a living body. Furthermore, the distal end surface 22a of the shaft body 3 does not have to have a blade surface inclined with respect to the axial direction A. In other words, the shaft body 3 does not need to have a puncture function. In such a case, for example, a through-hole that penetrates a part of a living body is formed in advance using a needle member separate from the implant placement device 1. This allows the outer cylindrical body 2 and the shaft body 3 to penetrate a part of a living body by inserting them into the pre-formed through-hole in the living body, even if the shaft body 3 does not have a puncture function. Furthermore, of the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft body 3, only the distal end surface 12a of the outer cylindrical body 2 may be a blade surface.

[0068] 13 , the shaft body 6 of this embodiment includes a distal portion 6a including the shaft groove portion 21, and a proximal portion 6b that is connected to the proximal side A2 of the distal portion 6a and is thinner than the distal portion 6a. The distal portion 6a and the proximal portion 6b share a common central axis. The maximum diameter R1b of the proximal portion 6b is smaller than the maximum diameter R1a of the distal portion 6a. The proximal end of the distal portion 6a includes a tapered portion 6a1 whose diameter decreases toward the proximal side A2. More specifically, the outer surface of the tapered portion 6a1 is inclined with respect to the axial direction A so that the diameter decreases toward the proximal side A2.

[0069] The shaft body 6 is provided with a proximal portion 6b that is thinner than the distal portion 6a, on the proximal side A2 of the distal portion 6a including the shaft groove 21, which makes it possible to increase the gap in the radial direction C between the inner surface of the outer tube body 2 and the outer surface of the shaft body 3 at the position of the proximal portion 6b of the shaft body 6. Therefore, in the setting step (see FIGS. 1 and 2) and the exposing step (see FIG. 4) described above, the portion of the filamentous embedding body 500 that extends from the shaft groove 21 to the proximal side A2 within the outer tube body 2 slides against the inner surface of the outer tube body 2 while being sandwiched between the inner surface of the outer tube body 2 and the outer surface of the shaft body 3, and this can prevent the portion from being damaged, broken, or the like.

[0070] 17A and 17B, the outer cylinder body 2 and the shaft body 3 of this embodiment are equipped with a movement restriction mechanism 8. The movement restriction mechanism 8 is capable of restricting movement of the shaft body 3 in the axial direction A relative to the outer cylinder body 2. Specifically, the movement restriction mechanism 8 of this embodiment is composed of an outer cylinder hub 5 and a shaft hub 7. The movement restriction mechanism 8 is not shown in FIGS. 1 to 7.

[0071] More specifically, an opening 14a is formed in the peripheral wall of the cylindrical hub body 14 of the sheath hub 5. The opening 14a is located on the proximal side A2 of the sheath groove portion 11. In this embodiment, the opening 14a extends to the proximal end face of the sheath hub 5, which constitutes the proximal end face 12b of the sheath body 2. In addition, a slit opening 14b is formed in the peripheral wall of the cylindrical hub body 14 of the sheath hub 5, and is continuous with the opening 14a in the circumferential direction B. The length of the slit opening 14b in the axial direction A is shorter than the length of the opening 14a in the axial direction A. The slit opening 14b is continuous with the opening 14a only at a portion of the opening 14a in the axial direction A. In this embodiment, two slit openings 14b are formed in the hub body 14, which are continuous with the opening 14a at different positions in the axial direction A of the opening 14a. Hereinafter, for convenience of explanation, the slit opening 14b located on the distal side A1 in the axial direction A will be referred to as the "first slit opening 14b1," and the slit opening 14b located on the proximal side A2 in the axial direction A will be referred to as the "second slit opening 14b2." Furthermore, when there is no particular need to distinguish between the first slit opening 14b1 and the second slit opening 14b2, they will simply be referred to as the "slit opening 14b."

