JP2024090538A - Transfer device - Google Patents

Abstract

To provide a transfer device for efficiently transferring a medical sheet to an object to be treated.SOLUTION: In a transfer device 10, a tip side region 25 of first and second shafts 24 and 48 comprises a curved part 27 to which a curved shape is given with respect to an axial direction of an outer cylinder 22. When the first and second shafts are located at a first position, the curved part has a straight shape or a shape closer to the straight shape than the curved shape. When the first and second shafts are located at a second position, a portion protruding from a tip opening of the outer cylinder out of the first and second shafts is curved with respect to the axial direction by an elastic restoring force of the curved part.SELECTED DRAWING: Figure 16

Description

The present invention relates to a transfer device for transferring a medical sheet to a treatment target area of a living body.

Patent Document 1 discloses a transfer device for transferring a medical sheet (cell sheet) used in organ transplantation, for example, to a treatment target area of a living body. This transfer device comprises a shaft and a support part provided at the tip of the shaft. The support part has a sheet support body on which the medical sheet is placed. The transfer device transfers the medical sheet from the support part to the treatment target area by sliding the transfer device while pressing the top surface of the medical sheet placed on the support surface of the sheet support body with forceps or the like.

JP 2009-000511 A

In the conventional technology described above, when transferring the medical sheet from the support surface of the support part to the part of the living body that is to be treated, it is necessary to operate the transfer tool while holding down the top surface of the medical sheet with forceps or the like, which raises concerns that the medical sheet cannot be transferred efficiently to the part of the body that is to be treated.

The present invention aims to solve the above-mentioned problems.

(1) An aspect of the present invention is a transfer device for transferring a medical sheet to a treatment target part of a living body, comprising: an outer tube; a tubular first shaft extending in the axial direction of the outer tube and disposed inside the outer tube so as to be movable along the axial direction; a first carrier member having a sheet-like support portion disposed at the tip of the first shaft and including a support surface capable of holding the medical sheet; and a second carrier member having a second shaft extending along the first shaft within the first shaft and disposed so as to be movable along the first shaft, wherein at a first position where the first and second shafts are moved in a proximal direction relative to the outer tube so that the support portion is contained within the outer tube, the support portion is contained within the outer tube in a curved and deformed state, and the support portion is At a second position where the first and second shafts are moved in a distal direction relative to the outer tube so as to protrude from the distal opening of the outer tube, the support portion unfolds by being exposed in the distal direction from the outer tube, and the distal region of at least one of the first and second shafts has a curved portion that is curved in the axial direction, and when the first and second shafts are positioned at the first position, the curved portion housed in the outer tube is straight or has a shape closer to a straight shape than the curved shape, and when the first and second shafts are positioned at the second position, the portion of the first and second shafts protruding from the distal opening of the outer tube is curved in the axial direction by the elastic restoring force of the curved portion.

According to the present invention, since the transfer instrument is equipped with a second carrier member, the medical sheet can be transferred from the support part to the treatment target part using the second carrier member without using other devices (forceps, etc.). This allows the medical sheet to be efficiently transferred to the treatment target part.

In addition, the portions of the first and second shafts that protrude from the tip opening of the outer tube are curved relative to the axial direction of the outer tube, so that the first and second shafts can be curved at a position close to the support part that holds the medical sheet. This makes it possible to adjust the angle of the support part relative to the axial direction inside the living body when the outer tube is inserted inside the living body and the medical sheet is transferred to the treatment target part of the living body. As a result, the medical sheet held by the support part whose angle has been adjusted can be easily transferred to the treatment target part.

(2) In the transfer device described in (1) above, the distal end region of the first shaft may have a first curved portion that is the curved portion, and the distal end region of the second shaft may have a second curved portion that is the curved portion, and the first and second curved portions may be curved in the same direction relative to the axial direction.

Since the first and second curved portions are curved in the same direction, the portions of the first and second shafts that protrude from the tip opening of the outer tube can be curved in the same direction relative to the axial direction by the elastic restoring force of the first and second curved portions. This makes it possible to prevent the support portion from rotating around the axial direction of the outer tube when it protrudes from the tip opening of the outer tube. As a result, the medical sheet held by the support portion can be reliably transferred to the treatment target area.

(3) In the transfer device described in (1) or (2) above, a sheet-like second support part including a second support surface capable of holding the medical sheet is provided at the tip of the second shaft, and the second support part may be movable relative to the support part between a retracted position where it overlaps with the support surface and an advanced position where it is positioned distally of the support surface.

The second support portion having a second support surface allows the medical sheet to be moved along the support portion.

(4) In the transfer device described in any one of (1) to (3) above, the support part is formed of a flexible sheet having a front surface including the support surface and a back surface that is the opposite surface of the front surface, and the support part has a pair of protrusions that protrude upward from both sides of the width direction of the support surface perpendicular to the moving direction of the first shaft, and at the first position, the support part may be accommodated in the outer tube in a curved and deformed state such that both sides of the width direction of the support part on the back surface contact each other.

When the support part is housed within the outer tube, the back surfaces of the pair of protrusions that have been curved and deformed into a convex shape come into contact with each other, and the pair of protrusions are displaced toward the support surface, causing the support part to curve and deform into a heart shape. This allows the support part to be housed in a heart shape within the outer tube, which reduces damage to the medical sheet held by the support part compared to when the support part deforms into a shape that is not heart-shaped. In addition, because the support part can be housed smoothly and compactly within the outer tube, the diameter of the outer tube can be made smaller compared to a configuration in which the support part does not curve and deform into a heart shape.

According to the present invention, since the transfer instrument is equipped with a second carrier member, the medical sheet can be transferred from the support part to the treatment target part using the second carrier member without using other devices (forceps, etc.). This allows the medical sheet to be efficiently transferred to the treatment target part.

In addition, the portions of the first and second shafts that protrude from the tip opening of the outer tube are curved relative to the axial direction of the outer tube, so that the first and second shafts can be curved at a position close to the support part that holds the medical sheet. This makes it possible to adjust the angle of the support part relative to the axial direction inside the living body when the outer tube is inserted inside the living body and the medical sheet is transferred to the treatment target part of the living body. As a result, the medical sheet held by the support part whose angle has been adjusted can be easily transferred to the treatment target part.

FIG. 1 is a perspective view of a delivery device according to an embodiment of the present invention. FIG. 2 is an exploded perspective view of the delivery device of FIG. FIG. 3 is a side view of the first carrier member. FIG. 4 is a side view of the second carrier member. FIG. 5 is a plan view of the tip of the transfer device of FIG. FIG. 6 is a vertical cross-sectional view taken along line VI-VI in FIG. FIG. 7 is a cross-sectional view taken along line VII-VII in FIG. FIG. 8 is a flow chart showing the steps of a method for transferring a medical sheet using the transfer device of FIG. FIG. 9 is a first explanatory diagram of the sheet placing step. FIG. 10 is a second explanatory diagram of the sheet placing step. FIG. 11 is an explanatory diagram of the accommodation step. FIG. 12 is a cross-sectional view taken along line XII-XII in FIG. FIG. 13 is a cross-sectional view taken along line XIII-XIII in FIG. FIG. 14 is an explanatory diagram of the placement process. FIG. 15 is an explanatory diagram of the development process. FIG. 16 is a first explanatory diagram of the moving step. FIG. 17 is a second explanatory diagram of the moving step. FIG. 18 is a first explanatory view of the removal step. FIG. 19 is a second explanatory view of the removal step. FIG. 20 is a cross-sectional view of a transportation device including a movement restricting portion according to a first modified example. FIG. 21A is a plan view of the tip of a transportation device showing a movement restricting portion relating to a second modified example, and FIG. 21B is a plan view showing the first support portion of the transportation device of FIG. 21A housed in an outer tube. FIG. 22 is a plan view of a tip portion of a transportation device according to a third modified example having a first support portion. FIG. 23 is a cross-sectional view taken along line XXIII-XXIII in FIG. FIG. 24 is an enlarged perspective view of a tip portion of a conveying device according to a fourth modified example having a pressing body. FIG. 25 is an enlarged perspective view of a tip portion of a transportation device according to a fifth modified example having a pressing body. 26 is a cross-sectional view of the distal end of the transfer device of FIG. 25. FIG.

