JP2019187739A - Medical feeder - Google Patents

Abstract

To provide a medical feeder capable of reducing a burden applied to a medical worker and patient, and supplying and collecting a medical instrument or the like.SOLUTION: A first storage part 16 and a second storage part 26 on a medical feeder 100 are formed into a shape of a plurality of arcs on the same circle whose center is a center line C, and the storage parts are respectively divided into four parts along a peripheral direction. A linear mount object 70 is stored in the first storage part 16 and the second storage part 26. Then, the medical feeder 100 surely holds a tip of an endoscope 1, and is supplied with the endoscope 1 to a target part, and using a clamp 2 of the endoscope 1, the mount object 70 stored in the first storage part 16 and the second storage part 26 can be taken out. Therefore, by the medical feeder 100, supply and collection can be safely and quickly performed, a burden applied to the medical worker and patient can be reduced, as an effect.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical supply tool that is used during in-vivo examinations and surgery.

  When performing treatments and inspections (hereinafter sometimes referred to as “treatments”) on target parts in the body, medical instruments such as electric scalpels, medical materials such as gauze, drugs and tissues (hereinafter “medical instruments, etc.”) Need to be supplied to the target site or collected from the target site. For example, when an endoscope is inserted into the body from the lumen or the abdominal cavity and a treatment is performed on the target site, the operation wire of the endoscope needs to be taken in and out each time. When inserting and removing the operation wire etc. of this endoscope, the medical staff must carefully perform complicated work, so it takes a very long time compared to the time to actually perform treatment on the target site. In some cases, there is a risk of prolonging the time of treatment and increasing the burden on the patient.

  Patent Document 1 discloses that a flake-shaped or sheet-shaped medical material is accommodated in a cylindrical treatment instrument and supplied to an affected area.

JP-A-2006-214759

  However, in Patent Document 1, in order to adjust the shape and position of the medical material supplied from the treatment tool to the periphery of the affected area, it is necessary to supply the endoscope to the affected area after the treatment tool is once pulled out of the body. Yes, it did not reduce the burden on healthcare professionals and patients.

  Then, the objective of this invention is providing the medical supply tool which can reduce the burden of a medical worker and a patient, and can supply and collect | recover medical instruments etc.

  In order to solve the above-described problem, the medical supply device of the present invention has a substantially cylindrical shape having a predetermined thickness, and includes a main body having an opening cut in an axial direction, and the main body includes the opening. An endoscope is detachably sandwiched through a portion, and a housing portion in which one end side in the axial direction is closed and the other end side is opened between the inner wall and the outer wall of the main body portion in the circumferential direction and / or the radial direction. Are provided along the line.

  Further, the medical supply device may be characterized in that the main body portion is provided with a fixing means capable of closing the opening in a state where the endoscope is held.

  Further, the medical supply tool is characterized in that the fixing means is a fixing pin for fixing adjacent circumferential ends of the main body when the opening is closed. Also good.

  Further, the medical supply device is rotated by energizing the main body portion in a direction in which the opening is widened in a substantially line symmetrical position with the fixing means sandwiching the central axis of the main body portion in the closed state. It is good also as what is provided with the rotation means to make it come.

  The medical supply device may be characterized in that one end side in the axial direction of the main body portion has a streamline shape.

  Further, in the medical supply device, the cross-sectional shape of the housing portion viewed from the axial direction is at least one of an arc shape, a fan shape, a circular shape, an elliptical shape, a C shape, and a polygonal shape. It is good also as what to do.

  The medical supply device may be characterized in that a cover member for sealing the opening on the other end side in the axial direction of the housing portion is provided on the main body portion.

  Further, the medical supply device may be characterized in that the storage part is provided with a holding means for holding an object to be stored.

  Further, the medical supply device may be characterized in that the holding means is a gel-like substance and / or a reduced diameter portion provided in the housing portion.

  The medical supply device may be characterized in that first and second gripping portions are provided on the outer wall on one end side and the other end side.

  According to the medical supply device of the present invention, it is possible to reduce the burden on medical staff and patients, and to supply and collect medical devices and the like.

It is a perspective view in the closed state which shows an example of the medical supply tool which concerns on the 1st Embodiment of this invention, (a) It is the state seen from the front-end | tip part side, (b) The state seen from the rear-end part side FIG. It is the perspective view in the open state of the medical supply tool shown by FIG. 1, (a) The state seen from the front-end | tip part side, (b) It is the state figure seen from the rear-end part side. It is a figure (a plurality of circular arc shape on the same circumference) showing the medical supply tool shown in FIG. 1, (a) a rear view in an unaccommodated state, (b) a rear view in an accommodated state, c) It is a front view of an unaccommodated state, (d) It is a side view of an unaccommodated state. It is a perspective view which shows an example of the load mounted in the medical supply tool shown by FIG. 1, (a) It is a whole perspective view of a load, (b) It is an enlarged perspective view of the broken-line part in (a). is there. It is the schematic explaining the bunker method of an example using the medical supply tool shown by FIG. 1, (a) It is the state before mounting | wearing an endoscope with a medical supply tool, (b) Medical supply It is a figure which shows the state which mounted | worn the tool with the endoscope. It is the schematic explaining the bunker method of an example using the medical supply tool shown by FIG. 1, (a) It is the state which inserted the medical supply tool into the digestive organ cavity with the endoscope, (b) Medical It is a figure which shows the state which removed and fixed the supply tool from the endoscope. It is the schematic explaining the bunker method of an example using the medical supply tool shown by FIG. 1, (a) The state which takes out a bunker needle with forceps, (b) The bunker needle is stabbed in the predetermined site | part of a tumor It is a figure which shows a state. It is the schematic explaining the bunker method of an example using the medical supply tool shown by FIG. 1, (a) It is the state which inserted the bunker needle several times in the predetermined site | part of a tumor, (b) The dissolved bunker It is a figure which shows the state which the chemical | medical agent of a needle | hook penetrates into a tumor. It is a rear view which shows the other example of the medical supply tool which concerns on 1st Embodiment, (a) It is a rear view (several circular shape on the same periphery) of an unaccommodated state, (b) An accommodated state (C) is a rear view of a non-accommodating state (a plurality of arc shapes on a double identical circumference), and (d) a rear surface of the accommodating state (E) a rear view of the unaccommodated state (a plurality of circular shapes on the same double circumference), and (f) an accommodated state. It is a rear view (a plurality of circular shapes on the same double circumference), and (g) is a rear view in a sealed state. It is a perspective view which shows the other example of the load accommodated in the medical supply tool of 1st Embodiment, (a) It is a female electric knife, (b) It is a loop type electric knife, c) Needle type electric knife, (d) Ball type electric knife, (e) Tweezers type electric knife, (f) Clip, (g) Clamp, (h) Medical (I) It is a figure which shows a radiation material. It is sectional drawing explaining the holding means of the mounted article or collection | recovery thing in the medical supply tool of 1st Embodiment, (a) It is a holding means by a gel-like substance, (b) Shows the holding means by a reduced diameter part. FIG. It is a rear view in the medical supply tool of 2nd Embodiment, (a) It is a rear view (two circular arc shape on the same periphery) of an unaccommodated state, (b) The rear view (the same circle) of an accommodated state (C) a rear view of the unaccommodated state (two arc shapes on the same double circumference), and (d) a rear view of the accommodated state (double identical) (E) a rear view in an unaccommodated state (two C-shapes on the same circumference), and (f) a rear view in an accommodated state (on the same circumference). It is a figure which shows two C-shapes. It is a top view which shows an example of the mounted material accommodated in the medical supply tool of 2nd Embodiment. It is the schematic explaining an example patch method using the medical supply tool of 2nd Embodiment, (a) It is in the state which takes out artificial tissue cloth with forceps, (b) The tumor was covered with artificial tissue cloth It is a figure which shows a state. It is the schematic explaining an example patch method using the medical supply tool of 2nd Embodiment, and is a figure which shows the state which fastens an artificial tissue cloth with a clip.