[0072] The shaft hub 7 of this embodiment includes a main body portion 26, a protrusion portion 27 protruding from the main body portion 26 in the radial direction C, and an operating portion 28 connected to the protrusion portion 27. The main body portion 26 is receivable in the inner cavity 5a within the hub body 14 of the outer cylindrical hub 5. When the main body portion 26 is receptacle in the inner cavity 5a, the protrusion portion 27 protrudes to the outside of the hub body 14 through the opening 14a of the hub body 14. In this state, the main body portion 26 is movable in the axial direction A within the inner cavity 5a. The protrusion portion 27 is movable in the axial direction A together with the main body portion 26. Specifically, the protrusion portion 27 is movable in the axial direction A within the opening 14a of the hub body 14. The operating portion 28 is connected to the outer end of the protrusion portion 27 in the radial direction C. A user, such as a surgeon, can move the main body portion 26 and the protrusion portion 27 in the axial direction A as described above by operating the operating portion 28 with their fingers. In this manner, the shaft hub 7 of this embodiment is allowed to move in the axial direction A relative to the outer cylindrical hub 5 with the protrusion 27 housed in the opening 14a.

[0073] Furthermore, the protrusion 27 can move between the opening 14a and the slit opening 14b by rotating in the circumferential direction B. In other words, the main body 26 can rotate in the circumferential direction B within the hub body 14 of the outer cylindrical hub 5 by moving the protrusion 27 between the opening 14a and the slit opening 14b. The movement of the main body 26 and the protrusion 27 in the circumferential direction B may be performed by a user, such as a surgeon, operating the operation unit 28. When the protrusion 27 is housed in the slit opening 14b, it abuts against edges on both sides of the slit opening 14b in the axial direction A that define the slit opening 14b, thereby restricting its movement in the axial direction A. In other words, when the protrusion 27 is housed in the slit opening 14b, the movement of the main body 26 in the axial direction A is also restricted. In this way, when the protrusion 27 is housed in the slit opening 14b, the shaft hub 7 of this embodiment is restricted from moving in the axial direction A relative to the outer cylindrical hub 5.

[0074] As described above, the movement restriction mechanism 8 of this embodiment is composed of the opening 14a and slit opening 14b of the hub body 14 of the outer cylindrical hub 5, and the main body 26 and protrusion 27 of the shaft hub 7. In other words, by moving the protrusion 27 between the opening 14a and the slit opening 14b, it is possible to switch between a state in which the outer cylindrical body 2 and the shaft body 3 can move relatively in the axial direction A (see FIG. 17B) and a state in which the outer cylindrical body 2 and the shaft body 3 cannot move relatively in the axial direction A (see FIG. 17A).

[0075] As shown in FIG. 14 , with the shaft body 3 in the first position, the filamentous embedding body 500 is accommodated in the shaft groove 21 through the outer tube groove 11. The shaft body 3 is then moved toward the distal side A1 in the axial direction A, resulting in the state shown in FIG. 15 . At this time, the protrusion 27 moves through the opening 14a in the axial direction A. In the state shown in FIG. 15 , the distal end surface 12a of the outer tube 2 and the distal end surface 22a of the shaft body 3 are aligned substantially flush with each other (see FIG. 2 ). In this embodiment, in the state shown in FIG. 15 , the protrusion 27 is accommodated in the second slit opening 14b2 (see FIG. 17A ). This allows the distal end surface 12a of the outer tube 2 and the distal end surface 22a of the shaft body 3 to remain aligned substantially flush with each other. This prevents the outer tube 2 and the shaft body 3 from moving relative to each other in the axial direction A, facilitating the puncture step (see FIG. 3 ).