As shown in FIG. 1, the transfer device 10 according to this embodiment is a medical device for transferring a medical sheet 300 to a treatment target part of a living body. The transfer device 10 is used, for example, in the treatment of severe heart failure caused by ischemic heart disease. In this case, the medical sheet 300 is transplanted to a transplant target part 402 of a heart 400 (a treatment target part of a living body) (see FIGS. 14 to 19). The transfer device 10 can attach multiple medical sheets 300 to the transplant target part 402.

Such medical sheets 300 include pharmaceuticals for medical use, regenerative medicine products, medical devices, etc. The medical sheets 300 are formed in the form of a sheet such as a film or membrane (gel-like substance). The medical sheets 300 may be reinforced by applying fibrin or the like. Regenerative medicine products containing cells include, for example, cell sheets (sheet-like cell cultures), spheroids, etc. The cell sheets can be formed by culturing autologous cells or allogeneic cells. The cell sheets are, for example, skeletal muscle-derived cell sheets or iPS cell-derived cardiomyocyte sheets.

The medical sheet 300 may contain a tissue adhesive, a local anesthetic, etc. The thickness of the medical sheet 300 is, for example, about 100 μm, and the diameter of the medical sheet 300 is, for example, about 60 mm. However, the thickness and diameter (size) of the medical sheet 300 can be set as appropriate.

The medical sheet 300 may be a sheet to be transplanted into an organ other than the heart 400 (e.g., the lungs, liver, pancreas, kidneys, small intestine, esophagus, etc.). In addition, the medical sheet 300 may be a sheet for preventing adhesions, for example, if it is for medical use.

As shown in Figs. 1 and 2, the transport device 10 includes a device body 12, an endoscope 14, and a fixing member 16. The device body 12 includes a first carrier member 18, a second carrier member 20, an outer tube 22, and a movement restricting portion 23. As shown in Figs. 3 and 4, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 each have a curved shape, but in the exploded perspective view of Fig. 2, for convenience of illustration, the first shaft 24 and the second shaft 48 are each shown in a straight state, as in Fig. 1. Note that the transport device 10 is not limited to being equipped with an endoscope 14.

In FIG. 2, the first carrier member 18 has a first shaft 24 and a first support portion 26.

The first shaft 24 is a tubular body (in this embodiment, a circular tubular member) having a first lumen 28. The first lumen 28 opens at the tip end (the end in the direction of arrow X1) of the first shaft 24 and 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 circumferential surface of the second shaft 48 is provided at the base end of the first shaft 24.

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

3, the distal region 25 of the first shaft 24 has a curved portion 27 that is curved in the axial direction of the outer tube 22 (the direction along the axis Ax of the first shaft 24 shown in FIG. 6). FIG. 3 illustrates a case in which the distal region 25 of the first shaft 24 has a first curved portion 29 that is the curved portion 27. Therefore, the distal region 25 of the first shaft 24 may be made of a soft resin material. That is, the distal region 25 of the first shaft 24 has flexibility. In this case, the first curved portion 29 can be formed by bending the distal region 25 of the first shaft 24 into the shape shown in FIG. 3. The base region of the first shaft 24 may be made of a hard resin material.

As shown in Figures 1 and 2, the outer tube 22 is a tubular body with a straight shape. Therefore, when the first shaft 24 is housed in the outer tube 22, such as in the first position (see Figures 11 and 14) described below, the shape of the first curved portion 29 housed in the outer tube 22 is restricted by the inner peripheral surface of the outer tube 22. In other words, the first curved portion 29 housed in the outer tube 22 has a straight shape or a shape closer to a straight shape than a curved shape (see Figures 11 and 14). The tip region of the outer tube 22 may be slightly curved.

At least the portion of the outer tube 22 in which the curved portion 27 and the first support portion 26 are housed is made of a hard resin material. This allows the first support portion 26 to be curved and deformed into a heart shape, which will be described later, when the first support portion 26 is housed in the outer tube 22. In addition, the first curved portion 29, which is the curved portion 27, and the second curved portion 61, which will be described later, can be housed in the outer tube 22 in a straight shape or a shape closer to a straight shape than a curved shape (slightly curved shape).

In addition, as in the second position described below (see Figures 15 to 19), when the tip region 25 of the first shaft 24 protrudes from the tip opening 80 of the outer tube 22, the portion of the first shaft 24 protruding from the tip opening 80 of the outer tube 22 is curved in the axial direction of the outer tube 22 by the elastic restoring force of the first curved portion 29 (see Figures 15 to 19). In this case, by adjusting the amount of protrusion of the first shaft 24 from the tip opening 80 of the outer tube 22, the degree of curvature of the first shaft 24 in the axial direction of the outer tube 22 (the angle of the first shaft 24 in the axial direction) can be adjusted.

As shown in Figures 2, 3, 5 and 6, the first support part 26 is attached to the tip of the first shaft 24. The first support part 26 is made of, for example, a resin material. The first support part 26 is capable of holding a medical sheet 300. The first support part 26 is formed by folding a flexible resin sheet material (film material) into a predetermined shape. The first support part 26 is formed, for example, by forming the sheet material into a predetermined shape using a sheet forming die. The thickness of the sheet material is not particularly limited, but is preferably set to, for example, 100 μm or more and 200 μm or less. The first support part 26 has a first joint part 30 and a first support body 32.

The material of the first support section 26 is not particularly limited, but is preferably transparent, and examples of the material include polyethylene, polycarbonate, polyamide, polystyrene, polypropylene, polyacetal resin, polyimide, polyetherimide, polyether ether ketone, polyethylene terephthalate, and fluororesin. The first support section 26 may also be mesh-shaped.

In FIG. 6, the first joint 30 is bonded to the inner circumferential surface of the tip of the first shaft 24 with an adhesive. The adhesive is not particularly limited, but examples thereof include a UV adhesive, a hot melt adhesive, and an instant adhesive (e.g., a cyanoacrylate instant adhesive). The first joint 30 may be heat fused to the inner circumferential surface of the first shaft 24.

As shown in FIG. 5, the first support body 32 extends from the first joint 30 (see FIG. 6) toward the tip. The first support body 32 has a base end support portion 34, an intermediate support portion 36, a pair of first protrusions 38, a pair of second protrusions 40, and a tip support portion 42.

The base end support part 34 extends from the tip of the first joint part 30 toward the tip direction (the direction of the arrow X1) so as to generally follow the axis Ax of the first shaft 24 (see FIG. 6). The base end support part 34 is formed to be wider in the direction of extension. In other words, both sides in the width direction of the base end support part 34 are tapered toward the first joint part 30.

The intermediate support part 36 extends from the tip of the base end support part 34 toward the tip end (arrow X1 direction) intersecting the axis Ax of the first shaft 24 and toward the tip end (arrow X1 direction) of the first support part 26 (see FIG. 6). The intermediate support part 36 is formed in a tapered shape that gradually narrows from the tip toward the base end (arrow X2 direction).