  Embodiments of the present invention will be described in detail with reference to FIGS. However, the present invention is not limited to the aspect of the present embodiment. The medical supply tool of the present invention is supplied together with a flexible endoscope, a rigid endoscope (laparoscope) or singly into a lumen and an abdominal cavity. As an example of the form of use of the supply tool, what is supplied into the lumen and the abdominal cavity together with the flexible endoscope 1 will be described.

(First embodiment)
<Outline of medical supplies>
FIG.1 and FIG.2 is each perspective view in the closed state which shows an example of the medical supply tool which concerns on the 1st Embodiment of this invention, and an open state, (a) It is the state seen from the front-end | tip part side. (B) It is a figure which shows the state seen from the rear-end part side. In the figure, the X-axis direction indicates the direction of the central axis C of the medical supply tool, the Y-axis direction is orthogonal to the X-axis direction, and the endoscope 1 in the opened state of the medical supply tool. The Z axis direction indicates a direction perpendicular to the X axis direction and the Y axis direction. Here, the broken lines in FIG. 1A and FIG. 1B indicate the shape of the endoscope 1 for convenience of explanation.

  Conventionally, it has been very difficult to transport a medical instrument or the like to a target site using an endoscope, and it has been necessary to insert and remove an operation wire and the like each time. Accordingly, the inventor has developed a DDSS (Device & Drug Delivery System) (hereinafter referred to as “medical supply device”) 100 specialized in transporting medical instruments and the like using the endoscope 1. Since the medical supply tool 100 can be transported together with the distal end portion of the endoscope 1, it is possible to supply a medical instrument or the like to the target site and reliably collect the medical instrument or the like from the target site. .

  The medical supply device 100 has a substantially cylindrical shape having a predetermined thickness, and main body portions 10 and 20 each having an opening OP that is cut open in the axial direction, and rotating means 30 that rotates the opening OP in a direction in which the opening OP is widened. And fixing means 40 for closing the opening OP, and gripping portions 52 to 55 are provided. Hereinafter, these outline | summary is demonstrated in order.

  First, the main body portions 10 and 20 are composed of a first main body portion 10 and a second main body portion 20 that are substantially semi-cylindrical, and the first main body portion 10 and the second main body portion 20 are substantially the same circle. It arrange | positions on the periphery (refer Fig.1 (a)). The first main body 10 is provided with a first accommodating portion 16 surrounded by the first inner wall 14, the first outer wall 13, and the pair of circumferential first end walls 18. . The first accommodating portion 16 is closed at the positive X-axis direction (one end) side by the first closing wall 17 and is opened at the negative X-axis direction (the other end) side, and has a plurality of portions along the circumferential direction. It is partitioned by the first partition wall 15 (see FIG. 1B). Similarly, the second body portion 20 is provided with a second housing portion 26 surrounded by the second inner wall 24, the second outer wall 23, and the pair of circumferential second end walls 28. It has been. The second housing portion 26 has one end side in the X-axis direction closed by a second closing wall 27, the other end side in the X-axis direction opened, and a plurality of second partition walls 25 along the circumferential direction. It is divided by. Since the closing walls 17 and 27 are streamlined from one end side to the other end side in the X-axis direction, it is possible to suppress frictional resistance generated when the closing walls 17 and 27 are transported together with the endoscope 1.

  The first main body 10 includes a first Y-axis direction (one side) on the other end side in the X-axis direction and a first Y-axis direction (other side) side on one end side in the X-axis direction. A first engaging portion 11 and a third engaging portion 12 that protrude from the end wall 18 along the outer side in the circumferential direction are provided. The first engaging portion 11 and the third engaging portion 12 are formed with a first insertion hole 11a and a third insertion hole 12a penetrating in the axial direction, respectively. Similarly, the second main body 20 extends along the outer side in the circumferential direction from the second end wall 28 on one side on one end side in the X-axis direction and on the other side on the other end side in the X-axis direction. A protruding second engaging portion 21 and a fourth engaging portion 22 are provided. The second engagement portion 21 and the fourth engagement portion 22 are respectively formed with a second insertion hole 21a and a fourth insertion hole 22a penetrating in the axial direction. Here, the first insertion hole 11a and the second insertion hole 21a, and the third insertion hole 12a and the fourth insertion hole 22a have substantially the same inner diameter.

  Here, the material of the first main body 10 and the second main body 20 may be any material that does not easily penetrate liquid and has little influence on the human body. For example, vinyl such as polyvinyl chloride. Plastic, silicone, etc. can be used.

  As will be described in detail later, the accommodating portions 16 and 26 in the first embodiment are, for example, linear objects such as shown in FIGS. 4 and 10, liquids such as body fluids, and solid objects such as cells. It is suitable for housing.

  In the present embodiment, the partition walls 15 and 25 that isolate the accommodating portions 16 and 26 are used. However, the present invention is not limited to this. For example, when the mounted object is a solid, Instead of 25, partitioning columns that do not separate the accommodating portions 16 and 26 may be employed. Moreover, in this embodiment, as shown in FIG. 1, the 1st engaging part 11 of the 1st main-body part 10 and the 2nd engaging part 21 of the 2nd main-body part 20 are positive X-axis directions. However, the present invention is not limited to this, and may be sequentially arranged in the negative X-axis direction. Similarly, in the present embodiment, as shown in FIG. 2, the fourth engagement portion 22 of the second body portion 20 and the third engagement portion 12 of the first body portion 10 are positive X-axis. Although it arrange | positions in order toward a direction side, you may arrange | position not only to this but to the negative X-axis direction side in order. Furthermore, in the present embodiment, the inner diameters of the first insertion hole 11a and the second insertion hole 21a are the same. However, the present invention is not limited to this. For example, the inner diameter of the second insertion hole 21a is set to the first insertion hole. It may be larger than the inner diameter of 11a.

