JP5219610B2 - Equipment for transporting and administering therapeutic substances - Google Patents

Description

  The present invention relates to a device for transporting and administering a sheet-like therapeutic substance to an affected area.

  In respiratory surgery, in order to reinforce a sutured part and prevent air leakage, a treatment in which a sheet-like (fabric) substance made of a biodegradable and absorbable material such as polyglycolic acid is attached to an organ is performed. Further, as in Non-Patent Document 1, a treatment technique for culturing and regenerating a patient's own cells into a sheet and transplanting the cell sheet to an affected area has also been proposed. In recent years, endoscopic surgery has been widely used as a minimally invasive surgical method for the human body, and endoscopic forceps are mainly used as a means for transporting and administering the above-mentioned sheet-like therapeutic substance. I came.

However, advanced techniques are required to transport a fragile or self-adhering sheet-like therapeutic substance to the affected area with forceps and accurately transplant it, and improvement in workability has been desired. . Therefore, the applicant applies to the elastically deformable sheet support that supports the sheet-like therapeutic substance, by changing the fluid pressure of the fluid supplied to the inside, into a flat deployed shape and a cylindrical storage shape. The therapeutic substance delivery administration device which performs a deformation | transformation operation | movement and the bending operation | movement of a base end part was proposed (patent document 1).
"Trial of cell sheet closure for intraoperative air leak" Japanese Society of Regenerative Medicine, 3rd Annual Meeting of Japan Society of Regenerative Medicine, 2003 Japanese Patent Application No. 2007-10452

  The transport and administration device of Patent Document 1 is required to provide a fine fluid flow path inside the sheet support and to strictly manage the flow of the fluid because of its structure, improving the production cost and reliability during driving. There was room for. Accordingly, an object of the present invention is to provide a transport administration device that can be obtained at low cost as compared with the prior art, has excellent reliability, and can easily and reliably administer a sheet-like therapeutic substance to an affected area. .

In one aspect, the therapeutic substance delivery administration device of the present invention comprises a cylindrical outer cylinder, a slide member supported so as to be slidable in the axial direction in the outer cylinder, and a sheet-like therapeutic substance. It is supported and provided at the tip of the slide member, and in a free state protruding from the tip of the outer cylinder, it is maintained in a flat developed shape and moves inward of the outer cylinder according to the sliding movement of the slide member is possess a seat support member that is housed in the outer tube while being deformed in contact with the tubular at the distal end of the outer cylinder when the sheet supporting member in the radial direction of the outer cylinder relative to the slide member It is detachable and, in a normal use state, is provided with a movement restricting means for restricting a movable range of the slide member within a range in which attachment / detachment of the sheet support member is restricted by an inner peripheral surface of the outer cylinder . .

  The sheet support member has a support surface portion for supporting the sheet-like therapeutic substance, and a width gradually changing portion that gradually narrows the lateral width from the support surface portion toward the connection portion with the slide member, and protrudes from the outer cylinder. When the sheet is moved from the developed state toward the inside of the outer cylinder, the sheet supporting member may be deformed into a cylindrical shape by contact between the gradually changing width portion and the tip of the outer cylinder. In this case, if an inclined end surface that is not parallel to a plane orthogonal to the axis of the outer cylinder is formed at the tip of the outer cylinder, the sheet support member can be easily deformed into a cylindrical shape.

In another aspect, the therapeutic substance delivery administration device of the present invention comprises a cylindrical outer cylinder, a slide member supported so as to be slidable in the axial direction in the outer cylinder, and a sheet-like therapeutic substance. It is supported and provided at the tip of the slide member, and in a free state protruding from the tip of the outer cylinder, it is maintained in a flat developed shape and moves inward of the outer cylinder according to the sliding movement of the slide member And a sheet support member that is accommodated in the outer cylinder while deforming into a cylindrical shape while abutting on the tip of the outer cylinder, and inside the outer cylinder that supports the sheet support in the outer cylinder By forming the partition wall portion that increases the surface area of the sheet, it is possible to accommodate a wider sheet support member.

  A connection member provided between the sheet support member and the slide member, and the sheet support member is deployed in a planar shape substantially parallel to the axis of the outer cylinder in a deployed state protruding from the outer cylinder. Can be supported. Or you may make a connection member support a sheet | seat support member so that it may become a planar shape inclined with respect to the axis line of this outer cylinder in the expansion | deployment state protruded from an outer cylinder.

  If the sheet support member is wider than the inner peripheral length of the outer cylinder and part of it overlaps when it is in the cylindrical storage shape, the shape of the sheet support member in the deployed state should be parallel to the axis of the outer cylinder. By making the shape asymmetric with respect to the center line passing through the connecting portion with the slide member, it is possible to prevent the overlapping portion from interfering and smoothly store it. Specifically, the seat support member may have an asymmetric shape in a partial region on the base end side connected to the slide member, or the whole from the base end side connected to the slide member to the front end portion is asymmetric. Any shape may be used.

  According to the therapeutic substance delivery administration device of the present invention above, the sheet support member is formed into a cylindrical shape and stored in the outer cylinder, thereby reducing the degree of invasion to the human body and performing the sheet-shaped treatment up to the transplantation site. Can transport materials. And, since the sheet support member is restored to a flat deployed shape by its shape maintaining property by simply pushing the slide member in the protruding direction when reaching the transplant site, compared to the conventional method using forceps, The transplantation of the sheet-like therapeutic substance can be performed very easily and reliably. This transport administration device of the present invention has a simple structure in which a flexible sheet support is deformed into an expanded state and a cylindrical storage state in accordance with the forward and backward movement of the slide member in the outer cylinder. Therefore, there is little risk of malfunctions such as malfunctions, and manufacturing costs can be kept low.