2 and 5, the pair of first protrusions 38 protrude upward (in the direction of arrow Y) and inward in the width direction of the intermediate support part 36 from both sides of the width direction of the intermediate support part 36 perpendicular to the movement direction of the first shaft 24. The pair of first protrusions 38 are connected to the base end support part 34.

As shown in FIG. 7, each of the pair of first protrusions 38 has a fixed end 441 connected to the upper surface (first support surface 261) of the intermediate support part 36, and a free end 442 that is an end spaced apart from the first support surface 261 in the protruding direction of the first protrusion 38.

In a cross section perpendicular to the protruding direction of the first protruding portion 38 shown in FIG. 7 and perpendicular to the first support surface 261, each cross section of the first protruding portion 38 has an intermediate portion 443 that is between the free end 442 and the fixed end 441. The intermediate portion 443 is an arc-shaped portion that bulges outward in a direction away from the first support surface 261. The cross section of the intermediate portion 443 is not limited to an arc-shaped portion having a single radius, and may be an arc-shaped portion. In other words, in the cross section of the first protruding portion 38 shown in FIG. 7, the intermediate portion 443 is disposed on the outside of the line segment L that connects the fixed end 441 and the free end 442.

In a cross section perpendicular to the protruding direction of the first protruding portion 38 shown in FIG. 7 and perpendicular to the first support surface 261, the curvature R of the intermediate portion 443 increases toward the base end of the first support portion 26 (the direction of the arrow X2 in FIG. 5).

As shown in FIG. 5, the pair of second protrusions 40 are connected to the tips of the pair of first protrusions 38, respectively. The pair of second protrusions 40 protrude upward from both sides of the intermediate support portion 36 in the width direction and outward in the width direction of the intermediate support portion 36. The second protrusions 40 are formed with a smaller curvature than the first protrusions 38. The second protrusions 40 protrude lower from the first support surface 261 than the first protrusions 38.

The tip support portion 42 is connected to the tip of the intermediate support portion 36 and the tips of the pair of second protrusions 40. The tip support portion 42 protrudes in an arc shape toward the tip direction (the direction of the arrow X1). That is, when viewed from a direction perpendicular to the first support surface 261 shown in FIG. 5, the tip support portion 42 of the first support portion 26 is in an arc shape connecting the pair of second protrusions 40.

Each of the pair of first protrusions 38 has a pair of bent portions 444 on the base end side of the fixed end 441. Each of the pair of bent portions 444 bends the pair of first protrusions 38 against the first support surface 261 (middle support portion 36) of the first support portion 26 (see FIG. 7). As shown in FIG. 5, when the bent portions 444 of the first support portion 26 are bent to form the pair of first protrusions 38 that bulge outwardly in a convex shape, it is preferable to fold both ends of the resin sheet material 26a (see the imaginary line shape in FIG. 5) that becomes the first support portion 26 at the bent portions 444 at a location that is the maximum width Wm in the width direction.

When viewed from a direction perpendicular to the first support surface 261 shown in FIG. 5, the widthwise spacing W of the pair of bent portions 444 in the first support portion 26 gradually decreases toward the base end (the direction of the arrow X2). That is, in the first support body 32, the pair of bent portions 444 are formed in a tapered shape toward the base end.

The first support body 32 has a surface 461 that faces upward (in the direction of arrow Y) and includes the first support surface 261, and a back surface 462 that is the opposite surface to the surface 461. The first support surface 261 is a flat surface that is connected to the upper surface of the base end support part 34, the intermediate support part 36, and the upper surface of the tip support part 42. A lubricant may be applied to the first support surface 261 so that the second support part 50 of the second carrier member 20, which will be described later, can slide smoothly against the first support surface 261.

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

The second shaft 48 is a tubular body (in this embodiment, a circular tube member) having a second lumen 57. The length of the second shaft 48 along the axial direction is longer than the length of the first shaft 24 along the axial direction. The second shaft 48 is inserted into the first lumen 28 of the first shaft 24 (see Figs. 1 and 6). In other words, the tip of the second shaft 48 protrudes in the tip direction (arrow X1 direction) from the tip opening 53 of the first shaft 24. The base end of the second shaft 48 protrudes in the base direction (arrow X2 direction) from the base opening of the first shaft 24 (see Fig. 1). The second shaft 48 extends along the first shaft 24 and is provided movably along the first shaft 24. The second shaft 48 is not limited to a tubular body and does not have to be a tubular body.

A resilient member such as a spring may be provided between the first inner cavity 28 of the first shaft 24 and the second shaft 48, and the resilient force of the resilient member may bias the second shaft 48 in the proximal direction (arrow X2 direction) relative to the first shaft 24. As a result, when the user moves the second shaft 48 in the distal direction (arrow X1 direction) relative to the first shaft 24, the user's operating force is eliminated, and the second shaft 48 can be moved in the proximal direction by the resilient force.

The second shaft 48 is configured so as to be able to follow the shape of the first support portion 26. For example, a material that is more flexible than the material of the first shaft 24 is selected as the material of the second shaft 48. Specifically, examples of the material of the second shaft 48 include polyamide elastomer, polyester elastomer, polyurethane elastomer, polyvinyl chloride, polybutadiene, silicone rubber, metal coil (including composites with resin), and the like. The second shaft 48 is flexible.

As shown in FIG. 4, the distal region 59 of the second shaft 48 has a curved portion 27 that is curved in the axial direction of the outer tube 22. FIG. 4 illustrates a case in which the distal region 59 of the second shaft 48 has a second curved portion 61 that is the curved portion 27. Therefore, the distal region 59 of the second shaft 48 may be made of a soft resin material. That is, the distal region 59 of the second shaft 48 has flexibility. In this case, the second curved portion 61 can be formed by bending the distal region 59 of the second shaft 48 into the shape shown in FIG. 4. The base region of the second shaft 48 may be made of a hard resin material.

As described above, when the first shaft 24 is housed in the outer tube 22, the shape of the first shaft 24 is restricted by the inner peripheral surface of the outer tube 22, and becomes straight or close to a straight shape (see FIGS. 11 and 14). Therefore, when the first and second shafts 24, 48 are housed in the outer tube 22, the shape of the second curved portion 61 housed in the outer tube 22 and the first shaft 24 is restricted by the inner peripheral surfaces of the outer tube 22 and the first shaft 24. That is, the shape of the second curved portion 61 housed in the outer tube 22 and the first shaft 24 is straight or becomes closer to a straight shape than a curved shape (slightly curved shape) (see FIGS. 11 and 14).

When the tip region 59 of the second shaft 48 protrudes from the tip opening 80 of the outer tube 22 together with the tip region 25 of the first shaft 24, the portion of the second shaft 48 protruding from the tip opening 80 of the outer tube 22 is curved in the axial direction of the outer tube 22 by the elastic restoring force of the second curved portion 61 (see Figures 15 to 19). In this case, too, the degree of curvature of the second shaft 48 in the axial direction of the outer tube 22 (the angle of the second shaft 48 in the axial direction) can be adjusted by adjusting the amount of protrusion of the second shaft 48 from the tip opening 80 of the outer tube 22.

In this embodiment, it is only necessary that the protruding portions of the first and second shafts 24, 48 from the tip opening 80 of the outer tube 22 can be curved in the axial direction of the outer tube 22. Therefore, in this embodiment, it is only necessary that the tip region 25, 59 of at least one of the first and second shafts 24, 48 has a curved portion 27. In addition, when the first and second curved portions 29, 61 are provided, it is desirable that the first and second curved portions 29, 61 are curved in the same direction in the axial direction of the outer tube 22.