  Next, as shown in FIG. 1A, the fixing means 40 includes a first insertion hole 11a and a second insertion hole 21a that are arranged so as to overlap each other when viewed from the X-axis direction, and the first insertion hole. The fixing pin 41 is inserted through the hole 11a and the second insertion hole 21a from the X-axis direction. When viewed from the X-axis direction, the distal end portion of the endoscope 1 is held between the main body portions 10 and 20 by a simple operation of inserting the fixing pin 41 into the first insertion hole 11a and the second insertion hole 21a that overlap each other. Can be maintained.

  The fixing pin 41 is provided on one end side in the X-axis direction, and is provided on the large-diameter portion 42 that defines the insertion length, and on the other end side in the X-axis direction. The first insertion hole 11a and the second insertion hole And a small-diameter portion 43 inserted through 21a. The large-diameter portion 42 is provided with a ring-shaped extraction portion 45 through a through-hole 44, and the small-diameter portion 43 has the same inner diameter of the first insertion hole 11 a and the second insertion hole 21. A slightly smaller outer diameter is formed. Although the details will be described later, the maximum diameter of the fixing pin 41 is set to a size that can be accommodated in the accommodating portion 16 or a size that allows insertion of the forceps port of the endoscope 1.

  Here, the material of the fixing pin 41 may be a material having a predetermined rigidity, and for example, vinyl such as metal or polyvinyl chloride, plastic, silicone, or the like can be used. Moreover, the material of the extraction part 45 should just be a material which has predetermined intensity | strength at least temporarily and has little influence on a human body. As the material of the extraction portion 45, for example, a material having a property of being decomposed and absorbed in the body such as polylactic acid, polyglycolic acid, polycaprolactone or the like (hereinafter sometimes referred to as “bioabsorbable material”). Can be used.

  In addition, although the shape of the extraction | drawer part 45 in this embodiment was made into ring shape, it may not be restricted to this, for example, may be string shape, a sheet shape, etc. Moreover, although the small diameter part 43 in this embodiment was made into the same outer diameter along the X-axis direction, it is not restricted to this, For example, when the inner diameter of the 1st insertion hole 11a and the 2nd insertion hole 21 differs, It may have different outer diameters along the X-axis direction. Furthermore, the large-diameter portion 42 in the present embodiment is provided with the extraction portion 45 of the fixing pin 41 via the through-hole 44, but is not limited thereto, and the extraction portion 45 is not connected to the large-diameter portion 42 without the through-hole 44. 45 may be directly fixed. Furthermore, although the fixing means 40 in this embodiment showed what inserts the fixing pin 41 in the 1st penetration hole 11a and the 2nd penetration hole 21a, it is not restricted to this, For example, the endoscope 1 of If the forceps 2 are operated, any device that releases the closure of the opening OP may be used.

  Further, the rotation means 30 is provided in the third insertion hole 12a and the fourth insertion hole 22a that are arranged so as to overlap with each other when viewed from the X-axis direction, and the third insertion hole 12a and the fourth insertion hole 22a. , A support shaft 34 inserted therethrough, and a spring 32 that urges the opening OP in a direction to expand the opening OP. The support shaft 34 has an outer diameter smaller than the same inner diameter of the third insertion hole 12a and the fourth insertion hole 22a. Further, the spring 32 is wound around the outer periphery of the support shaft 34, and both end portions thereof are in contact with the inner walls 14, 24 side of the first end wall 18 and the second end wall 28 adjacent to the support shaft 34. It is touched.

  When the fixing pin 41 in the fixing means 40 is pulled out from the first insertion hole 11a and the second insertion hole 21a, the main body parts 10 and 20 are expanded in the direction of expanding the opening OP by the urging force of the spring 32 of the rotation means 30. Rotate. At this time, the opening OP has a predetermined opening that allows the endoscope 1 to be inserted from the Y-axis direction without contacting the main body portions 10 and 20 (see FIG. 2A).

  Here, the material of the support shaft 34 and the spring 32 may be a material having a predetermined rigidity, and for example, metal such as vinyl, polyvinyl chloride such as polyvinyl chloride, or plastic can be used.

  In addition, although the rotation means 30 in this embodiment showed what rotates the main-body parts 10 and 20 in the direction which expands opening part OP by the urging | biasing force by the spring 32, it is not restricted to this, Opening part OP is shown. Any device that rotates in the spreading direction may be used. For example, when the opening OP has the aforementioned predetermined opening, the first main body 10 and the second main body 20 are integrally formed of an elastic body, and when the opening OP is closed, You may use the restoring force (elastic force) which acts on the connection part of the 1st main-body part 10 and the 2nd main-body part 20. FIG.

  Further, the gripping parts 52 to 55 are provided with a first gripping part 52 and a second gripping part 53 provided on the first outer wall 13 on one end side and the other end side in the X-axis direction, and on one end side in the X-axis direction. It comprises a third gripping portion 54 and a fourth gripping portion 55 provided on the first closing wall 17 and the second closing wall 27. Each of the grip portions 52 to 55 has a ring shape.

  Although details will be described later, as shown in FIG. 6B, the first grasping portion 52 and the second grasping portion 53 are each grasped by the clip 75 together with the peripheral portion (for example, the stomach wall) of the target site. Thus, the medical supply tool 100 can be fixed in the vicinity of the target site. Further, the third gripping portion 54 and the fourth gripping portion 55 are gripped by the forceps 2 of the endoscope 1, so that the main body portions 10, 20 are attached in a direction to close against the urging force of the spring 32. It is a force.

  Here, the material of the grips 52 to 55 may be any material that has at least temporarily predetermined strength and has little influence on the human body. For example, a bioabsorbable material can be used.

  In addition, although the shape of the holding parts 52 to 55 in the present embodiment is a ring shape, it is not limited to this, and may be, for example, a string shape, a sheet shape, or a combination thereof. The third gripping portion 54 and the fourth gripping portion 55 in the present embodiment are provided on the first closing wall 17 and the second closing wall 27 on one end side in the X-axis direction. It may be provided on each of the first end wall 18 and the second end wall 28 in the positive Y-axis direction on one end side in the axial direction. Further, the means for attaching the gripping parts 52 to 55 in the present embodiment to the main body parts 10 and 20 includes the outer walls 13 and 23, the closing walls 17 and 27, the end walls 18 and 28, etc. However, the present invention is not limited to this. The attachment means for the gripping portions 52 to 55 may be configured not to provide a communication hole for communicating the accommodating portions 16 and 26 with the outside, for example, to directly fix the gripping portions 52 to 55 to the main body portions 10 and 20. Thereby, the accommodating parts 16 and 26 can form a sealed state by closing only the opening side. Furthermore, although the 1st holding part 52 and the 2nd holding part 53 in this embodiment are used when fixing the medical supply tool 100 to the peripheral part of a target region, the medical supply tool 100 is not necessarily used. Since it is not necessary to fix, it is not an essential structure. In addition, the third gripping portion 54 and the fourth gripping portion 55 in the present embodiment are used for extracting the medical supply tool 100 together with the endoscope 1, but for example, an endoscope Since the medical supply tool 100 can be directly gripped by one forceps 2, this is not an essential configuration.