  A transport administration device 10 of the present embodiment whose entire structure is shown in FIGS. 1 to 4 includes a hollow cylindrical outer cylinder 11, a slide member 12 slidably supported in the outer cylinder 11, and the slide member. 12 is provided with a sheet support (sheet support member) 13 provided at the front end portion. In the following description, “axial direction” and “radial direction” mean an axial direction (longitudinal direction) and a radial direction of the outer cylinder 11. A grip portion 14 having a pair of finger-hanging flanges 14a spaced apart in the axial direction is provided at one end portion of the outer cylinder 11, and the slide member 12 has a ring shape at the end portion protruding from the grip portion 14 side. Is provided. When sliding the slide member 12 with respect to the outer cylinder 11, the index finger and the middle finger are sandwiched between the pair of finger-hanging flanges 14a, the thumb is inserted into the finger-hanging portion 15, and the slide member 12 is moved by the operation of the thumb. The operability is good. The other end portion of the outer cylinder 11 is an inclined end surface 11 a that is inclined with respect to a plane P (indicated by a one-dot chain line in FIG. 8) orthogonal to the axis of the outer cylinder 11. The inclination angle of the inclined end surface 11a with respect to the plane P is about 30 degrees. The inclined end surface 11a is chamfered and has a smooth tip shape.

  As shown in FIG. 6, an O-ring 16 is provided between the inner peripheral surface of the outer cylinder 11 and the slide member 12. The O-ring 16 has a function of preventing air leakage from passing through the outer cylinder 11 to the outside space during use of the delivery device 10 and a function of giving appropriate resistance to the sliding operation of the slide member 12. And a function of preventing the slide member 12 from falling over the outer cylinder 11 (maintaining concentricity). Although only one O-ring 16 is shown in FIG. 6, a plurality of O-rings may be provided at different positions in the axial direction of the outer cylinder 11. Further, an O-ring similar to the O-ring 16 may be provided between the outer peripheral surface of the connecting member 17 described later and the inner peripheral surface of the outer cylinder 11.

  The sheet support 13 is a flexible thin plate-like body, and a sheet support surface portion 13a that supports the sheet-like therapeutic substance 30 (hereinafter referred to as the sheet 30) shown in FIGS. 1, 7, and 11; It has a connecting portion 13b located at the base end portion of the sheet supporting surface portion 13a and a width gradually changing portion 13c that gradually decreases in width from the sheet supporting surface portion 13a toward the connecting portion 13b. The width gradually changing portion 13c has a pair of side edge portions that are substantially symmetrical with respect to the axis of the outer cylinder 11, and each side edge portion is a convex arc portion (continuous to the sheet supporting surface portion 13a). (R surface) and a concave arc portion (R surface) following the connecting portion 13b. In a free state in which no external force is applied, the sheet support 13 is maintained in a shape in which the sheet support surface portion 13a is flattened as shown in FIGS.

  The sheet support 13 and the slide member 12 are connected via a connection member 17. As shown in FIGS. 8 to 10, the connecting member 17 has two screw holes 17 a, an insertion groove 17 b, and a fitting step portion 17 c in order from the tip end side, and moves apart on the fitting step portion 17 c. A restricting projection 17d is formed. A support plane 17e that is substantially parallel to the axis of the outer cylinder 11 is formed in the formation region of the screw hole 17a. Two through holes 13d are formed in the connection portion 13b of the sheet support 13 so as to overlap the two screw holes 17a of the connection member 17, and the end portion of the connection portion 13b can be engaged with the insertion groove 17b. A terminal bent portion 13e is formed by bending. When the terminal bending portion 13e is engaged with the insertion groove 17b and the connection portion 13b is placed on the support plane 17e, the two through holes 13d are positioned so as to overlap the two screw holes 17a. Here, the seat support 13 and the connecting member 17 are fixed by screwing the fixing screws 20 into the screw holes 17a through the through holes 13d. Alternatively, the sheet support 13 and the connection member 17 may be fixed by press-fitting a pin instead of the fixing screw 20.

  The front end of the slide member 12 is a fitting step portion 12a that fits into the fitting step portion 17c of the connection member 17, and the fitting step portion 12a is spaced with a shape in which the separation movement restricting projection 17d is fitted. A movement restricting recess 12b (only a cross section is shown in FIG. 8) is formed. As shown in FIG. 9, the separation movement restricting protrusion 17 d provided on the connection member 17 is a trapezoidal protrusion that gradually increases in width from the distal end side of the slide member 12 toward the proximal end side (finger holding portion 15 side). is there. Therefore, the relative movement of the slide member 12 and the connection member 17 in the direction away from each other in the axial direction is restricted by the fitting relationship between the separation movement restriction recess 12b and the separation movement restriction protrusion 17d. On the other hand, the fitting step portion 12a and the fitting step portion 17c regulate relative movement of the slide member 12 and the connection member 17 in a direction approaching each other in the axial direction by the contact relationship between the end faces. That is, the slide member 12 and the connection member 17 are coupled so as not to move relative to either the forward or reverse axial direction. This connection structure can be released by a relative movement in the radial direction.