As shown in FIG. 6, the second shaft 48 has a carrier holding portion 54 and a pressing portion 56 formed by the tip of the second shaft 48. The pressing portion 56 is formed from an elastic body such as an elastomer material. The pressing portion 56 presses the first support portion 26 against the inner surface of the outer tube 22 when the first support portion 26 is housed inside the outer tube 22.

The tip of the carrier holding part 54 has a pressing surface 58. The carrier holding part 54 can press the outer peripheral end surface of the medical sheet 300 supported by the first support part 26 in the tip direction (arrow X1 direction) with the pressing surface 58. In this embodiment, the pressing part 56 is provided with a carrier holding part 54 that supports the second support part 50. The carrier holding part 54 has a pressing surface 58 and an attachment hole 60. The carrier holding part 54 is formed to be wider toward the tip direction when viewed from above. The carrier holding part 54 is formed in a trapezoidal shape when viewed from above. In a cross section perpendicular to the axis of the second shaft 48 shown in FIG. 7, the carrier holding part 54 has a shape that is line-symmetrical with respect to a virtual line L1 that passes through the center line C of the carrier holding part 54 and is parallel to the width direction of the carrier holding part 54. In other words, the carrier holding part 54 has a shape that is symmetrical in the vertical direction with the virtual line L1 as the center.

Specifically, in a cross section perpendicular to the axis of the second shaft 48, the cross section of the carrier holding portion 54 has a pair of straight portions 621, 622 perpendicular to the axis of the second shaft 48, and a pair of convex portions 641, 642 arranged on both sides of the pair of straight portions 621, 622 and convex in a direction away from the straight portions 621, 622 (outward in the width direction). The convex portions 641, 642 are formed in a cross section of an arc. The first length D1 (width dimension) of the carrier holding portion 54 along the extension direction of the straight portions 621, 622 is greater than the second length D2 (thickness dimension) of the carrier holding portion 54 perpendicular to the extension direction. That is, the carrier holding portion 54 has a flat cross section. Note that the carrier holding portion 54 is not limited to being formed in a flat cross section, and may be formed in, for example, a circular cross section, an elliptical cross section, a square cross section, a rectangular cross section, or the like. Also, instead of the convex portions 641 and 642, the carrier holding portion 54 may be provided with an uneven structure that presses the first support portion 26 against the inner surface of the outer tube 22 when the first support portion 26 is housed inside the outer tube 22.

The width (first length D1) of the pressing portion 56 is set so that when the first support portion 26 is housed in the inner cavity 78 of the outer tube 22 together with the pressing portion 56, the first support portion 26 is pressed toward the inner cavity 78 of the outer tube 22 by both widthwise ends (a pair of convex portions 641, 642) of the pressing portion 56. The first length D1 of the pressing portion 56 is set to be, for example, equal to or slightly larger than the inner diameter (diameter of the inner cavity 78) of the outer tube 22. Because the first support portion 26 is thick, the first length D1 of the pressing portion 56 may be set to be slightly smaller than the inner diameter of the outer tube 22.

6, the pressing surface 58 is provided on the tip surface of the carrier holding part 54. An attachment hole 60 is opened in the pressing surface 58. The second support part 50 is attached to the pressing surface 58. The pressing surface 58 presses the outer peripheral end surface of the medical sheet 300 in the tip direction (arrow X1 direction) (see FIG. 17). The pressing surface 58 is a flat surface perpendicular to the axis of the carrier holding part 54. The pressing surface 58 may be provided with a supply hole (not shown) that can supply liquid (e.g., saline) toward the tip of the second shaft 48 via the second lumen 57 of the second shaft 48. The liquid is, for example, for priming or wetting.

The mounting hole 60 opens into the pressing surface 58 of the carrier holding part 54. The mounting hole 60 is positioned on the center line C of the carrier holding part 54 on the pressing surface 58. The mounting hole 60 is a slit extending from the center line C in parallel to the width direction of the carrier holding part 54. The mounting hole 60 is symmetrical in the width direction with the center line C as the center. The mounting hole 60 extends in the axial direction from the pressing surface 58. A part of the second support part 50 is inserted into the mounting hole 60 and connected.

2, 5, and 6, 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 base end of the second support portion 50. The second joint portion 70 is provided at the base 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, glued. The second joint portion 70 may be bonded to the mounting hole 60 of the carrier holding portion 54 by an appropriate bonding method other than bonding. The second support portion 50 may also be molded integrally with the carrier holding portion 54.

The second support body 72 extends from the second joint 70 in the tip direction (arrow X1 direction). The length of the second support body 72 in the extension direction from the second joint 70 is shorter than the length of the first support body 32 in the extension direction from the first joint 30. A second support surface 74 for placing the medical sheet 300 is provided on the upper surface of the second support body 72. The second support surface 74 is a flat surface. The second support body 72 is smaller than the first support body 32. In other words, the area of the second support surface 74 is smaller than the area of the first support surface 261.

As shown in FIG. 5, the base end of the second support body 72 is narrowed toward the base end (arrow X2 direction). The intermediate portion between the tip and base end of the second support body 72 extends with a substantially constant width. The tip of the second support part 50 protrudes in an arc toward the tip end (arrow X1 direction). A lubricant may be applied to both surfaces (lower and upper surfaces) of the second support body 72.

In FIG. 2, the hub 52 is attached to the base end of the second shaft 48.

1 and 2, the outer tube 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 tube 22 (the end in the direction of the arrow X1). The inner cavity 78 opens at the base end of the outer tube 22 (the end in the direction of the arrow X2). The outer tube 22 is flexible. Examples of materials constituting the outer tube 22 include the same materials as the materials constituting the first shaft 24 described above.

The first shaft 24 is inserted into the inner cavity 78 of the outer tube 22. The axial length of the outer tube 22 is shorter than the axial length of the first shaft 24. In Figs. 5 and 6, the inner diameter of the outer tube 22 is smaller than the width of the intermediate support portion 36. The width of the intermediate support portion 36 is substantially the same as or shorter than the circumferential length of the inner surface of the outer tube 22 so that the first support portion 26 can be accommodated in the outer tube 22 in a cylindrically rolled state along the circumferential direction of the inner surface of the outer tube 22. An airtight valve body 84 that is in close contact with the outer circumferential surface of the first shaft 24 is provided at the base end of the outer tube 22.

In Figures 2 and 6, the tip surface of the outer tube 22 extends along a direction perpendicular to the axial direction of the outer tube 22.

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

The fixing member 16 includes, for example, a fixed cylinder 90 and a fixed tube 92. The fixed cylinder 90 is made of, for example, a hard resin material. The endoscope body 86 can be inserted into the inner cavity of the fixed cylinder 90. The fixed cylinder 90 is arranged along the longitudinal direction of the outer cylinder 22. The fixed tube 92 is a tube for fixing the fixed cylinder 90 to a predetermined position of the outer cylinder 22. The fixed tube 92 is, for example, a heat shrink tube. Note that the outer cylinder 22 and the fixed cylinder 90 may be integrally molded. However, the method of fixing the tip of the endoscope body 86 to the outer cylinder 22 can be set appropriately.

The movement restricting portion 23 can restrict the relative movement in the axial direction between the first shaft 24 and the second shaft 48. The movement restricting portion 23 is composed of a carrier holding portion 54 (pressing portion 56) formed by the tip portion of the second shaft 48. When the first support portion 26 is housed in the outer tube 22, the carrier holding portion 54 presses the first support portion 26 against the inner surface (bore 78) of the outer tube 22, thereby restricting the relative displacement between the first support portion 26 and the second shaft 48. As the relative movement between the first support portion 26 and the second shaft 48 is restricted, the relative movement between the first shaft 24 and the second shaft 48 in the axial direction is restricted (see FIG. 12).