<Non-contained state and accommodated state of medical supply device>
3 is a diagram (a plurality of arc shapes on the same circumference) showing the medical supply device shown in FIG. 1, (a), (b) a rear view of the unaccommodated state and the accommodated state, and (c). (D) It is the front view and side view of a non-accommodating state.

  The first container 16 and the second container 26 in the medical supply device 100 have a plurality of circular arcs on the same circumference centered on the center line C, as shown in FIG. And divided into four parts by three first partition walls 15 and second partition walls 25 along the circumferential direction. Moreover, in FIG.3 (b), the linear mounted object 70 whose cross-sectional shape is circular shape is shown as an example of a mounted object. The mounted object 70 is accommodated in an inscribed state with respect to walls surrounding the arc-shaped accommodating portions 16 and 26. Here, the shape of the front end portion of the load 70 is a sharp shape, while the shape of the rear end 72 of the load 70 is a Y-shape divided into three parts, that is, the endoscope 1. The shape is easy to be surely grasped by the forceps 2.

  In the present embodiment, the load 70 is held by being inscribed in the walls forming the accommodating portions 16 and 26, but is not limited thereto, and is held by, for example, holding means 90 and 92 described later. May be. Moreover, although the cross-sectional shape of the mounted object 70 in the present embodiment is a circular shape, the cross-sectional shape is not limited to this, and for example, a cross-section that can be included in the accommodating portions 16 and 26 such as an arc shape, a fan shape, an elliptical shape, or a polygonal shape. The shape may be sufficient, and it may be the same shape as the accommodating portions 16 and 26. Moreover, although the mounted object 70 in the present embodiment has a shape with a sharp tip, the present invention is not limited thereto, and the tip may have a convex shape, a concave shape, a planar shape, or the like. Furthermore, the load 70 in the present embodiment has a Y-shape in which the rear end 72 is divided into three parts. However, the present invention is not limited to this. Any shape may be used as long as it is easily gripped by the forceps 2 of the mirror 1. In addition, in the present embodiment, the forceps 2 that is about 2 mm even in the opened state can be accommodated in the accommodating portions 16 and 26 by increasing the diameter of the virtual inscribed circle in the accommodating portions 16 and 26, for example, 2 mm or more. And the side portion of the load 70 can be gripped. Therefore, the shape that is easily gripped provided at the rear end 72 is not an essential configuration.

The outer diameter D1 of the main body portions 10 and 20 may be such that the medical supply device 100 can be inserted into the lumen and the abdominal cavity, for example, a size of 15 to 25 mm. Further, the inner diameter D2 of the main body portions 10 and 20 is set to be slightly smaller than the outer diameter of the endoscope 1, for example, 5 to 15 mm. Thus, by arranging the endoscope 1 in the space S surrounded by the inner walls 14, 24, the medical supply tool 100 can securely hold the endoscope 1.
The length L of the main body portions 10 and 20 can correspond to the length of the load 70. In addition, when it is desired to increase the amount or type of the load 70, a plurality of medical supply tools 100, for example, a medical supply tool 100 for medical instruments or medicines, are prepared, and a plurality of medical supplies 100 are provided in the endoscope 1. You may supply to an object site | part by holding the medical supply tool 100, respectively. At this time, for example, by interposing the gap between the medical supply tools 100 to the endoscope 1 with a little space between them, it is possible to suppress, for example, preventing the bending in the flexible endoscope 1.

<Loaded medical supplies>
FIG. 4 is a perspective view showing an example of a load housed in the medical supply tool shown in FIG. 1, (a) an overall perspective view of the load object, and (b) of a broken line portion in (a). It is an expansion perspective view.

  The accommodating portions 16 and 26 in the first embodiment are mainly suitable for accommodating linear objects and the like, and are used in a bunker method described later as an example of the linear objects. A bunker needle (hereinafter sometimes referred to as “needle-like medicine”) 70 is shown.

  The bunker needle 70 is made of, for example, a bioabsorbable material, which is a material in which a hemostatic agent is mixed and has little influence on the human body. Further, since the bunker needle 70 is an ultrafine needle having a diameter of, for example, about 0.1 mm, it can be inserted into a relatively hard tumor or the like that is a target site using the forceps 2 of the endoscope 1. Thus, it has a desired rigidity. The bunker needle 70 contains a plurality of capsules 71 such as gel (anticancer agent or molecular target therapeutic agent). The dissolution rate of the plurality of capsules 71 can be variously adjusted by changing the components and amounts of the drug to be encapsulated. The bunker needle 70 is directly inserted into a tumor or the like, thereby enabling local control of the tumor or the like.

  The other end side of the bunker needle 70 in the present embodiment has a planar shape. However, the present invention is not limited to this, and for example, the other end side may be a shape that can be reliably grasped by the forceps 2 of the endoscope 1. .

<Bunker method using medical supplies>
5 to 8 are schematic views illustrating an example bunker method using the medical supply tool shown in FIG. 5A shows a state before the medical supply tool is attached to the endoscope, FIG. 5B shows a state where the medical supply tool is attached to the endoscope, and FIG. FIG. 6B shows a state where the medical supply tool is inserted into the digestive organ cavity together with the endoscope, and is a state where the medical supply tool is removed from the endoscope and fixed. 7 (a) shows a state where the bunker needle is taken out, FIG. 7 (b) shows a state where the bunker needle is inserted into the tumor, and FIG. 8 (a) shows a state where a plurality of bunker needles are inserted into the tumor. FIG. 8 (b) is a diagram showing a state where the dissolved drug of the bunker needle penetrates the tumor. Here, the tumor in the lumen will be described as an example, but the present invention is not limited to this, and the bunker method using the medical supply tool 100 can be applied to the tumor in the abdominal cavity. In addition, the bunker method will be described as an example using the medical supply device 100, but it can also be used for other treatments.

  At present, endoscopic submucosal dissection (ESD) using an endoscope is performed for advanced cancer in the lumen, but an artificial ulcer floor is formed after the operation. The burden on is increasing. In order to reduce the burden on the patient, it is conceivable that the needle-like drug is directly inserted into the tumor using the endoscope 1 without excising the tumor. Since this needle-shaped medicine is required to have the desired rigidity in order to penetrate into a hard tumor, the needle-shaped medicine inserted from the forceps opening is caught by the bending of the forceps opening and supplied to the tumor. It was difficult.