  As shown in FIG. 6, the outer cylinder 11 and the grip portion 14 have screw holes that communicate with each other, and are integrated by screwing a slide control screw 22 into the screw holes. In addition to the function of fixing the outer cylinder 11 and the grip portion 14, the slide control screw 22 also functions as a movement limiting unit that controls the amount of movement of the slide member 12 in the axial direction.

  The distal end portion of the slide control screw 22 is engaged with a regulation groove (movement restriction means) 12 c that protrudes from the inner circumferential surface of the outer cylinder 11 and is formed on the outer circumferential surface of the slide member 12. As shown in FIG. 5, the regulation groove 12 c includes a first linear groove portion 12 c-1 that is long in the axial direction of the outer cylinder 11, and a circumferential groove whose one end communicates with the first linear groove portion 12 c-1. A portion 12c-2 and a second linear groove portion 12c-3 formed in the axial direction of the outer cylinder 11 from the other end portion of the circumferential groove portion 12c-2 toward the finger hooking portion 15; It is a crank-shaped groove. FIG. 6 shows a state in which the slide control screw 22 is abutted against the terminal end portion of the first linear groove portion 12c-1 of the restricting groove 12c, that is, the circumferential groove portion 12c-2. The axial movement of the slide member 12 in the direction toward the distal end portion of the outer cylinder 11 is further restricted. In this slide regulation state, the connecting portion of the slide member 12 and the connection member 17 is at a position surrounded by the inner peripheral surface of the outer cylinder 11 as shown in FIGS. As described above, relative movement of the connecting member 17 with respect to the slide member 12 is restricted in the axial direction of the outer cylinder 11 (left-right direction in FIG. 8), and the radial direction of the outer cylinder 11 (up-down direction in FIG. 8). However, in the state of FIG. 8, the relative movement of the connecting member 17 and the slide member 12 in the radial direction is restricted by the inner peripheral surface of the outer cylinder 11. That is, in the normal use state where the slide control screw 22 is positioned in the first linear groove portion 12c-1 of the restriction groove 12c, the slide member 12 and the connecting member 17 are not disassembled.

  As shown in FIG. 6, the outer cylinder 11 and the slide member 12 are moved relative to each other from the state in which the slide control screw 22 is in contact with the terminal end portion (circumferential groove portion 12c-2) of the first linear groove portion 12c-1 of the restriction groove 12c. If the second linear groove portion 12c-3 in the restricting groove 12c and the circumferential phase of the slide control screw 22 coincide with each other, the slide member 12 is slid further in the projecting direction than the positions in FIGS. It becomes possible to make it. Then, the restriction by the outer cylinder 11 is released, and the connection member 17 can be detached from the slide member 12 as shown in FIG. Further, if the slide control screw 22 is removed, the outer cylinder 11, the slide member 12, and the grip portion 14 can be disassembled.

  In addition, although the slide control screw 22 shown in FIG. 6 is a screw formed in the whole axial part, the screw is not formed in the front-end | tip part engaged with the slide member control groove | channel 12c, for example. You can also Thus, the smoothness when the slide member 12 slides can be improved by making the sliding part for slide guidance into a smooth surface.

  FIG. 11 shows a state in which the slide member 12 is pushed out to the maximum protruding position (forward movement end) in the normal use state due to the relationship between the restriction groove 12c (first linear groove portion 12c-1) and the slide control screw 22 described above. In this state, the sheet support 13 is projected from the tip of the outer cylinder 11, and the sheet support surface portion 13a is developed in a flat shape due to its shape maintenance. The unfolded sheet support 13 has a width wider than the inner diameter size of the outer cylinder 11. When the slide member 12 is slid in the pull-in direction indicated by the arrow S1 from the state shown in FIG. 11, the width gradually changing portion 13c of the sheet support 13 contacts the inclined end surface 11a of the outer cylinder 11 as shown in FIG. Then, due to the respective inclined shapes of the inclined end surface 11a and the width gradually changing portion 13c, a component force F (FIG. 12) is generated that tries to round the sheet support 13 into a cylindrical shape from the moving force in the axial direction of the slide member 12. At this time, the inner surface of the sheet support 13 which is going to be cylindrical becomes a support surface for supporting the sheet 30. Specifically, what is visible in FIGS. 11 and 12 is the support surface of the sheet 30, and what is visible in FIGS. 1, 3, and 7 is the back surface opposite to the support surface. . 4 and 8, the lower surface in the figure of the sheet support 13 is the support surface of the sheet 30, and the upper surface in the figure is the back surface thereof.

  When the retracting operation of the slide member 12 is continued from the state of FIG. 12, the sheet support 13 changes the shape of the inner peripheral surface of the outer cylinder 11 according to the movement of the slide member 12 as shown in order in FIGS. 13 and 14. And is housed in the outer cylinder 11 while being rounded into a cylindrical shape. In the stage of FIG. 13, the width gradually changing portion 13 c is still in contact with the inclined end surface 11 a, and a component force is applied to round the sheet support 13 into a cylindrical shape according to the axial movement force of the slide member 12. Yes. When the stage of FIG. 14 is reached, the width gradually changing portion 13c is housed in the outer cylinder 11. At this time, at the front end portion of the outer cylinder 11 (opening portion of the inclined end surface 11a), the sheet supporting surface portion 13a The two side portions are brought close to each other, and the sheet support 13 has been substantially deformed into a cylindrical shape. Therefore, even if the slide member 12 is slid in the retracting direction from the state shown in FIG. The support body 13 is housed in the outer cylinder 11 while being gradually rounded into a cylindrical shape toward the tip end side of the sheet support surface portion 13a without being caught between the support body 13 and the inclined end surface 11a. Since the inclined end surface 11a of the outer cylinder 11 is chamfered to eliminate a sharp portion, there is no possibility that the sheet support 13 is damaged due to contact with the inclined end surface 11a during the above storage operation.