Next, a method for transferring the medical sheet 300 to a treatment target part of a living body will be described. Specifically, as shown in Figures 14 to 19, a method for transferring the medical sheet 300 to a transplant target part 402 of a heart 400 (treatment target part of a living body) by thoracoscopic surgery will be described. As shown in Figure 8, the transfer method according to this embodiment includes a preparation process, a sheet placement process, a storage process, a positioning process, an unfolding process, a moving process, and a removal process.

First, in the preparation step (step S1), the transfer device 10 according to the present embodiment is prepared. In the following, the state shown in FIG. 1 will be described as the initial state of the transfer device 10. In the initial state, the first and second shafts 24, 48 are moved in the distal direction (arrow X1 direction) relative to the outer tube 22, and the first support portion 26 and the second support portion 50 are in a protruding position (second position) protruding in the distal direction from the distal opening 80 of the outer tube 22. Each of the first and second support portions 26, 50 is exposed in the distal direction from the outer tube 22 and deployed, and the second support portion 50 is positioned on the first support surface 261 of the first support portion 26. That is, the second support portion 50 is positioned in a retracted position overlapping the first support surface 261 of the first support portion 26. At this time, the base end portion of the carrier holding portion 54 is inserted into the first inner cavity 28 of the first shaft 24.

Therefore, in the preparation process, the tip regions 25, 59 (see Figures 3 and 4) of the first and second shafts 24, 48 do not protrude from the tip opening 80 of the outer tube 22 (see Figures 1, 5, 9, and 10). Therefore, the shape of the curved portion 27 (first curved portion 29, second curved portion 61) housed in the outer tube 22 is regulated by the inner peripheral surface of the outer tube 22. That is, the curved portion 27 is held in a straight shape, or in a shape closer to a straight shape than a curved shape (slightly curved shape).

Next, in the sheet placement process (step S2), as shown in FIG. 9, the medical sheet 300 placed in the petri dish 401 is placed on the second support surface 74. As shown in FIG. 10, the medical sheet 300 protrudes outward from the second support portion 50 when placed on the second support surface 74. The first support surface 261 supports the protruding portion 302 of the medical sheet 300 that protrudes outward from the second support portion 50. The pair of second protrusions 40 suppress movement (displacement) of the medical sheet 300 in the width direction of the intermediate support portion 36 when the medical sheet 300 is placed on the second support surface 74.

Then, in the accommodation step (step S3 in FIG. 8), the medical sheet 300 is accommodated in the outer tube 22 together with the first support portion 26 and the second support portion 50 to a accommodation position (first position). Specifically, the first shaft 24 of the first carrier member 18 and the second shaft 48 of the second carrier member 20 are moved together in the base end direction (arrow X2 direction) relative to the outer tube 22.

Then, the base end support part 34 is drawn in the base end direction from the tip opening 80 of the outer tube 22. At this time, the tapered both sides of the base end support part 34 come into contact with the tip opening 80 of the outer tube 22, so that a force acts on the base end support part 34 to curl the base end support part 34 along the circumferential direction of the outer tube 22. Therefore, the base end support part 34 is smoothly drawn into the outer tube 22 while curling. At this time, the first support part 26 is accommodated in the outer tube 22 while curling into a cone shape with a large diameter at the tip side and a small diameter at the base end support part 34.

When the base end support portion 34 is deformed, a force acts on the intermediate support portion 36 to curl up along the circumferential direction of the outer tube 22, so that the intermediate support portion 36 is drawn into the outer tube 22 while curling up. At this time, the intermediate support portion 36 is deformed into a cylindrical shape along the inner surface of the outer tube 22. Each of the pair of first protrusions 38 is curved so that the surface 461 of the first support portion 26 is on the inside and the back surface 462 of the first support portion 26 is on the outside, so that the fixed end 441 is rolled inward. As shown in FIG. 13, the back surfaces 462 of the intermediate portions 443 that bulge outward in the radial direction come into contact with each other on a virtual line L2 that extends perpendicular to the central axis of the outer tube 22. The intermediate portion 443 of one first protrusion 38 and the intermediate portion 443 of the other first protrusion 38 come into contact with each other and are accommodated downward (first support surface 261, surface 461).

As a result, the back surface 462 of the first support portion 26 is curved in close contact with the inner surface of the outer tube 22, and each first protrusion 38 is further curved from the fixed end 441 to the free end 442 so as to fold back toward the center of the outer tube 22, and the pair of free ends 442 are positioned below the central axis of the outer tube 22. In other words, the first support portion 26 is curved into a heart shape that fits along the inner surface of the outer tube 22.

The heart shape refers to a generally circular shape consisting of a convexly curved shape on one side and two convexly curved shapes on the opposite side. When a heart shape is formed in the inner cavity 78 of the tubular body (outer tube 22), the two convexly curved shapes that protrude to the other side along the inner surface of the tubular body approach each other and some of the circumferential surfaces come into contact with each other, resulting in an overall outline that is generally circular along the inner surface of the tubular body (see the shape of the first support part 26 in Figure 13).

As the first support part 26 is curved, the second support part 50 is also curved along the first support part 26 on the inside (surface 461 side) of the first support part 26. As the first and second support parts 26, 50 are curved, the medical sheet 300 is deformed into a shape corresponding to the shapes of the first and second support bodies 32, 72, and the medical sheet 300 is contained within the outer tube 22. The containment process is completed when the entire first support part 26 is completely inserted into the outer tube 22, as shown in FIG. 11.

When the first support part 26, the second support part 50 and the medical sheet 300 are housed within the outer tube 22, as shown in FIG. 13, the pair of first protrusions 38 are located distally (in the direction of arrow X1) from the pressing surface 58 of the pressing part 56 with their back surfaces 462 in contact with each other (see FIG. 11).

In addition, in the sheet loading process and the storage process, similar to the preparation process, the curved portion 27 (first curved portion 29, second curved portion 61) stored in the outer tube 22 is maintained in a straight shape or in a shape closer to a straight shape than a curved shape (see Figures 9 to 11).

In the placement step (step S4 in FIG. 8), as shown in FIG. 14, a trocar 411 is inserted into the thoracic cavity 410 through the incision 409 in the chest 408. Next, the user inserts the transfer device 10 into the thoracic cavity 410 through the trocar 411. This allows the tip of the transfer device 10 to be positioned near the transplant target portion 402 in the heart 400, and the tip of the endoscope 14 to be positioned within the thoracic cavity 410. Note that before inserting the transfer device 10 into the thoracic cavity 410, a liquid supply device (not shown) may be connected to the connection port of the hub 52 to introduce liquid (e.g., saline solution).

Next, in the unfolding process (step S5 in FIG. 8), the first support part 26, the second support part 50, and the medical sheet 300 are unfolded as shown in FIG. 15. Specifically, in the unfolding process, the first shaft 24 is grasped and moved toward the tip (arrow X1 direction) relative to the outer tube 22. As a result, the valve body 55 of the first shaft 24 moves the second shaft 48 together with the first shaft 24 toward the tip (arrow X1 direction). At this time, the first shaft 24 and the second shaft 48 move toward the tip together via the movement restriction part 23. Then, the first support part 26 exposed from the tip opening 80 of the outer tube 22 returns to its original shape by a restoring force. In the second position where the first support part 26 is unfolded, the second support part 50 and the medical sheet 300 spread out into a flat shape.

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

Next, in the movement step (step S6 in FIG. 8), the user further moves the first shaft 24 in the distal direction (arrow X1 direction) relative to the outer tube 22. This causes the first and second shafts 24, 48 to protrude in the distal direction (arrow X1 direction) from the distal opening 80 of the outer tube 22 (see FIG. 16).