  Here, it is also conceivable to reduce the rigidity of the needle-shaped medicine and supply it to the tumor through the forceps opening. However, since it is necessary to stab at least 20 to 30 needle-shaped drugs into the tumor, taking out the operation wire of the endoscope every time the needle-shaped drugs are supplied is considered a burden on the patient. It was difficult to implement.

  The bunker method devised to solve these various problems involves storing the bunker needle 70, which is a needle-like drug, in the medical supply device 100 and supplying it directly to the tumor. It is a useful treatment.

  The procedure of the bunker method using the medical supply tool 100 that houses the bunker needle 70 and the like will be described.

  As a preparatory stage, 3D-CT (Colonography) is used to create a 3D image of tumor CA, and the elution speed, insertion site, insertion angle, and the like of the drug in each bunker needle are determined in advance. Thereafter, the insertion site is marked with an electric knife or the like.

  Next, as shown in FIG. 5 (a), each housing portion 16, 26 has a plurality of bunker needles 70 and a plurality of clips 75 (see FIG. 10 (f)) having the elution speed determined in the preparation stage. ) Etc. are accommodated.

  Here, in order to easily identify individual bunker needles 70 and clips 75 accommodated, numbers, letters, and the like around the accommodating parts 16 and 26 and / or the other end side of the bunker needles 70 and clips 75, etc. A color or shape can be attached. Further, the bunker needle 70 and the like are held in the accommodating portions 16 and 26 by holding means 90 and 92, which will be described later, so as not to be detached from the accommodating portions 16 and 26 due to vibration or the like (FIG. 11A, (See (b)).

  Subsequently, as shown in FIG. 5B, the endoscope 1 is inserted into the space S from the opening OP along the Y-axis direction, and the first insertion hole 11a and the first insertion hole are viewed from the X-axis direction. The opening OP is closed against the biasing force of the spring 32 of the rotating means 30 so that the two insertion holes 21a overlap. By inserting the fixing pin 41 into the first insertion hole 11a and the second insertion hole 21a, the distal end portion of the endoscope 1 is securely held by the medical supply tool 100. At this time, the extraction portion 45 provided on the fixing pin 41 is gripped by the forceps 2 of the endoscope 1.

  Further, as shown in FIG. 6A, the medical supply tool 100 together with the endoscope 1 is inserted from the patient's mouth through the digestive tract cavity in the direction of arrow A inside the stomach ST. At this time, since the medical supply device 100 has a streamline shape in the insertion direction, it can be smoothly inserted while suppressing frictional resistance. Thereafter, by pulling out the forceps 2 of the endoscope 1 with an operation wire or the like, the extraction portion 45 is pulled, and the fixing pin 41 is extracted from the first insertion hole 11a and the second insertion hole 21a (FIG. 5B). )reference). Thereby, the opening OP is rotated in the opening direction by the urging force of the spring 32 of the rotation means 30, and the endoscope 1 can be taken out of the medical supply tool 100 from the opening OP. Thereafter, the fixing pin 41 may be taken out and collected together with the grasping forceps 2 through the forceps opening of the endoscope 1, or may be grasped by the unaccommodated accommodating portions 16 and 26. The fixing pin 41 may be accommodated using the existing forceps 2.

  Further, as shown in FIG. 6B, a clip 75 accommodated in the accommodating portions 16 and 26 of the medical supply tool 100 or a clip 75 supplied from the outside via the forceps opening of the endoscope 1 is used. Thus, the first grip portion 52 and the second grip portion 53 are each fixed at a desired position. This makes it possible to accurately pull out the ultrafine bunker needle 70 and the like while the medical supply tool 100 is fixed around the tumor CA.

  As described above, the bunker needle 70 made of a bioabsorbable material or the like is accommodated in the medical supply tool 100 and supplied to the vicinity of the tumor CA, so that the bunker needle 70 hardly comes into contact with liquid or the like. Thereby, the bunker needle 70 can maintain desired rigidity, a chemical component, and the like without being dissolved by a liquid or the like.

  In addition, since the accommodating portions 16 and 26 in the present embodiment are open on the other end side in the X-axis direction, the bunker needle 70 may slightly contact with liquid or the like. However, you may employ | adopt the cover member 60 as shown in FIG.9 (g). That is, in the preparation stage, the accommodating portions 16 and 26 are closed by the cover member 60, and after the medical supply tool 100 is supplied around the tumor CA, the cover member 60 is used using the forceps 2 of the endoscope 1 or the like. Can be opened. At this time, when a part of the cover member 60, for example, the inner walls 14 and 24 side is left without being removed from the medical supply device 100, the cover member 60 can be extracted together with the medical supply device 100. Further, when the cover member 60 is completely removed from the medical supply device 100, for example, the cover member 60 is accommodated in the unaccommodated accommodation portions 16 and 26 using the forceps 2 of the endoscope 1. Thus, the cover member 60 can be extracted together with the medical supply tool 100.

  Then, as shown in FIG. 7A, the bunker needle 70 is pulled out in the direction of arrow B from the medical supply tool 100 in the order determined in advance in the preparation stage using the forceps 2 of the endoscope 1. Thereafter, as shown in FIG. 7B and FIG. 8A, the bunker needle 70 is moved in the direction of the arrow C or the direction of the arrow D, and the puncture to the desired insertion site of the tumor CA marked in advance is repeated. Thereby, the bunker needle 70 can be safely and quickly arranged at an appropriate insertion site or the like.

  Thereafter, although not shown, the distal end of the endoscope 1 is disposed so as to face the third gripping portion 54 and the fourth gripping portion 55 of the main body portions 10 and 20, and the forceps of the endoscope 1 are arranged. 2, the third grip part 54 and the fourth grip part 55 are gripped simultaneously. At this time, the third grasping portion 54 and the fourth grasping portion 55 are pulled by the forceps 2 of the endoscope 1 and rotate in a direction in which the main body portions 10 and 20 are closed.

  The medical supply tool 100 is extracted together with the endoscope 1. At this time, since the medical supply device 100 has a streamline shape in the extraction direction, it can be smoothly extracted with reduced frictional resistance. In addition, the 1st holding part 52 and the 2nd holding part 53 which fix the medical supply tool 100 to the circumference | surroundings of tumor CA may be cut | disconnected by extracting the medical supply tool 100 etc., and are fixed to a stomach wall. The clip 75 that has been removed is naturally discharged from the body over time. Although details will be described with reference to FIG. 11A, when the specimen or the like is collected in the storage parts 16 and 26, the third grip part 54 and the fourth grip part 55 are connected to the other end in the X-axis direction. You may arrange | position in the position which pinched | interposed the opening part OP in the side. Thereby, the opening side of the accommodating parts 16 and 26 is extracted so as to face the inlet side of the stomach ST, and the detachment of the specimen and the like from the accommodating parts 16 and 26 can be reliably prevented.