[0076] After the puncture step (see FIG. 3 ) is completed, the shaft hub 7 is rotated relative to the outer tube hub 5 in the circumferential direction B. This changes the protrusion 27 from being accommodated in the second slit opening 14 b 2 to being accommodated in the opening 14 a (see FIG. 17B ). Then, the exposure step (see FIG. 4 ) is performed, in which the shaft hub 7 is moved toward the distal side A1 in the axial direction A relative to the outer tube hub 5, resulting in the state shown in FIG. 16 . In this embodiment, in the state shown in FIG. 16 , the protrusion 27 is accommodated in the first slit opening 14 b 1 (see the arrow in FIG. 17B ). By accommodating the protrusion 27 in the first slit opening 14 b 1, the shaft groove 21 of the shaft body 3 can be maintained exposed on the distal side A1 beyond the distal end surface 12 a of the outer tube body 2. In other words, the shaft body 3 can be maintained in the second position. By doing so, the outer cylinder body 2 and the shaft body 3 do not move relative to each other in the axial direction A, so that the removal step (see FIG. 5) of removing the thread-like embedding body 500 from the shaft groove portion 21 can be easily carried out.

[0077] After the removal step (see FIG. 5) is completed, the shaft hub 7 is rotated relative to the outer cylindrical hub 5 in the circumferential direction B. This changes the protrusion 27 from being housed in the first slit opening 14b1 to being housed in the opening 14a (see FIG. 17B). In this state, the shaft removal step (see FIG. 6) is performed.

[0078] As described above, the movement restricting mechanism 8 of the present embodiment can maintain the state in which the distal end surface 12a of the outer tube 2 and the distal end surface 22a of the shaft 3 are substantially flush with each other and the state in which the shaft 3 is in the second position, but it may also be configured to maintain other states. For example, the movement restricting mechanism 8 may also be configured to maintain the state in which the shaft 3 is in the first position. Such a configuration may be achieved, for example, by extending the outer tube hub 5 proximally and providing the outer tube hub 5 with another slit opening capable of accommodating the protrusion 27.

[0079] 18 to 26, an implant placement device 101 will be described as another embodiment of the implant placement device according to the present disclosure. The implant placement device 101 of this embodiment is different from the above-described implant placement device 1 (see FIG. 1, etc.) in the presence or absence of a protrusion 15, the configuration of the outer tube groove 111, and the configuration of the shaft body 106, but is otherwise identical in configuration. Here, the above-described differences will be mainly described, and a description of the same configuration as the implant placement device 1 (see FIG. 1, etc.) will be omitted.

[0080] 18 to 22 are diagrams showing an example of a method for inserting a filamentous implant 500 into a patient using the implant placement device 101. Specifically, FIGS. 18 to 22 show a method for inserting a filamentous implant 500 into a patient using the so-called "pull-back method." FIG. 23 is a perspective view showing the vicinity of the outer tube hub 105 of the outer tube 2. FIG. 24 is a side view of the outer tube 2 viewed along the extending direction D of the outer tube groove 111, showing the vicinity of the outer tube groove 111. FIG. 25 is a diagram showing how the filamentous implant 500 is placed in the shaft groove 121 of the shaft 3. FIG. 26 is a side view of the shaft 3 viewed along the extending direction E of the shaft groove 121, showing the vicinity of the shaft groove 121.

[0081] The implant placement device 101 of this embodiment includes an outer cylinder 2 and a shaft 3. The outer cylinder 2 of this embodiment includes an outer cylinder main body 4 and an outer cylinder hub 105. The outer cylinder main body 4 has the same configuration as the implant placement device 1 described above. As described above, the outer cylinder hub 105 does not include the protrusion 15 (see FIG. 10 , etc.). Furthermore, the outer cylinder hub 105 has a different shape of the outer cylinder groove 111 compared to the outer cylinder hub 5 of the implant placement device 1 described above. The shaft 3 of this embodiment includes a shaft main body 106 and a shaft hub 7. The shaft hub 7 has the same configuration as the implant placement device 1 described above. The shaft main body 106 has a different shape of the shaft groove 121 compared to the shaft main body 6 of the implant placement device 1 described above.

[0082] 18 to 22, a procedure for placing thread-like collagen as a thread-like implant 500 in a patient by the so-called "pull-back method" using an implant placement device 101. The pull-back method differs from the above-mentioned push-out method (see FIGS. 1 to 7) mainly in the following two points.