As described above, each of the distal end regions 25, 59 of the first and second shafts 24, 48 has a curved portion 27 (first curved portion 29, second curved portion 61) (see Figs. 3 and 4). Therefore, as shown in Fig. 16, when the first and second shafts 24, 48 protrude in the distal direction from the distal end opening 80 of the outer tube 22, the portion of the first and second shafts 24, 48 protruding from the distal end opening 80 of the outer tube 22 is curved in the axial direction of the outer tube 22 by the elastic restoring force of the curved portion 27. As a result, the first and second shafts 24, 48 protrude from the distal end opening 80 of the outer tube 22 toward the transplant target portion 402 in a curved manner. As a result, the first support portion 26 can be positioned in the vicinity of the transplant target portion 402. In this case, the degree of curvature (angle with respect to the axial direction) of the first and second shafts 24, 48 with respect to the axial direction of the outer tube 22 can be adjusted by adjusting the amount of protrusion of the first and second shafts 24, 48 from the tip opening 80 of the outer tube 22. This allows the angle of the first support part 26 connected to the first shaft 24 with respect to the axial direction to be adjusted by adjusting the amount of protrusion of the first and second shafts 24, 48 from the tip opening 80 of the outer tube 22.

In addition, since the first and second curved portions 29, 61 are curved in the same direction relative to the axial direction of the outer tube 22, when the first support portion 26 protrudes from the tip opening 80 of the outer tube 22, the first support portion 26 can be prevented from rotating around the axial direction of the outer tube 22. In other words, the first support portion 26 can be prevented from being turned inside out.

Next, as shown in FIG. 17, the second carrier member 20 is moved in the distal direction (arrow X1 direction) relative to the first carrier member 18, so that the second support part 50 on which the medical sheet 300 is placed moves from the retracted position to the advanced position, and the second support part 50 protrudes in the distal direction (arrow X1 direction) beyond the tip of the first support part 26. Specifically, the second shaft 48 is moved in the distal direction relative to the first shaft 24.

As a result, the second support part 50 moves in the distal direction (arrow X1 direction) relative to the first support part 26. At this time, when the pressing surface 58 of the carrier holding part 54 (pressing part 56) presses the outer peripheral end face of the medical sheet 300 in the distal direction, the entire medical sheet 300 is positioned in the distal direction from the first support part 26. In this moving process, the medical sheet 300 is moved above the transplant target part 402 of the heart 400, and the protruding part 302 of the medical sheet 300 is brought into contact with the transplant target part 402.

Then, in the removal process (step S7 in FIG. 8), as shown in FIG. 18, the second carrier member 20 is moved in the base end direction (the direction of the arrow X2) to pull out the second support part 50 from between the transplantation target part 402 and the medical sheet 300. This brings the entire medical sheet 300 into contact with the surface of the transplantation target part 402. This completes the transfer of the medical sheet 300 to the transplantation target part 402.

Next, as shown in FIG. 19, the second carrier member 20 is further moved in the proximal direction (arrow X2 direction) to the first position. As a result, the first support part 26 and the second support part 50 are housed in the outer tube 22. Finally, the transport device 10 is removed from the chest 408 by pulling it out of the trocar 411.

This embodiment provides the following advantages:

As shown in Figures 1 and 2, the transfer device 10 includes a second carrier member 20 that is axially movable relative to the first carrier member 18, so that the medical sheet 300 can be transferred from the first support portion 26 to the transplantation target portion 402 of the living body using the second carrier member 20 without using any other device (forceps, etc.). This allows the medical sheet 300 to be efficiently transferred to the transplantation target portion 402.

As shown in Figs. 3 and 4, the portions of the first and second shafts 24, 48 that protrude from the tip opening 80 of the outer tube 22 are curved relative to the axial direction of the outer tube 22, so that the first and second shafts 24, 48 can be curved at a position close to the first support part 26 that holds the medical sheet 300 (see Fig. 16). This makes it possible to adjust the angle of the first support part 26 relative to the axial direction of the outer tube 22 inside the living body when the outer tube 22 is inserted inside the living body and the medical sheet 300 is transferred to the treatment target part of the living body (the transplant target part 402 of the heart 400). As a result, the medical sheet 300 held by the first support part 26 with the adjusted angle can be easily transferred to the transplant target part 402 (see Fig. 17).

Furthermore, as shown in Figs. 3 and 4, the first and second curved portions 29, 61 are curved in the same direction, so that the portions of the first and second shafts 24, 48 protruding from the distal end opening 80 of the outer tube 22 can be curved in the same direction relative to the axial direction of the outer tube 22 by the elastic restoring force of the first and second curved portions 29, 61 (see Fig. 16). This makes it possible to prevent the first support portion 26 from rotating around the axial direction of the outer tube 22 when the first support portion 26 protrudes from the distal end opening 80 of the outer tube 22. As a result, the medical sheet 300 held by the first support portion 26 can be reliably transferred to the treatment target portion (transplant target portion 402) (see Fig. 17).

As shown in FIG. 1, a sheet-like second support part 50 including a second support surface 74 capable of holding a medical sheet 300 is provided at the tip of the second shaft 48. The second support part 50 is movable relative to the first support part 26 between a retracted position where it overlaps with the first support surface 261 and an advanced position where it is located further distally (in the direction of arrow X1) than the first support surface 261. With this configuration, the second support part 50 having the second support surface 74 can move the medical sheet 300 along the first support surface 261 of the first support part 26.

As shown in FIG. 7, the first support portion 26 is formed of a flexible sheet having a surface 461 and a back surface 462. The first support portion 26 has a pair of first protrusions 38 that protrude upward from both sides in the width direction of the first support surface 261 perpendicular to the movement direction of the first shaft 24. With this configuration, when the first support portion 26 is accommodated in the outer tube 22, the back surfaces 462 of the first protrusions 38 that are curved and deformed to be convex contact each other. The pair of first protrusions 38 are displaced toward the first support surface 261, and the support portion is curved and deformed into a heart shape (see FIG. 13). As a result, the first support portion 26 can be accommodated in a heart shape in the outer tube 22, and damage to the medical sheet 300 held by the first support portion 26 can be effectively suppressed compared to when the first support portion 26 is deformed into a shape that is not heart-shaped. In addition, because the first support part 26 can be smoothly and compactly housed inside the outer tube 22, the diameter of the outer tube 22 can be made smaller than in a configuration in which the first support part 26 does not bend and deform into a heart shape.

12, when the first support portion 26 is stored in the outer tube 22, the tip of the second shaft 48 and the first support portion 26 come into contact with each other by the movement restricting portion 23, thereby preventing the first shaft 24 and the second shaft 48 from moving relative to each other in the axial direction. As a result, even if the user mistakenly tries to move the second carrier member 20 in the tip direction (arrow X1 direction) before the first support portion 26 reaches the second position where it protrudes from the tip of the outer tube 22, the second carrier member 20 does not move relative to the first carrier member 18 in the axial direction. Specifically, even if the user mistakenly grasps the second carrier member 20 and pushes it in the tip direction, both the first carrier member 18 and the second carrier member 20 do not move in the tip direction relative to the outer tube 22. However, when the user mistakenly grasps the second carrier member 20 and pushes it in the tip direction, the first carrier member 18 may also move in the tip direction together with the second carrier member 20 relative to the outer tube 22. In this case, the second carrier member 20 does not move relative to the first carrier member 18 in the axial direction. As a result, the second support part 50 and the medical sheet 300 are prevented from protruding from the tip opening 80 of the outer tube 22. This prevents the medical sheet 300 contained inside the outer tube 22 from being pushed and damaged by the tip of the second shaft 48. Therefore, the medical sheet 300 can be efficiently transported to the transplantation target site 402 without being damaged.