  Therefore, conventionally, supply and recovery of medical instruments and the like to the target site required the operation wire and the like of the endoscope 1 to be taken in and out several tens of times. By using the supply tool 100, it can carry out safely and rapidly. For this reason, there exists an effect that the burden of a medical worker and a patient can be reduced.

  Finally, as shown in FIG. 8B, the bunker needle 70 pierced into the tumor CA is gradually dissolved, and the high-concentration drug contained in the capsule 71 penetrates into the tumor CA. Further, when the drug rides on the lymph flow LF and reaches the lymph node LN via the lymph passage LC, metastasis to the lymph node LN can also be controlled. Furthermore, if the drug enters the bloodstream, hematogenous distant metastasis can be controlled. Thereby, local control of the tumor CA becomes possible and the lymph node LN can be reduced.

  As described above, the bunker method is a new endoscopic treatment method designed to control tumors and the like with ultra-low invasiveness, and directly has a high concentration of anticancer agents, molecular target therapeutic agents, Since regenerative medical materials can be supplied, there are very few side effects.

<Non-accommodating state and accommodating state of other medical supplies>
FIG. 9 is a rear view showing another example of the medical supply device according to the first embodiment. (A), (b) unaccommodated state and accommodated state (multiple circular shapes on the same circumference), (c), (d) unaccommodated state and accommodated state (double arcs on the same circumference) (Shape), (e), (f) unaccommodated state and accommodated state (a plurality of circular shapes on the same double circumference), (g) sealed state. Here, the case where it is circular as an example of the cross-sectional shape of the mounted object 70 in the drawing is shown.

  First, as shown in FIGS. 9A, 9 </ b> B, 9 </ b> E, and 9 </ b> F, the cross-sectional shape of the accommodating portions 16 a, 16 c, 26 a, and 26 c is slightly larger than the load 70 to accommodate The rattling of the load 70 in the state is suppressed, and stable supply or the like is possible.

  Further, as shown in FIGS. 9 (c), (d), (e), and (f), a plurality of accommodating portions 16b, 16c, 26b, and 26c are arranged on the same double circumference, thereby accommodating. The number of loads 70 that can be accommodated in the portions 16b, 16c, 26b, and 26c can be increased.

  Although the accommodating part in this embodiment showed what was a some circular arc shape or circular shape provided on the same circumference or a double same circumference, it is not restricted to this. For example, the housing portion may be a shape provided in a plurality along the circumferential direction and / or the radial direction or a shape partitioned into a plurality of lattice shapes, and may be a combination of the shapes of the various housing portions described above. There may be.

  Further, as shown in FIG. 9G, the opening side of the accommodating portions 16c and 26c (see FIG. 9F) accommodating the load 70 is closed by the sheet-shaped cover member 60. Thereby, the load 70 accommodated in the medical supply tool 100 is maintained in a sterilized state until it is actually provided. The cover member 60 is provided with an extending portion 61 extending along the Z-axis direction. The cover member 60 can be easily opened by grasping the extending portion 61 with a finger, forceps 2 or the like. can do.

  The cover member 60 in the present embodiment has a sheet shape, but is not limited to this, and may be a cap-shaped member in which a part is inserted into each housing portion and all or a part thereof is connected. The extending portion 61 may be provided on the cap-shaped cover member 60. Moreover, although the extension part 61 in this embodiment is provided in a pair along the Z-axis direction, it is not restricted to this, For example, you may provide at least one part in the outer periphery of the cover member 60. FIG. Furthermore, although the cover member 60 in this embodiment is provided with the extension part 61, it is not restricted to this, The extension part 61 does not need to be provided.

<Other loads>
FIG. 10 is a perspective view illustrating another example of the mounted object accommodated in the medical supply tool according to the first embodiment. (A) to (e) shows a knife type 74a, a loop type 74b, a needle type 74c, a ball type 74d, and an electric knife of a tweezer type 74e, respectively (f) clip 75, (g) clamp 76, (h) It is a figure which shows the medical screw 77 and (i) radiation material 78. FIG.

  In addition to the bunker needle 70 having both the medical instrument and the medicine shown in FIG. 4, the load 70 in the first embodiment includes various uses.

  Mounted objects accommodated when supplying the medical supply tool 100 to the target site are roughly classified into medical instruments, medical materials, drugs, tissues, and the like. Specific examples are shown below.

  As shown in FIGS. 10A to 10E, medical instruments include a female electric knife 74a, a loop electric knife 74b, a needle electric knife 74c, a ball electric knife 74d, and a tweezers type. Electric scalpel 74e, clip 75 and clamp 76 are included. Furthermore, medical instruments include a scalpel, a needle and the like. Here, since there are various types of tip shapes of the electric knife, what is shown is a part of the electric knife.

  Next, as shown in FIGS. 10H and 10I, the medical material includes a medical screw 77 and a radiation material 78 such as a sealed braid source. In addition, for medical materials, tissue substitute artificial fiber cloth (hereinafter referred to as “artificial tissue cloth”) such as tissue encapsulating agent Neobale (registered trademark), tissue adhesive sheet such as taco seal (registered trademark) (hereinafter referred to as “tissue adhesive sheet”). ”), Knotting materials such as gauze and string, rivets, tuckers and the like. Here, the medical screw 77 has a drug inside the screw and combines the medical material and the drug, and is fixed by screwing the medical screw 77 into the surface of the tumor CA. Further, when the radiation material 78 is supplied to the target site by the medical supply tool 100, the lumen, the abdominal cavity, and the like corresponding to the supply path may be exposed to radiation. Therefore, it is necessary to cover the walls surrounding the accommodating portions 16 and 26 that accommodate the radiation material 78 and the opening side of the accommodating portions 16 and 26 with lead or the like to shield radiation from the outside.

  Moreover, although illustration is abbreviate | omitted, a chemical | medical agent contains a contrast agent, a low molecular weight drug, a biopharmaceutical drug, a molecular target drug, an antibiotic agent, an anticancer agent, a regenerative medical material, a cleaning agent, etc.

  Furthermore, the tissue includes a multifunctional stem cell piece, a tissue piece, etc., although not shown.

  Further, the load 70 accommodated when the medical supply device 100 is collected includes, in addition to the load accommodated at the time of insertion, a body fluid (for example, a sample in a test such as a visceral cancer that easily causes liver cancer) and Foreign substances (for example, parasites and mis drinks) are included.

  The mounted object 70 in the present embodiment is an example of a medical instrument, a medical material, a drug, a tissue, and the like, but is not limited thereto, and is variously used for medical treatment or the like. Things are included.