[0083] (Difference 1 from the push-out method) In the push-out method (see FIGS. 1 to 7), the thread-shaped embedding body 500 is housed in the shaft groove 21 when the shaft body 3 is in the first position, whereas in the pull-back method, the thread-shaped embedding body 500 is housed in the shaft groove 121 when the shaft body 3 is in the second position. (Difference 2 from the push-out method) In the push-out method (see FIGS. 1 to 7), the thread-shaped embedding body 500 is removed from the shaft groove 21 when the shaft body 3 is in the second position, whereas in the pull-back method, the thread-shaped embedding body 500 is removed from the shaft groove 121 when the shaft body 3 is in the first position.

[0084] 18 is a diagram showing a puncturing step in which the distal end of the implant placement device 101 is inserted into the living body from the living body surface BS so as to pass through the subcutaneous tissue ST, and then protrudes again from the living body surface BS. As shown in Fig. 18, in the puncturing step, the implant placement device 101 is inserted so as to penetrate a part of the patient's living body. The implant placement device 101 is inserted into the living body near the target site where the filamentous implant 500 is to be placed.

[0085] 18 , the filamentous implant 500 is not housed in the shaft groove 121 of the shaft 3. As shown in FIG. 18 , the puncture step may be performed with the distal end surface 22a of the shaft 3 and the distal end surface 12a of the outer cylindrical body 2 positioned substantially flush with each other. In this embodiment, the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft 3 are blade surfaces that are inclined with respect to the axial direction A. Therefore, by aligning the distal end surface 12a of the outer cylindrical body 2 and the distal end surface 22a of the shaft 3 so that they are substantially flush with each other, it is possible to prevent biological tissue from becoming entangled in the outer cylindrical body 2 when the distal end of the implant placement device 101 is punctured into the living body from the biological surface BS, thereby reducing puncture resistance.

[0086] The outer cylinder hub 105 of the outer cylinder body 2 and the shaft hub 7 of the shaft body 3 are equipped with a movement restriction mechanism similar to the movement restriction mechanism 8 described above (see FIGS. 17A and 17B ). Therefore, in the puncture step shown in FIG. 18 , the movement restriction mechanism restricts relative movement of the outer cylinder body 2 and the shaft body 3 in the axial direction A. This makes it possible to easily perform the puncture step shown in FIG. 18 .

[0087] 19 is a diagram showing an exposing step in which the shaft groove 121 of the shaft body 3 is exposed from the outer cylindrical body 2, and a setting step in which the filamentous implant 500 is placed in the shaft groove 121. The setting step is performed after the exposing step. As shown in FIG. 19 , in the exposing step, the shaft body 3 is moved from the state shown in FIG. 18 to the distal side A1 in the axial direction A. As a result, the shaft groove 121 of the shaft body 3 is moved further distally to the distal end surface 12 a of the outer cylindrical body 2 and is exposed to the outside of the outer cylindrical body 2 from the hollow portion 2 a within the outer cylindrical body 2.

[0088] Then, as shown in FIG. 19, in the setting step, the thread-like embedding body 500 is accommodated in the shaft groove portion 121 exposed to the outside of the outer cylinder body 2.

[0089] 20 is a diagram showing the removal step. In the removal step, with the filamentous embedding body 500 housed in the shaft groove 121, the shaft body 3 is moved toward the proximal side A2 in the axial direction A, and the filamentous embedding body 500 housed in the shaft groove 121 is removed to the outside of the outer barrel body 2 through the outer barrel groove 111 of the outer barrel body 2. As a result, one end 500a of the filamentous embedding body 500 is exposed to the outside of the outer barrel body 2 through the outer barrel groove 111 of the outer barrel body 2. As shown in FIG. 20 , the filamentous embedding body 500 has one end 500a exposed to the outside of the outer barrel body 2 through the outer barrel groove 111 of the outer barrel body 2, and the other end 500b retracted into the outer barrel body 2 from the distal end surface 12a of the outer barrel body 2 and positioned inside the outer barrel body 2. The portion of the thread-shaped embedding body 500 between the one end 500 a and the other end 500 b extends along the axial direction A into the hollow portion 2 a of the outer cylinder body 2 .