As shown in Figures 1, 2, 5 and 6, the movement restricting portion 23 is a pressing portion 56 that constitutes the tip of the second shaft 48. With the first support portion 26 housed in the outer tube 22, the pressing portion 56 presses the first support portion 26 against the inner cavity 78 (inner surface) of the outer tube 22. As a result, the pressing portion 56 and the first support portion 26 that constitute the movement restricting portion 23 are in close contact with each other in the radial direction, so that the relative displacement between the first support portion 26 and the second shaft 48 is restricted. With the first support portion 26 protruding from the tip of the outer tube 22, the second shaft 48 can be moved in the axial direction relative to the first shaft 24.

Because the pressing portion 56 is made of an elastic material, it is possible for the pressing portion 56 to be effectively brought into close contact with the first support portion 26. Even if the second shaft 48 presses the pressing portion 56 toward the tip (in the direction of the arrow X1) while the pressing portion 56 is housed within the outer tube 22, the second shaft 48 flexes and the pressing force is not easily transmitted to the pressing portion 56, so the user can easily notice an erroneous operation.

As shown in FIG. 7, in a cross section perpendicular to the axis of the second shaft 48, the pressing portion 56 has a pair of straight portions 621, 622 and a pair of convex portions 641, 642 provided on both sides of the pair of straight portions 621, 622. The first length D1 along the extension direction of the straight portions 621, 622 is longer than the second length D2. As a result, when the first support portion 26 is housed in the outer tube 22, the pair of convex portions 641, 642 provided on both sides of the straight portions 621, 622 press the first support portion 26 toward the outer tube 22, thereby making it possible to bring the first support portion 26 and the carrier holding portion 54 into closer contact with each other.

As shown in FIG. 11, in the storage position (first position), the second support part 50 is stored inside the outer tube 22 while being curved and deformed together with the first support part 26. With this configuration, even if the second support part 50 has a width dimension, the second support part 50 can be suitably stored together with the first support part 26 inside the outer tube 22 during the storage process.

As shown in FIG. 2, a carrier holding part 54 that holds the base end of the second support part 50 is provided at the tip of the second shaft 48. Unlike this embodiment, if the carrier holding part 54 is not symmetrical in the up-down direction and the second support part 50 is held at the lower end of the carrier holding part 54, the user rotates the second shaft 48, the up-down direction of the second support part 50 is reversed, and the second support part 50 is positioned above the carrier holding part 54. In this case, the second support part 50 floats up relative to the first support surface 261 of the first support part 26, and the first support part 26 and the second support part 50 are separated in the up-down direction.

In contrast, in this embodiment, as shown in FIG. 7, in a cross section perpendicular to the axis of the second shaft 48, the carrier holding part 54 is formed symmetrically (vertically symmetrically) with respect to the center line C of the carrier holding part 54. In addition, the carrier holding part 54 holds the second support part 50 on the center line C. Therefore, even if the user rotates the second shaft 48 to invert the up-down direction of the second support part 50, the second support part 50 can be prevented from floating up from the first support surface 261 of the first support part 26, compared to a configuration in which the second support part 50 is held at the lower end of the carrier holding part 54. This allows the second support part 50 to perform a stable transplant operation of the medical sheet 300.

As shown in FIG. 7, in a cross section perpendicular to the protruding direction of the first protruding portion 38 and perpendicular to the first support surface 261, the cross section of each of the first protruding portions 38 has a shape in which the intermediate portion 443 between the free end 442 and the fixed end 441 of the first protruding portion 38 bulges outward in a convex shape in a direction away from the first support surface 261. With this configuration, when the first support portion 26 is housed in the outer tube 22, the first support portion 26 can be reliably curved and deformed into a heart shape. This makes it possible to prevent damage to the medical sheet 300 caused by the first support portion 26 deforming into a shape other than a heart shape.

Unlike this embodiment, when the intermediate portion 443 on the back surface 462 of the first support portion 26 is curved so as to be concave toward the first support surface 261, it may rarely happen that the first support portion 26 does not bend into an appropriate heart shape inside the outer tube 22. For example, it may rarely happen that the free end 442 (front surface 461) of one first protrusion 38 rides on the fixed end 441 (back surface 462) of the other first protrusion 38 that has been curved and deformed, causing the free end 442 to bend in a V-shape toward the inner surface of the outer tube 22. In this embodiment, the intermediate portion 443 is shaped to bulge convexly in the direction away from the first support surface 261, so that the first support portion 26 can be prevented from bending in a V-shape.

By forming the intermediate portion 443 of the pair of first protrusions 38 in an arc shape, it is easy to form the first protrusions 38 with an outwardly bulging shape.

The curvature R of the intermediate portion 443 of the first protrusion 38 increases toward the base end of the first support portion 26 (the direction of the arrow X2), so the widthwise spacing W between the first protrusions 38 at the tip side of the first protrusions 38 can be increased. This makes it easier to place the medical sheet 300 on the first support surface 261 of the first support portion 26 through the tip support portion 42.

As shown in FIG. 5, the distance W between the pair of bent portions 444 in the width direction of the first support portion 26 becomes smaller toward the base end. Therefore, when the first support portion 26 is accommodated in the outer tube 22 from the base end side, the pair of first protrusions 38 can be appropriately curved and deformed into a cone shape by contact with the outer tube 22. As a result, interference between the base ends of the pair of bent portions 444 is suppressed, so that the first support portion 26 can be smoothly accommodated in the outer tube 22 from the base end side.

As shown in FIG. 5, when viewed from a direction perpendicular to the first support surface 261, the tip of the first support part 26 is arc-shaped connecting a pair of second protrusions 40. Compared to a configuration in which the tip of the first support part 26 has a cornered shape, this reduces the sliding resistance between the first support part 26 and the outer tube 22 when the first support part 26 is housed in the outer tube 22. When the first support part 26 is moved in the tip direction (arrow X1 direction) to place the medical sheet 300 on the first support part 26, the first support part 26 can be gradually inserted into the interface between the medical sheet 300 and the petri dish 401 (container) to perform the operation smoothly.

As shown in FIG. 20, the transport device 100 according to the first modified example includes a movement restricting section 102. Note that in this modified example, the same components as those in the transport device 10 described above are given the same reference numerals, and detailed descriptions of the same components are omitted. The same applies to the transport devices 120, 130, 150, and 160 according to the second to fifth modified examples described below.

The movement restriction portion 102 includes a first fitting portion 104 provided on the first support portion 26 and a second fitting portion 106 provided on the carrier holding portion 54 at the tip of the second shaft 48.

The first fitting portion 104 has a pair of first protrusions 1081, 1082 that protrude upward from the first support surface 261 of the first support portion 26. Each of the first protrusions 1081, 1082 is disposed equidistant from the widthwise center of the first support portion 26. When viewed from a direction perpendicular to the widthwise direction of the first support portion 26, the cross section of the first protrusions 1081, 1082 is, for example, rectangular. The cross section of the first protrusions 1081, 1082 may be another shape (such as semicircular).

The second fitting portion 106 is disposed at each of both widthwise ends (convex portions 641, 642) of the carrier holding portion 54 (pressing portion 56). The second fitting portion 106 has recesses 1101, 1102 recessed from the outer surfaces of the convex portions 641, 642. The recesses 1101, 1102 are recessed in the widthwise direction from the outer surfaces of the convex portions 641, 642. When viewed from the axial direction of the carrier holding portion 54, the cross sections of the recesses 1101, 1102 are rectangular corresponding to the first convex portions 1081, 1082. The cross sections of the recesses 1101, 1102 may be other shapes (semicircular, etc.).