<Holding means for loaded or collected items>
FIG. 11 is a cross-sectional view for explaining the load 70 or the recovered material holding means 90, 92 in the medical supply device 100 according to the first embodiment. (A) The gel-like substance holding means 90; b) It is a figure which shows the holding means 92 by a reduced diameter part.

  When accommodating the load 70 in the accommodating portions 16, 26 and when removing the load 70 from the accommodating portions 16, 26, the accommodating portions 16, 26 and the load 70 are not disturbed. A predetermined gap is provided between the two. However, if the predetermined gap is too large, the load 70 is easily dropped from the accommodating portions 16 and 26, while if the predetermined gap is too small, the load 70 is accommodated in the accommodating portions 16 and 26. Therefore, it has been necessary to perform management so that a predetermined gap is obtained. However, this gap management has contributed to an increase in the manufacturing cost of the medical supply device 100.

  Therefore, in order to solve these problems, the loading parts 70 or the recovered material holding means 90, 92 are provided in the housing parts 16, 26 themselves.

  As shown in FIG. 11 (a), the holding means 90 made of a gel substance is provided at an arbitrary position in the X-axis direction inside the accommodating portions 16 and 26.

  When the mounted object 70 has a linear shape such as a bunker needle, for example, the mounted object 70 comes into contact with the gel material, and the mounted object 70 is placed in the accommodating portions 16 and 26 by a predetermined adhesive force by the gel material. Retained. When the load 70 is taken out, it can be easily taken out by urging the load 70 with a force against the viscous resistance caused by the gel substance.

  Further, when the load 70 is, for example, a cell piece (solid) or the like collected in an inspection or the like, the gel-like substance contains a formalin solution or physiological saline, and the collected cell piece or the like is converted into a gel-like substance. By being surrounded by, it can be safely recovered.

  Further, when the mounted object 70 is, for example, a body fluid (liquid) or a cell piece (solid) collected in an examination or the like, the holding means 90 made of a gel-like substance is attached to the closed wall 17 in the accommodating portions 16 and 26. , 27 so as to form a sealed space. Thereby, the collected body fluid, cell debris, and the like can be safely recovered by enclosing them in a sealed space via a gel substance.

  Next, as shown in FIG. 11 (b), at least one holding means 92 with a reduced diameter portion is provided at any position in the X-axis direction inside the accommodating portions 16 and 26. The load 70 comes into contact with the reduced diameter portion, and the load 70 is held in the accommodating portions 16 and 26 by the frictional resistance caused by the reduced diameter portion.

  The holding means in the present embodiment is a gel-like substance or a reduced diameter part, but is not limited thereto, and a deformable member such as a sponge may be provided in the accommodating parts 16 and 26, or these holding means May be combined. In addition, the holding means in the present embodiment is provided in the accommodating portions 16 and 26, but is not limited to this, and the mounting object 70 is provided with at least one holding member such as a gel-like substance, a large diameter portion, or a deformable member. Means may be provided. Furthermore, although the accommodating parts 16 and 26 in this embodiment are provided with a holding means, it is not restricted to this and does not need to be provided with a holding means.

  The gel-like substance in the present embodiment is used as a holding member, but is not limited to this. For example, the gel-like substance is enclosed in a sealed space formed by the gel-like substance, such as cleaning liquid or distilled water contained in the gel-like substance. The forceps 2 and the like used for the biopsy may be washed using a washing solution or the like.

(Second Embodiment)
A second embodiment of the present invention will be described. Since the basic configuration of the second embodiment is the same as that of the first embodiment, the second embodiment will be described below with a focus on differences from the first embodiment. In addition, although the accommodating part in 1st Embodiment is especially suitable for accommodating linearly mounted objects, the accommodating part in 2nd Embodiment accommodates mounted objects, such as a sheet shape. It is suitable for doing.

<Non-contained state and accommodated state of medical supply device>
FIG. 12 is a rear view of the medical supply device of the second embodiment. (A), (b) unaccommodated state and accommodated state (arc shape on the same circumference), (c), (d) unaccommodated state and accommodated state (double arc shape on the same circumference), ( e), (f) It is a figure which shows the unaccommodated state and the accommodated state (C shape on the same periphery).

  As shown in FIGS. 12A and 12B, the first housing portion 16d and the second housing portion 26d in the medical supply device 100 have an arc shape on the same circumference. In addition, as will be described in detail later as an example of the sheet-shaped load 80 in the accommodating portions 16d and 26d, the artificial tissue cloth 80 (see FIG. 13) is folded and accommodated in the two accommodating portions 16d and 26d, respectively. ing. The ring-shaped lead portion 82 provided on the artificial tissue cloth 80 is disposed on the opening side of the housing portions 16d and 26d.

  As shown in FIGS. 12C and 12D, the first housing portion 16e and the second housing portion 26e in the medical supply device 100 have a double circular arc shape on the same circumference. Accordingly, it is possible to increase the number of sheet-shaped loads 80 that can be accommodated in the accommodating portions 16e and 26e. Further, the sheet-shaped load 80 is accommodated by being folded into the four accommodating portions 16e and 26e, respectively.

  As shown in FIGS. 12E and 12F, the first storage portion 16f and the second storage portion 26f in the medical supply device 100 are C-shaped on the same circumference. Thereby, the surface area of the sheet-shaped load 80 that can be accommodated in the accommodating portions 16f and 26f can be increased. Further, the sheet-shaped load 80 is housed by being folded into the two housing portions 16f and 26f.

  Although the accommodating part in this embodiment showed what is two circular arc shape or C shape provided on the same circumference or double identical circumference, not only this but an accommodating part, for example, There may be two arc shapes, C-shapes, S-shapes or Σ-shapes provided on the same multiple circumferences. In addition, the various shapes provided on the same circumference of the multiplex are the same as the shape of the accommodating portion in the first embodiment (the shape provided in a plurality along the circumferential direction and / or the radial direction, and the plurality in the lattice shape). (Combined shape) may be used. Furthermore, although the shape of the drawer | drawing-out part 82 in this embodiment was made into ring shape, you may make it not only into this but a string shape, a sheet | seat shape, etc., for example. In addition, although the load 80 in the present embodiment is provided with the drawer portion 82, the forceps 2 of the endoscope 1 can directly grip the load 80 of the storage portions 16d to 16f and 26d to 26f. The drawer portion 82 is not an essential configuration.

<Loaded medical supplies>
FIG. 13 is a plan view illustrating an example of a mounted object mounted on the medical supply tool of the second embodiment. The accommodating portions 16d to 16f and 26d to 26f in the second embodiment are mainly suitable for accommodating a load such as a sheet shape, a liquid such as a body fluid, and a solid load such as a cell. . Here, an artificial tissue cloth 80 used in a patch method to be described later is shown as an example of a sheet-shaped load.