  FIG. 15 shows a state in which the entire sheet support 13 is housed in the outer cylinder 11, and the sheet support 13 is deformed into a cylindrical shape along the inner peripheral surface of the outer cylinder 11. The width of the sheet support 13 is determined so that parts of the sheet support 13 do not overlap in this cylindrical storage state. Specifically, when the inner cylinder 11 has an inner diameter of 9.5 mm, and the lateral width of the sheet support 13 is about 28 mm, the outer cylinder 11 has a cylindrical shape along the inner peripheral surface without overlapping. Can be stored.

  Contrary to the above storage, when the slide member 12 is slid in the protruding direction indicated by the arrow S2 from the storage state of FIG. 15, the sheet support 13 gradually moves the portion protruding from the outer cylinder 11 due to its shape recoverability. It expands in the plane direction and deforms to the state of FIG. 14, the state of FIG. 13, and the state of FIG. Then, when the slide member 12 is moved to the maximum projecting position in FIG. 11, the width gradually changing portion 13c is separated from the inclined end surface 11a, the shape restriction on the sheet support 13 by the outer cylinder 11 is released, and the free state is entered. The sheet support surface portion 13a is developed in a planar shape.

  As shown in FIG. 4, the position of the sheet support 13 in the radial direction of the outer cylinder 11 is preferably decentered as much as possible in the direction opposite to the direction of bending deformation into the cylindrical shape (downward in FIG. 4). That is, when the sheet support 13 is positioned below the position of FIG. 4, for example, below the center axis position of the outer cylinder 11, the sheet support 13 is curved and deformed into a cylindrical shape in the outer cylinder 11. When it is going to be stored, there is a possibility that it will be caught between the outer cylinder 11 and can only be stored halfway. Or the width | variety of the sheet | seat support body 13 which can be accommodated in the outer cylinder 11 will become narrow. On the other hand, as shown in FIG. 4, the sheet support 13 is positioned close to the radially inner edge (upward in FIG. 4) of the outer cylinder 11 on the side opposite to the bending direction, thereby smoothly causing no interference. The sheet support 13 can be stored in the outer cylinder 11, and the width of the sheet support 13 that can be stored in the outer cylinder 11 can be increased.

  As described above, the sheet support 13 is deformed into a flat developed shape and a cylindrical shape in accordance with the forward / backward movement of the slide member 12, and is developed into a flat shape when projected from the outer cylinder 11. It has a shape maintenance (restoration) property. For example, the sheet support 13 having the shape maintaining property as described above can be obtained by using a resin film having an appropriate thickness made of a material such as polypropylene, acrylic resin, polyethylene terephthalate, or polyethylene. Alternatively, the sheet support 13 can be formed of a thin metal plate such as silicon rubber, a superelastic alloy, or a shape memory alloy. Further, the shape of the sheet support 13 can be configured as a net (metal mesh) instead of a thin plate as shown. The flexibility (hardness) of the sheet support 13 can be arbitrarily set by changing its material and thickness, but as an example, when the sheet support 13 is formed of the resin film as described above, The thickness is preferably about 50 to 500 μm.

  Further, the sheet support surface portion 13a of the sheet support 13 is subjected to a surface treatment for stably holding the sheet 30. The surface treatment can take various forms. For example, a surface material that frictionally engages with the sheet 30 is coated on the surface of the sheet support surface portion 13a, or an adhesive layer having a relatively weak adhesive force is provided on the sheet support surface portion 13a. Or better. In particular, when the sheet 30 is a fibrous therapeutic substance, it is useful to attach a fiber layer to the sheet support surface portion 13a. Since the fibers on the sheet support surface portion 13a side and the fibers on the sheet 30 side are entangled, the sheet 30 can be temporarily fixed with such a strength that there is no fear of dropping during transportation, and it is easy without causing damage during transplantation. In addition, the sheet 30 can be detached from the sheet support surface portion 13a. Alternatively, it is also possible to form a cut in a part of the sheet support surface portion 13a and prevent the dropout by physically sandwiching a part of the sheet 30 during transportation. In any manner, the sheet 30 is not inadvertently dropped from the sheet support 13 at the time of transportation, and at the time of transplantation, the sheet 30 can be detached from the sheet support surface portion 13a and reliably transplanted to the affected part side. Is set to have. As a configuration for facilitating separation of the sheet 30 from the sheet support surface portion 13a at the time of transplantation, for example, a fine hole is formed in the sheet support surface portion 13a, and physiological saline or the like is permeated through the hole to support the sheet. A configuration may be adopted in which a liquid layer is formed between the surface portion 13a and the sheet 30 so that the sheet 30 can be easily peeled off.

  In consideration of convenience during use, the sheet support 13 is preferably transparent or translucent. If it is transparent, the state of the sheet 30 supported on the sheet support surface portion 13a can be observed even from the back side. Further, during the sheet transplanting operation, the position of the affected part can be visually recognized through the sheet support 13 and the sheet 30 can be easily aligned.