When the first support part 26 is accommodated in the outer tube 22 and is curved and deformed, the first convex parts 1081, 1082 of the first fitting part 104 constituting the movement restricting part 102 are fitted into the concave parts 1101, 1102 of the second fitting part 106, respectively. This restricts the relative displacement between the first support part 26 and the carrier holding part 54, and accordingly restricts the relative axial movement of the second shaft 48 with respect to the first shaft 24.

As described above, in the transfer device 100 according to the first modified example, when the first support portion 26 is housed in the outer tube 22 (first position), the first fitting portion 104 and the second fitting portion 106 of the movement restricting portion 102 are fitted together, thereby preventing relative axial movement between the first shaft 24 having the first support portion 26 and the second shaft 48. When the first support portion 26 protrudes from the tip of the outer tube 22 (second position), the first fitting portion 104 and the second fitting portion 106 of the movement restricting portion 102 are released from the fitting, allowing the second shaft 48 to move in the tip direction (arrow X1 direction) relative to the first support portion 26.

As shown in FIG. 21A, the transport device 120 according to the second modified example includes a movement restricting portion 122. The movement restricting portion 122 includes a first engagement portion 124 and a second engagement portion 126. The first engagement portion 124 is provided on the surface 461 of the first support portion 26, which includes the first support surface 261. The second engagement portion 126 is formed by the carrier holding portion 54 at the tip of the second shaft 48.

The first engagement portion 124 has a pair of second protrusions 1281, 1282 that protrude upward from the first support surface 261. Each of the second protrusions 1281, 1282 is disposed equidistantly from the widthwise center of the first support portion 26. The second engagement portions 126 are disposed on both sides of the tip of the carrier holding portion 54.

As shown in FIG. 21B, when the first support portion 26 is housed in the outer tube 22 and is curved and deformed, the second protrusions 1281 and 1282 of the first engagement portion 124 face the second engagement portion 126 in the axial direction of the outer tube 22, and the first engagement portion 124 and the second engagement portion 126 are engaged in the axial direction.

As described above, in the transfer device 120 according to the second modified example, in the state (first position) in which the first support portion 26 is housed in the outer tube 22 shown in FIG. 21B, the first engaging portion 124 and the second engaging portion 126 constituting the movement restricting portion 122 are engaged in the axial direction, thereby preventing relative movement in the axial direction between the first shaft 24 having the first support portion 26 and the second shaft 48. In the state (second position) in which the first support portion 26 protrudes from the tip opening 80 of the outer tube 22 shown in FIG. 21A, the first support portion 26 unfolds, so that the first engaging portion 124 and the second engaging portion 126 do not face each other in the axial direction, and the engagement between the first engaging portion 124 and the second engaging portion 126 is released. This allows the second shaft 48 to move in the tip direction (arrow X1 direction) relative to the first support portion 26.

As shown in Figures 22 and 23, the transfer device 130 according to the third modified example includes a first support portion 132. The protrusions 129 provided on both sides of the width of the first support portion 132 have an intermediate portion 134 that is between the free end 442 and the fixed end 441. The intermediate portion 134 has a shape that bulges out in a convex shape in a direction away from the first support surface 261. The intermediate portion 134 has an intermediate bent portion 136 that is bent so as to form a mountain fold on the back surface 462. The intermediate bent portion 136 is positioned closer to the free end 442 in the intermediate portion 134.

As described above, in the transfer device 130 according to the third modified example, by providing the intermediate bend 136 on the protrusion 129 of the first support part 132, it is possible to easily form the protrusion 129 in a shape that bulges out in a convex shape in a direction away from the first support surface 261.

Although the case where the second support part 50 is attached to the tip of the second shaft 48 has been described, the present invention is not limited to this. For example, as in the transfer device 150 according to the fourth modified example shown in FIG. 24, the tip of the second shaft 48 may be provided with a pressing body 152. The pressing body 152 has, for example, a flat cross section with a flat bottom surface. The medical sheet 300 placed on the first support surface 261 of the first support part 26 can be pressed downward with the bottom surface of the pressing body 152, thereby pushing the medical sheet 300 in the tip direction (arrow X1 direction) along the first support surface 261 of the first support part 26.

25 and 26, a configuration may be used in which a pressing body 162 is provided at the tip of the second shaft 48. The tip of the pressing body 162 has a pressing surface 164. The pressing surface 164 is a flat surface perpendicular to the axis of the pressing body 162. The base end of the pressing body 162 is connected to the tip of the second shaft 48. The pressing surface 164 of the pressing body 162 presses the medical sheet 300 placed on the first support surface 261 of the first support part 26, and the medical sheet 300 can be pushed out in the tip direction (arrow X1 direction) along the first support surface 261 of the first support part 26.

The present invention is not limited to the above disclosure, and various configurations may be adopted without departing from the gist of the present invention.

10, 100, 120, 130, 150, 160...Transportation device 18...First carrier member 20...Second carrier member 22...Outer tube 23, 102, 122...Movement restriction portion 24...First shaft 25, 59...Tip side region 26, 132...First support portion 27...Curved portion 29...First curved portion 48...Second shaft 61...Second curved portion 80...Tip opening 261...First support surface 300...Medical sheet 402...Transplantation target portion

Claims (4)

A transfer device for transferring a medical sheet to a treatment target part of a living body,
An outer cylinder,
a first carrier member including a tubular first shaft extending in an axial direction of the outer cylinder and disposed inside the outer cylinder so as to be movable along the axial direction; and a sheet-like support portion disposed at a tip portion of the first shaft and including a support surface capable of holding the medical sheet;
a second carrier member having a second shaft disposed within and extending along the first shaft for movement along the first shaft;
Equipped with
At a first position obtained by moving the first and second shafts in a proximal direction relative to the outer cylinder so that the support portion is accommodated in the outer cylinder, the support portion is accommodated in the outer cylinder in a curved and deformed state,
At a second position where the first and second shafts are moved in a distal direction relative to the outer tube so that the support portion protrudes from a distal opening of the outer tube, the support portion is exposed in the distal direction from the outer tube and deployed,
a distal end region of at least one of the first and second shafts has a curved portion that is curved in the axial direction;
When the first and second shafts are located at the first position, the curved portion housed in the outer cylinder has a straight shape or a shape closer to a straight shape than the curved shape,
A transfer device, wherein when the first and second shafts are positioned at the second position, portions of the first and second shafts protruding from a tip opening of the outer tube are curved relative to the axial direction due to the elastic restoring force of the curved portion. 2. The transfer device of claim 1,
The distal end region of the first shaft has a first curved portion that is the curved portion,
The distal end region of the second shaft has a second curved portion that is the curved portion,
The first and second curved portions are curved in the same direction relative to the axial direction. 3. The transfer device according to claim 1 or 2,
a sheet-like second support portion including a second support surface capable of holding the medical sheet is provided at a tip portion of the second shaft;
The second support portion is movable relative to the support portion between a retracted position where it overlaps the support surface and an advanced position where it is positioned distally of the support surface. 3. The transfer device according to claim 1 or 2,
the support portion is formed by a flexible sheet having a front surface including the support surface and a back surface opposite to the front surface,
The support portion has a pair of protruding portions protruding upward from both sides of the support surface in a width direction perpendicular to a moving direction of the first shaft,
A transfer device in which, at the first position, the support portion is accommodated within the outer tube in a curved and deformed state such that both sides of the support portion in the width direction on the back surface are in contact with each other.

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