[0090] Figure 21 is a diagram showing the shaft removal step of the shaft body 3. As shown in Figure 21, the shaft removal step is performed by further moving the shaft body 3 toward the proximal side A2 relative to the outer cylindrical body 2 after the removal step (see Figure 20) is completed. This allows the shaft body 3 to be removed from the outer cylindrical body 2. For example, during the removal step shown in Figure 20, the other end 500b of the filamentous embedding body 500 may be exposed to the outside of the outer cylindrical body 2 from the distal end surface 12a of the outer cylindrical body 2. In this way, the position of the filamentous embedding body 500 may be maintained by holding the other end 500b with a holder during the shaft removal step shown in Figure 21.

[0091] 22 is a diagram showing the outer tube removal step of the outer tube body 2. As shown in Fig. 22 , in the outer tube removal step, the outer tube body 2 is moved toward the proximal side A2 (see Fig. 21 ) while maintaining the position of the filamentous implant 500, and the outer tube body 2 is removed from inside the living body to outside the living body. The position of the filamentous implant 500 may be maintained, for example, by having the other end 500b held by a holder 600. The holding of the other end 500b by the holder 600 may be performed, for example, after the outer tube body 2 is moved slightly toward the proximal side A2 (see Fig. 6 ) in the outer tube removal step of the outer tube body 2, and the other end 500b is exposed to the outside of the outer tube body 2 from the distal end surface 12a of the outer tube body 2. Furthermore, the holding of the other end 500b by the holder 600 may be performed, for example, during the removal process shown in Figure 20, by leaving the other end 500b exposed to the outside of the outer tube body 2 from the distal end face 12a of the outer tube body 2, before the outer tube removal process of the outer tube body 2 involves moving the outer tube body 2 a small amount toward the proximal side A2 (see Figure 6).

[0092] In this way, by using the implant placement device 101, the filamentous implant 500 can be easily placed through a part of the patient's body.

[0093] Here, the shaft body 3 can be displaced between a first position and a second position, where the shaft groove 121 is not covered by the outer tube body 2 but is exposed to the outside of the outer tube body 2, by moving in the axial direction A relative to the outer tube body 2. Specifically, at the first position, the shaft groove 121 of the shaft body 3 is exposed to the outside of the outer tube body 2 through the outer tube groove 111 of the outer tube body 2. That is, the first position of the shaft body 3 in this embodiment is the position shown in FIG. 20 . Meanwhile, at the second position, the shaft groove 121 of the shaft body 3 is exposed to the outside of the outer tube body 2 at a position A1 distal to the distal end surface 12 a of the outer tube body 2. That is, the second position of the shaft body 3 in this embodiment is the position shown in FIG. 19 .

[0094] As described above, in the implant placement device 101, the shaft body 3 is movable relative to the outer cylindrical body 2 between the first position (see FIG. 20 ) and the second position (see FIG. 19 ). Therefore, according to the implant placement device 101 of this embodiment, by hooking the filamentous implant 500 into the shaft groove 121 while the shaft body 3 is in the second position (see FIG. 19 ) and then moving the shaft body 3 to the first position (see FIG. 20 ), the filamentous implant 500 can be easily inserted into the outer cylindrical body 2, i.e., the filamentous implant 500 can be easily threaded into the hollow portion 2 a of the outer cylindrical body 2. This allows even a flexible and pliable filamentous implant 500 to be easily inserted into the outer cylindrical body 2. Therefore, with the implant placement device 101, by setting the outer cylinder 2 to a state in which it penetrates a part of the patient's living body (see FIGS. 18 to 21), the filamentous implant 500 can be easily passed through and placed by using this outer cylinder 2 (see FIG. 22). In other words, with the implant placement device 101, the operability when passing through and placing the filamentous implant 500 can be improved.