  In addition to the holding function for the sheet 30 and the color setting, the sheet support 13 can be provided with various functions depending on the application. For example, a coating that improves the lubricity of the portion in sliding contact with the outer cylinder 11 can be applied, or the water repellency of the surface can be changed depending on the choice of material and coating. In addition, the sheet support surface portion 13a of the sheet support body 13 of the present embodiment is substantially rectangular in the unfolded state, but the shape of the sheet support surface portion is not limited to a rectangle, and the shape of the sheet to be supported and supported Depending on the shape, any shape can be obtained.

  The delivery device 10 having the above structure is used as follows. In the transport administration device 10 of the present embodiment, the combination of the sheet support 13 and the connection member 17 constitutes a detachable part that can be detached from the slide member 12, and this detachable part is replaced with a new one every time it is used. Is done. On the other hand, the main body portion including the outer cylinder 11 and the slide member 12 is formed of a material (stainless steel or the like) having a strength and a structure that can withstand repeated use, and is sterilized after use, and then re-used. May be used. As a result, it is possible to reduce the operating cost while reducing the number of disposable parts and taking environmental measures.

  The detachable part having the sheet support 13 is sterilized and packed with the sheet 30 placed on the sheet support surface part 13a, and is taken out from the package and used at the tip of the slide member 12 via the connecting member 17 in use. It is attached. At the time of attachment, the slide member 12 is held at the disassembling position that protrudes from the maximum protruding position in the normal use state described above. At this time, the slide control screw 22 is located in the second linear groove portion 12c-3 which is a disassembling region in the restriction groove 12c. When the attachment of the detachable part is completed, the slide member 12 is slid in the pull-in direction. Then, since the slide control screw 22 abuts on the circumferential groove portion 12c-2 of the restriction groove 12c, the slide member 12 is rotated by a predetermined angle, and the rotation phase of the slide control screw 22 is set to the normal use of the restriction groove 12c. It is made to correspond with the 1st linear groove part 12c-1 which is an area | region. This state is the state shown in FIG. 1, FIG. 3, FIG. 4, FIG. When the slide member 12 is further slid in the pull-in direction, the width gradually changing portion 13c comes into contact with the inclined end surface 11a of the outer cylinder 11, and the sheet support 13 is rolled into a cylindrical shape in the outer cylinder 11 as described above. It is stored (FIGS. 12 to 15). At this time, since the sheet 30 is supported on the inner surface of the sheet support surface portion 13a that is closed in a cylindrical shape, the sheet 30 does not contact or rub against the inner wall of the outer cylinder 11, and the sheet 30 can be prevented from being damaged. it can. As shown in FIG. 2, when the sheet support 13 is completely stored in the outer cylinder 11, the sheet 30 is protected by the outer cylinder 11. Since the sheet support 13 is stored in the outer cylinder 11 so as not to be doubled, the sheet 30 supported on the sheet support 13 is also held in a stable shape without causing damage due to rubbing. The

  Next, the transport administration device 10 is inserted into the body while the sheet support 13 is kept in the outer cylinder 11. More specifically, the outer cylinder 11 is inserted through a trocar previously inserted into the body during laparoscopic surgery or thoracoscopic surgery. At this time, since the distal end portion of the outer cylinder 11 is an inclined end surface 11a, it is easy to perform an insertion operation. When the distal end portion of the outer cylinder 11 reaches the vicinity of the site to be transplanted (affected part) in the body, the slide member 12 is slid in the protruding direction (the distal end direction of the outer cylinder 11). Then, according to the above-described procedure, the sheet support 13 protrudes from the distal end of the outer cylinder 11 to restore the shape, and the sheet support surface portion 13a that supports the sheet 30 is developed in a planar shape as shown in FIG. At this time, even if the slide member 12 is moved to the maximum protruding position in the normal use state, the combined body of the sheet support 13 and the connection member 17 does not come off from the slide member 12, so that the sheet support 13 and the connection member 17 are brought into the body. There is no risk of dropping off.

  Subsequently, the direction of the delivery device 10 is adjusted so that the sheet 30 faces the transplant target site, and the sheet support surface portion 13a of the sheet support 13 is pressed against the transplant target site. Then, the sheet 30 leaves the sheet support surface portion 13a and is transplanted to the transplant target site. As described above, the surface of the sheet support surface portion 13a is subjected to a surface treatment that holds the sheet 30 with a holding force that does not drop off during transportation and does not hinder transplantation. By pressing with force, the sheet 30 can be detached from the sheet support surface portion 13a and reliably transplanted to the site to be transplanted. Moreover, since the sheet | seat support body 13 has a softness | flexibility, it can deform | transform somewhat flexibly and can respond | correspond to the shape of the sheet | seat 30 also with respect to a non-planar transplant object site | part.

  The transplantation of the sheet 30 may be performed in a different manner as well as simply pressing the sheet support surface portion 13a against the transplantation target site. As an example, the length of the sheet 30 is set so as to slightly protrude from the leading end of the sheet support surface portion 13a when the sheet support 13 supports the sheet 30. Then, in a state where the sheet support 13 is expanded and the sheet 30 is brought into contact with the site to be transplanted, the portion protruding from the front end of the sheet support surface portion 13a of the sheet 30 is pressed with forceps or the like, and separated from the sheet protruding portion. Thus, when the sheet support 13 is slid in the plane direction of the sheet support surface portion 13a (toward the connection portion 13b), the sheet 30 sticks to the transplant target site. This transplantation technique is useful for the type of sheet 30 that produces a surface tension of water and adhesiveness due to self-dissolution when exposed to moisture.

  When the transplantation of the sheet 30 is completed, the slide member 12 is slid in the retracting direction, the sheet support 13 is accommodated in the outer cylinder 11 as shown in FIGS. 2 and 15, and the delivery device 10 is pulled out from the body. Even if the sheet support 13 is pulled out without being stored in the outer cylinder 11, the trocar functions in the same manner as the outer cylinder 11 and the sheet support 13 is deformed into a cylindrical shape. The delivery device 10 can be pulled out from the body without causing damage. After pulling out, the slide member 12 is slid to the disassembly position, and the seat support 13 and the connection member 17 are removed from the slide member 12. When further transplantation (treatment) is required, a new attachment / detachment portion having the sheet support 13 is attached and the treatment is performed again.

  As described above, according to the transport administration device 10 of the present embodiment, the sheet 30 is stored in the outer cylinder 11 in a cylindrical shape, and the sheet 30 is transported to the transplant site by insertion of the outer cylinder 11. The degree of invasion to the human body can be reduced compared to the method of transporting 30 in a deployed state. When the transplant site is reached, the sheet support 13 supporting the sheet 30 is automatically deployed by pushing out the slide member 12 in the protruding direction, so that the conventional method using forceps or the like is used. Compared to the above, the sheet 30 can be transplanted extremely easily and reliably. The delivery device 10 has a simple structure in which the flexible sheet support 13 is deformed into an expanded state and a cylindrical storage state in accordance with the forward and backward movement of the slide member 12 in the outer cylinder 11. Therefore, there is little risk of malfunctions such as malfunctions. In addition, since the number of components is small and individual components can be formed from inexpensive materials, the manufacturing cost can be kept low.

16 and 17 show another embodiment that can support a wider sheet of therapeutic substance. In this embodiment, a partition wall portion 111 b that protrudes from the inner peripheral surface toward the inner diameter direction is formed inside the outer cylinder 111. The distal end portion of the outer cylinder 111 is an inclined end surface 111a, and when the sheet support 113 is stored in the outer cylinder 111, the width gradually changing portion 113c comes into contact with the inclined end surface 111a and gradually becomes cylindrical. The basic structure is the same as in the previous embodiment. In the previous embodiment, the width of the sheet support surface portion 13a of the sheet support 13 is set to be the outer cylinder 11 in order to prevent an overlapping portion from being generated in the cylindrical sheet support 13 accommodated in the outer cylinder 11. It was set below the inner circumference size. On the other hand, in the outer cylinder 111, since the support area for the sheet support 113 ( surface area inside the outer cylinder that supports the sheet support ) is increased by providing the partition 111b, as shown in FIG. The sheet support 113 having the sheet support surface 113a wider than the simple inner peripheral size of the cylinder 111 can be stored without causing overlap.

  In the previous embodiment, the sheet support surface portion 13a has a planar shape substantially parallel to the axis of the outer cylinder 11 when the sheet support 13 is deployed, but the angle of the sheet support during deployment is arbitrarily set. can do. FIG. 18 shows an example thereof. The connection member 217 that can be attached to and detached from the slide member 12 via the fitting step 217c and the separation movement restricting projection 217d is composed of two members, a support block 217A and a holding block 217B. . The support block 217A and the pressing block 217B are fixed via screws 220 that are screwed into the screw holes 217a. An inclined support plane 217e that is inclined with respect to the axis of the outer cylinder 11 is formed between the support block 217A and the holding block 217B, and the seat support 213 has a connecting portion 213b mounted on the inclined support plane 217e. In this state, it is held by being sandwiched between the support block 217A and the holding block 217B. Since the sheet support surface portion 213a of the sheet support 213 is positioned on the extension of the inclined support plane 217e, the sheet support surface portion 213a in the unfolded state has an inclination angle of the inclined support plane 217e with respect to the axis of the outer cylinder 11. A corresponding predetermined slope is provided.

As described above, in the embodiment of FIGS. 16 and 17, the partition wall portion 111 b is formed to increase the surface area for supporting the sheet support inside the outer tube 111, so that the simple inner periphery of the outer tube 111 is formed. The sheet support 113 wider than the length can be securely stored in the outer cylinder 111. On the other hand, an embodiment in which a wide sheet support can be smoothly stored by setting the shape on the sheet support side is shown in FIG. 19 and subsequent figures.

  19 and 20 is supported by the distal end portion of the slide member 312 via the connection portion 313b, and when the seat support member 313 is housed in the outer cylinder 311, the width gradually changing portion with respect to the inclined end surface 311a. The basic structure in which 313c abuts and gradually becomes cylindrical is the same as the previous embodiment. The sheet support 313 is characterized in that it has an asymmetric shape with respect to the center line C of the sheet support 313 that is parallel to the axis of the outer cylinder 311 and passes through the connecting portion 313b with the slide member 312. This asymmetrical shape part is formed in the base end side region of the sheet support 313 from the width gradually changing part 313c to both edges (side parts) of the sheet support surface part 313a, and as shown in FIG. In contrast to one normal shape portion K1 that is located across C, the other is a narrow shape portion K2 that is partially cut away.