[0095] Next, we will explain the structural differences between the implant placement device 101 of this embodiment and the above-mentioned implant placement device 1. As described above, the implant placement device 101 of this embodiment differs from the above-mentioned implant placement device 1 (see FIG. 1 , etc.) in the presence or absence of the protrusion 15, the configuration of the outer tube groove 111, and the configuration of the shaft main body 106.

[0096] As shown in Figures 23 and 24, the sheath hub 105 of this embodiment does not have the protrusion 15 (see Figure 10, etc.) that is included in the sheath hub 5 of the implant placement device 1 described above (see Figure 10, etc.). As described above, the implant placement device 101 of this embodiment is used in the pull-back method (see Figures 18 to 22). Therefore, the sheath hub 105 of this embodiment does not have to have the protrusion 15 (see Figure 10, etc.). In other words, the sheath hub 105 of this embodiment does not have to have the receiving surface 15a (see Figure 10, etc.). However, the sheath hub 105 of this embodiment may have, for example, a protrusion similar to the protrusion 15 described above (see Figure 10, etc.).

[0097] As shown in Fig. 24 , in a side view of the outer tube body 2 taken along the extending direction D of the outer tube groove 111, the groove wall 111b on the distal side A1 in the axial direction A of the outer tube groove 111 includes a first inclined surface portion 117a that inclines so as to extend toward the proximal side A2 in the axial direction A as it approaches the groove bottom 111a. Also, as shown in Fig. 24 , in a side view of the outer tube body 2 taken along the extending direction D of the outer tube groove 111, the groove wall 111c on the proximal side A2 in the axial direction A of the outer tube groove 111 includes a second inclined surface portion 117b that inclines so as to extend toward the distal side A1 in the axial direction A as it approaches the groove bottom 111a. More specifically, as shown in Fig. 24 , the outer tube groove 111 of this embodiment has a substantially V-shaped configuration. The groove wall 111b on the distal side A1 is formed by the first inclined surface portion 117a, and the groove wall 111c on the proximal side A2 is formed by the second inclined surface portion 117b.

[0098] Both groove walls 111b, 111c of the outer tube groove 111 do not necessarily have to have the inclined surface portion described above. That is, both groove walls 111b, 111c may be vertical surfaces extending in a direction perpendicular to the axial direction A. However, it is preferable that at least one of the groove walls 111b, 111c of the outer tube groove 111 has the inclined surface portion described above. This makes it easier to remove the filamentary embedding body 500 from the outer tube body 2 through the outer tube groove 111 during the removal step (see FIG. 20 ). In particular, as in this embodiment, it is preferable that both groove walls 111b, 111c of the outer tube groove 111 have the inclined surface portion described above. This makes it easier to remove the filamentary embedding body 500 from the outer tube body 2 through the outer tube groove 111 during the removal step (see FIG. 20 ).

[0099] As shown in Fig. 26 , in a side view of the shaft body 3 taken along the extension direction E of the shaft groove 121, at least one of the groove walls 121b, 121c on both sides of the shaft groove 121 in the axial direction A has an inclined surface portion inclined with respect to the axial direction A. More specifically, in this embodiment, the groove wall 121b on the distal side A1 has a return surface portion 125 as an inclined surface portion that is inclined so as to extend toward the distal side A1 as it approaches the groove bottom 121a in the side view shown in Fig. 26 . The filamentous embedding body 500 is pressed toward the proximal side A2 by the groove wall 121b, thereby moving toward the proximal side A2 within the hollow portion 2a of the outer tube body 2. Therefore, the provision of the return surface portion 125 on the groove wall 121b can prevent the filamentous embedding body 500 from slipping out of the shaft groove 121 while being pressed by the groove wall 121b and moving toward the proximal side A2.