  The width in the left-right direction of the sheet support 313 is larger than the inner peripheral length of the outer cylinder 311, and when the sheet support 313 is formed in a cylindrical storage shape, partial areas near both edges of the sheet support surface 313a are Overlapping state. Here, if the sheet support 313 has a symmetrical shape with respect to the center line C, when the sheet support 313 is deformed into a cylindrical shape, both edge portions (edge portions) of the sheet support surface portion 313a interfere with each other, and are caught smoothly. May be hindered. On the other hand, in the case of the sheet support body 313 having the left and right asymmetric base end side shapes of the normal shape portion K1 and the narrow shape portion K2, as shown in FIG. Since the deformation is performed in such a manner that the edge portion on the narrow shape portion K2 side sinks into the lower side (inside) of the normal shape portion K1, there is no possibility that both edge portions of the sheet support surface portion 313a interfere with each other. Therefore, the sheet support 313 wider than the inner peripheral length of the outer cylinder 311 can be smoothly accommodated in the outer cylinder 311.

  FIG. 21 shows a sheet support having a left-right asymmetric shape with respect to a center line C parallel to the axis of the outer cylinder 411 and passing through the connecting portion 413b, similar to the sheet support 313 of FIGS. 413 is shown. Whereas the previous sheet support 313 has an asymmetrical shape only on the base end side, this sheet support 413 supports the sheet from the base end side connected to the slide member 412 to the front end. The difference is that the entire surface portion 413a has an asymmetric shape. That is, the sheet support 413 has a shape having a wide portion H1 and a narrow portion H2 having different widths with the center line C interposed therebetween. When the sheet support 413 having this shape is accommodated in the outer cylinder 411 while being formed into a cylindrical shape due to the contact relationship between the inclined end surface 411a and the gradually changing width portion 413c, the narrow portion H2 is located below the wide portion H1. Since the deformation is performed in such a manner as to sink into the (inner side), there is no possibility that both edges of the sheet support surface portion 413a interfere with each other, and the sheet support body 413 that is wide with respect to the inner peripheral length of the outer cylinder 411 can be stored smoothly. Can be performed.

  In the sheet support 313 shown in FIGS. 19 and 20 and the sheet support 413 shown in FIG. 21, the gradual change portions 313c and 413c have edges of a substantially symmetrical shape (angle) across the center line C. However, by making the relative shapes (angles) of the left and right edge portions of the width gradually changing portion different, it is also possible to prevent interference between overlapping portions of both edges of the sheet support during storage.

  As mentioned above, although demonstrated based on illustration embodiment, this invention is not limited to illustration embodiment, It is possible to set it as a different form unless it deviates from the main point of invention. For example, in the illustrated embodiment, the sliding direction and the sliding amount of the slide member 12 are regulated by the engagement relationship between the crank-shaped regulation groove 12c and the slide control screw 22, but as a slide guide structure of the slide member 12, Other mechanical structures can also be used.

  In the illustrated embodiment, the grip operation unit for advancing and retracting the slide member 12 includes a grip unit 14 having a pair of finger-hanging flanges 14a and a finger-holding unit 15, and realizes the same operability as a syringe. Instead of this, it is also possible to use different types of grip operation units such as a so-called gun grip type.

It is a perspective view of the state which the sheet support body protruded from the front-end | tip of an outer cylinder, and was expand | deployed which shows one Embodiment of the delivery administration apparatus of the therapeutic substance by this invention. It is a perspective view which shows the conveyance administration instrument of the state which accommodated the sheet | seat support body in the outer cylinder. It is a top view of the conveyance administration apparatus in the protrusion expansion | deployment state of the sheet | seat support body of FIG. It is a side view of the conveyance administration apparatus in the protrusion expansion | deployment state of the sheet | seat support body of FIG. It is the fragmentary perspective view which expanded the grasping operation part vicinity of a conveyance administration instrument. It is side sectional drawing of the holding | grip operation part vicinity of a delivery administration apparatus. It is a perspective view near the front-end | tip part of the conveyance administration apparatus in the protrusion expansion | deployment state of the sheet | seat support body which showed a part of outer cylinder as a cross section. It is a sectional side view which shows the joint structure vicinity of a slide member and a connection member in the protrusion expansion | deployment state of a sheet | seat support body. It is a disassembled perspective view of the state which removed the coupling body of the connection member and the sheet | seat support body from the front-end | tip part of the slide member. It is a perspective view of the state which decomposed | disassembled the connection member and the sheet | seat support body. FIG. 6 is a partial perspective view of the vicinity of the outer cylinder tip, showing a state in which the sheet support protrudes from the tip of the outer cylinder and is developed in a planar shape when using the transport administration device. FIG. 12 is a partial perspective view of the vicinity of the front end of the outer cylinder showing a state in which the slide member is slightly moved in the retracting direction from the state of FIG. 11 and the sheet support starts to deform from the expanded state to the cylindrical state. FIG. 13 is a partial perspective view in the vicinity of a front end of the outer cylinder showing a state in which the slide member is moved in the retracting direction than in the state of FIG. FIG. 14 is a partial perspective view in the vicinity of a front end of the outer cylinder showing a state in which the slide member is further moved in the retracting direction from the state of FIG. 13 and the sheet support is deformed into the cylindrical state. FIG. 3 is a partial perspective view of the vicinity of a front end of the outer cylinder showing a state in which the entire sheet support is formed in a cylindrical shape and is housed inside the outer cylinder. It is a fragmentary perspective view of the outer cylinder vicinity showing the embodiment which provided the partition part in the outer cylinder and was able to accommodate a wide sheet | seat support body. It is sectional drawing of the state which accommodated the wide sheet | seat support body in the outer cylinder of FIG. FIG. 9 is a side sectional view of the vicinity of the coupling structure of the slide member and the connecting member, showing an embodiment in which the mounting angle of the sheet support is different from that of FIG. It is a perspective view of the unfolded state of a sheet support showing an embodiment in which the vicinity of the base end portion of the sheet support is formed asymmetrically left and right. FIG. 20 is a perspective view illustrating a state in the middle of deforming the left-right asymmetric sheet support of FIG. 19 into a cylindrical shape. It is a perspective view of the unfolded state of a sheet support showing an embodiment in which substantially the entire sheet support surface portion is formed asymmetrically left and right.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Delivery administration apparatus 11 Outer cylinder 11a Inclined end surface 12 Slide member 12a Fitting step part 12b Separation movement control recessed part 12c Control groove (movement restriction means)
13 Sheet Support (Sheet Support Member)
13a Seat support surface portion 13b Connection portion 13c Gradually varying portion 13d Through hole 13e Terminal bending portion 14 Grip portion 14a Finger hook flange 15 Finger hook portion 16 O ring 17 Connection member 17a Screw hole 17b Inserting groove 17c Fitting step portion 17d Separation movement restricting projection 17e Support plane 22 Slide control screw (movement limiting means)
30 Sheet-shaped therapeutic substance 111 Outer cylinder 111b Partition wall 113 Sheet support (sheet support member)
213 Sheet support (sheet support member)
217 Connecting member 217A Support block 217B Pressing block 217e Support plane 311 Outer cylinder 312 Slide member 313 Sheet support (sheet support member)
411 outer cylinder 412 slide member 413 sheet support (sheet support member)
C sheet support center line H1 wide portion H2 narrow portion K1 normal shape portion K2 narrow shape portion

Claims (9)

Cylindrical outer cylinder;
A slide member supported in the outer cylinder so as to be slidable in the axial direction; and a free member which is provided at the distal end portion of the slide member and supports the sheet-like therapeutic substance and protrudes from the distal end portion of the outer cylinder In the state, it is maintained in a flat developed shape, and when it is moved inward of the outer cylinder in response to the sliding movement of the slide member, it contacts the tip of the outer cylinder and deforms into a cylindrical shape A sheet support member housed in
The seat support member can be attached to and detached from the slide member in the radial direction of the outer cylinder, and in a normal use state, the slide member can be moved within a range that is restricted by the inner peripheral surface of the outer cylinder. A device for transporting and administering a therapeutic substance, characterized by comprising movement restriction means for restricting the area . Cylindrical outer cylinder;
  A slide member supported in the outer cylinder so as to be slidable in the axial direction; and
  A sheet-shaped therapeutic substance is supported to be provided at the distal end of the slide member, and in a free state protruding from the distal end portion of the outer cylinder, it is maintained in a flat unfolded shape and responds to the sliding movement of the slide member. A sheet support member that is accommodated in the outer cylinder while being deformed into a cylindrical shape while abutting against the tip of the outer cylinder when moved inwardly of the outer cylinder;
  A therapeutic substance delivery / administration device comprising a partition for increasing a surface area of an outer cylinder supporting a sheet support inside the outer cylinder. 3. The therapeutic substance delivery / administration device according to claim 1 or 2, wherein the sheet support member gradually supports a sheet-like therapeutic substance and a connection part between the support surface part and the slide member. And a width gradually changing portion that narrows the lateral width, and when moved in the inner direction of the outer cylinder from the expanded state, the sheet supporting member is moved by the contact between the width gradually changing portion and the distal end portion of the outer cylinder. A device for transporting and administering a therapeutic substance that is transformed into a cylindrical shape. 4. The therapeutic substance delivery / administration device according to claim 3, wherein an inclined end surface that is not parallel to a plane perpendicular to the axis of the outer cylinder is formed at a distal end portion of the outer cylinder. . The therapeutic substance delivery administration device according to any one of claims 1 to 4 , further comprising a connecting member interposed between the seat support member and the slide member, wherein the seat support member is projected from the outer cylinder. Thus, the therapeutic substance delivery / administration device supported by the connecting member so as to have a planar shape substantially parallel to the axis of the outer cylinder. The therapeutic substance delivery administration device according to any one of claims 1 to 4 , further comprising a connecting member interposed between the seat support member and the slide member, wherein the seat support member is projected from the outer cylinder. Then, the therapeutic substance delivery administration device supported by the connecting member so as to have a planar shape inclined with respect to the axis of the outer cylinder. 6. The therapeutic substance delivery / administration device according to any one of claims 1 to 5 , wherein the unfolded sheet support member is in relation to a center line passing through the connecting portion with the slide member in parallel with the axis of the outer cylinder. A therapeutic delivery device for a therapeutic substance having an asymmetric shape. 8. The therapeutic substance delivery / administration device according to claim 7, wherein the seat support member has a non-symmetrical shape in a partial region on the base end side connected to the slide member. . 8. The therapeutic substance delivery / administration device according to claim 7, wherein the sheet support member is entirely asymmetric from the proximal end side to the distal end part connected to the slide member. Administration device.

Images