[0100] In addition, in the present embodiment, the groove wall 121c on the proximal side A2 includes a guide surface portion 129 as an inclined surface portion that is inclined so as to extend toward the distal side A1 as it approaches the groove bottom 121a in the side view shown in Fig. 26. By providing such a guide surface portion 129, as shown in Fig. 25, when the filamentous embedding body 500 is placed in the shaft groove 121, the filamentous embedding body 500 comes into contact with and is guided by the guide surface portion 129, making it easier to place in the shaft groove 121.

[0101] The groove wall 121c on the proximal side A2 may have, instead of the guide surface portion 129, a return surface portion as an inclined surface portion that is inclined so as to extend toward the proximal side A2 as it approaches the groove bottom 121a in the side view shown in Fig. 26. Moreover, the groove wall 121b on the distal side A1 may have, instead of the return surface portion 125, a guide surface portion as an inclined surface portion that is inclined so as to extend toward the proximal side A2 as it approaches the groove bottom 121a in the side view shown in Fig. 26.

[0102] Furthermore, in the shaft body 106 of the shaft body 3 of this embodiment, the maximum diameter is approximately equal on both sides of the shaft groove 121 in the axial direction A. In other words, the shaft body 106 of the shaft body 3 of this embodiment does not have a portion with a narrowed diameter, such as the proximal portion 6b of the shaft body 6 described above (see FIG. 13 ). As described above, the implant placement device 101 of this embodiment is used in a pull-back system. Therefore, most of the filamentous implant 500 is passed through the outer cylindrical body 2 of the implant placement device 101 without being sandwiched between the inner surface of the outer cylindrical body 2 and the outer surface of the shaft body 3. Therefore, the shaft body 106 of this embodiment does not need to have a portion with a narrowed diameter, such as the proximal portion 6b of the shaft body 6 described above (see FIG. 13 ). However, the shaft body 106 of this embodiment may have a portion with a narrowed diameter, such as the proximal portion 6b of the shaft body 6 described above (see FIG. 13 ).

[0103] The implant placement device according to the present disclosure is not limited to the specific configurations described in the above-described embodiments and modifications, and various modifications, alterations, and combinations are possible without departing from the scope of the claims. The outer tube body of the outer tube of the implant placement device described above may be provided with, for example, a depth marker that indicates the insertion length of the filamentous implant into the outer tube body. FIG. 27 is a diagram showing an outer tube body 2 provided with such a depth marker 30. In the outer tube body 2 shown in FIG. 27, as an example, a scale is provided on the outer surface of the outer tube body 4 as the depth marker 30. The provision of such a depth marker 30 allows the insertion length of the filamentous implant 500 (see FIG. 2, etc.) inserted into the outer tube body 2 to be identified from the outside. Therefore, using the depth marker 30 on the outer tube body 2 as a guide makes it easier to set the desired length of the filamentous implant 500 to be implanted in the living body.

[0104] The present disclosure relates to implant placement devices.

[0105] 1: Implant placement device 2: Sheath body 2a: Hollow portion 3: Shaft body 4: Sheath body 4a: Inner cavity of sheath body 5: Sheath body hub 5a: Inner cavity of sheath body hub 6: Shaft body 6a: Distal portion 6a1: Tapered portion 6b: Proximal portion 7: Shaft hub 8: Movement restriction mechanism 11: Sheath body groove portion 11a: Groove bottom 11a1: Receiving groove portion 11b, 11c: Groove wall 12a: Distal end surface of sheath body 12b: Proximal end surface of sheath body 13: Distal end of sheath body 14: Hub body 14a: Opening 14b: Slit opening 14b1: First slit opening 14b2: Second slit opening 15: Protrusion 15a: Receiving surface 15a1: Storage groove portion 16a: First plate-shaped portion 16a1: Upper surface of first plate-shaped portion (an example of a receiving surface) 16b: Second plate-shaped portion 16b1: Proximal surface 16b2: Convex rib 17: Guide surface portion (an example of an inclined surface portion of an outer cylinder body) 18: Inclined surface portion 21: Shaft groove portion 21a: Groove bottom 21b, 21c: Groove wall 22a: Distal end surface of shaft body 23: Distal end of shaft body 25: Turned surface portion (an example of an inclined surface portion of a shaft body) 26: Main body portion 27: Protrusion 28: Operation portion 30: Depth marker 101: Implant placement device 105: Outer cylinder hub 106: Shaft main body 111: Outer cylinder groove portion 111a: Groove bottom 111b, 111c: Groove wall 117a: First inclined surface portion 117b: Second inclined surface portion 121: Shaft groove portion 121a: Groove bottom 125: Turned surface portion (an example of an inclined surface portion of a shaft body) 129: Guide surface portion (an example of an inclined surface portion of a shaft body) 500: Thread-like implant 500a: One end portion of the thread-like implant 500b: The other end portion of the thread-like implant 501: Extension portion of the thread-like implant 600: Holder A: Axial direction A1: Distal side A2: Proximal side B: Circumferential direction C: Radial direction D: Extension direction of outer cylinder groove E: Extension direction of shaft groove L1: Maximum axial length of receiving surface L2: Maximum axial length of outer cylinder groove O1: Central axis of outer cylinder R1a: Maximum diameter of distal portion of shaft body R1b: Maximum diameter of proximal portion of shaft body BS: Biological surface ST: Subcutaneous tissue

Claims

1. An implant placement device comprising: an outer cylindrical body defining a hollow portion therein; and a shaft body that can be inserted axially through the hollow portion of the outer cylindrical body, wherein the shaft body has a shaft groove that can accommodate a filamentous implant extending radially of the outer cylindrical body, and the shaft body can be displaced in the axial direction relative to the outer cylindrical body between a first position and a second position where the shaft groove is exposed to the outside of the outer cylindrical body without being covered by the outer cylindrical body.

2. The implant placement device according to claim 1, wherein the outer tube has an outer tube groove capable of accommodating the filamentous implant extending in the radial direction, and in the first position, the shaft groove of the shaft is exposed to the outside of the outer tube through the outer tube groove of the outer tube, and in the second position, the shaft groove of the shaft is exposed to the outside of the outer tube distal to the distal end face of the outer tube.

3. The implant placement device according to claim 2, wherein the outer tube comprises an outer tube main body and an outer tube hub connected to the proximal side of the outer tube main body, and the outer tube groove portion is provided in the outer tube hub.

4. An implant placement device as described in claim 3, wherein the outer tube hub comprises: a cylindrical hub body; and a protrusion protruding radially from the hub body; the outer tube groove is provided on the hub body; and the protrusion has a receiving surface that receives the portion of the filamentous implant housed in the outer tube groove of the hub body that extends radially outward from the outer tube groove.

5. An implant placement device as described in claim 4, wherein the receiving surface of the protrusion is formed with an accommodating groove portion that accommodates the portion of the filamentous implant extending radially outward from the outer tube groove portion.

6. An implant placement device as described in any one of claims 2 to 5, wherein, when viewed from the side of the outer tube body along the extension direction of the outer tube groove portion, the groove wall on at least one of the distal and proximal sides of the axial direction of the outer tube groove portion has an inclined surface portion that slopes so as to extend to the other side in the axial direction as it approaches the groove bottom.

7. An implant placement device as described in any one of claims 2 to 5, wherein, when viewed from above the outer tube along a direction perpendicular to the extension direction of the outer tube groove portion, the groove wall on the distal side in the axial direction of the outer tube groove portion is formed in a concave shape.

8. An implant placement device as described in any one of claims 1 to 5, wherein, when viewed from the side of the shaft body along the extension direction of the shaft groove portion, at least one of the groove walls on both sides of the axial direction of the shaft groove portion has an inclined surface portion that is inclined with respect to the axial direction.

9. An implant placement device according to any one of claims 1 to 5, wherein the shaft body comprises: a shaft main body; and a shaft hub connected to the proximal side of the shaft main body; and the shaft groove portion is provided in the shaft main body.

10. The implant placement device according to claim 9, wherein the shaft body is a solid rod-shaped body.

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