  The artificial tissue cloth 80 may be any material that has little influence on the human body. For example, a bioabsorbable material or the like can be used. However, the artificial tissue cloth 80 has a property of becoming a lump that is difficult to re-deploy when in contact with a liquid. Yes.

  The artificial tissue cloth 80 contains a high concentration of an anticancer agent, a molecular target therapeutic agent, a regenerative medical material, and the like, and a reinforcing member 84 for increasing rigidity is provided at the peripheral portion of the artificial tissue cloth 80. And a drawer portion 82 held by the forceps 2.

  The material of the reinforcing member 84 may be any material that has a predetermined strength at least temporarily and has little influence on the human body. For example, a bioabsorbable material can be used.

  Moreover, the material of the drawer | drawing-out part 82 should just be a material with little influence on a human body, for example, a bioabsorbable material etc. can be used.

  As the load 80 in the second embodiment, in addition to the artificial tissue cloth 80 having a high concentration of an anticancer drug and the like, which has both medical materials and drugs, the load 70 in the first embodiment is used. The indicated medical devices, medical materials, drugs, tissues, body fluids, foreign substances, and the like are included. Furthermore, the load 80 in the second embodiment includes various things that are used or collected for medical treatment or the like.

<Patch method using medical supplies>
FIG. 14 and FIG. 15 are schematic diagrams for explaining an example patch method using the medical supply device of the second embodiment. 14A shows a state where the artificial tissue cloth is taken out, FIG. 14B shows a state where the tumor is covered with the artificial tissue cloth, and FIG. 15 shows a state where the artificial tissue cloth is clipped. Here, the tumor in the lumen will be described as an example, but the present invention is not limited thereto, and the patch method using the medical supply tool 100 can be applied to the tumor in the abdominal cavity. Moreover, although the patch method is demonstrated as an example using the medical supply tool 100, it can be used also for uses, such as another treatment.

  The patch method was devised to accommodate an artificial tissue cloth 80 containing an anticancer agent or the like in the medical supply device 100 and directly supply it to the tumor, and is extremely useful for early cancer. It is a proper treatment. Below, the procedure of the patch method using the medical supply tool 100 will be described focusing on the differences from the bunker method in the first embodiment.

  For example, as illustrated in FIGS. 12A and 12B, the first accommodating portion 16 d of the medical supply device 100 has an arc shape on the same circumference, and is a sheet-shaped artificial tissue cloth 80. Is folded and accommodated in the accommodating portion 16d. The shape and size of the artificial tissue cloth 80 are determined based on the 3D image of the tumor CA created in the preparation stage. At this time, the shape may be divided into a plurality of artificial tissue cloths 80 according to the shape and size of the tumor. On the other hand, for example, as shown in FIGS. 3A and 3B, the second accommodating portion 26 has a plurality of arc shapes on the same circumference, and the clip 75 is provided in each accommodating portion. 26.

  First, similarly to the first embodiment, the medical supply device 100 together with the endoscope 1 is inserted into the stomach ST through the digestive tract cavity from the patient's mouth and fixed around the tumor CA. .

  Here, as described above, the artificial tissue cloth 80 has a property of becoming a lump that is difficult to be re-deployed when it is in contact with a liquid. By supplying it around the CA, the artificial tissue cloth 80 hardly comes into contact with liquid or the like. Thereby, the artificial tissue cloth 80 can maintain the sheet shape, the component of the medicine, and the like without being dissolved by the liquid or the like.

  Here, since the accommodation portions 16d and 26 in the present embodiment are open on the other end side in the X-axis direction, the artificial tissue cloth 80 may slightly contact with liquid or the like. As will be described later, a cover member 60 as shown in FIG. That is, in the preparation stage, the housing parts 16d and 26 are closed by the cover member 60, and after the medical supply tool 100 is supplied around the tumor CA, the cover member 60 is used by the forceps 2 of the endoscope 1 or the like. Can be opened.

  Next, as shown in FIG. 14 (a), the artificial tissue cloth 80 folded from the accommodating portion 16d of the medical supply tool 100 via the pull-out portion 82 using the forceps 2 of the endoscope 1 is indicated by an arrow E. Pull in the direction. At this time, the reinforcing member 84 that has been folded is subjected to a restoring force to return to the ring shape before being folded, and is automatically developed into a planar shape together with the artificial tissue cloth 80.

  Here, numbers, letters, colors, shapes, etc. are provided on the artificial tissue cloth 80, the reinforcing member 84, or the drawer portion 82 so that the individual artificial tissue cloths 80 having different shapes accommodated in the present embodiment can be easily identified. Can be attached.

  Thereafter, as shown in FIG. 14B, the artificial tissue cloth 80 is moved in the direction of the arrow F and arranged so as to cover the tumor CA.

  Furthermore, as shown in FIG. 15, the forceps 2 of the endoscope 1 is used to pull out the clip 75 from the accommodating portion 26 of the medical supply device 100, and the clip 75 is moved in the direction of arrow G, and the artificial tissue cloth is used. 80 is fixed in a desired position.

  Then, as in the first embodiment, the medical supply tool 100 is extracted from the body together with the endoscope 1. Thereafter, the high-concentration drug contained in the artificial tissue cloth 80 penetrates into the tumor CA.

  Therefore, conventionally, supply and recovery of medical instruments and the like to the target site required the operation wire and the like of the endoscope 1 to be taken in and out several tens of times. By using the supply tool 100, it can carry out safely and rapidly. Thereby, there exists an effect that the burden of a medical worker and a patient can be reduced.

  Similar to the bunker method, the patch method is a new endoscopic treatment method designed to control tumors and the like with minimally invasiveness. Since it can supply drugs, regenerative medical materials, etc., there are very few side effects.

  The sheet-like mounting material 80 used for the patch method in the present embodiment uses an artificial tissue cloth, but is not limited to this. For example, the tissue adhesive sheet has a high concentration of anticancer agent, molecular target therapeutic agent, and regeneration. A material containing medical material or the like can be used.

  In the present embodiment, the medical supply tool 100 is supplied to the target site together with the endoscope 1. However, the present invention is not limited to this. The supply tool 100 may be supplied alone to the target site. In that case, since the space S in which the endoscope 1 is arranged, the rotation means 30 and the fixing means 40 can also be omitted, the area of the accommodating portions 16 and 26 can be expanded.

DESCRIPTION OF SYMBOLS 1 Endoscope 2 Forceps 10 1st main-body part 11 1st engaging part 11a 1st insertion hole 12 3rd engaging part 12a 3rd insertion hole 13 1st outer wall 14 1st inner wall 15 1st 1 partition wall 16, 16a-16f 1st accommodating part 17 1st closing wall 18 A pair of 1st end wall 19 1st intermediate wall 20 2nd main-body part 21 2nd engaging part 21a 1st 2 insertion hole 22 4th engagement part 22a 4th insertion hole 23 2nd outer wall 24 2nd inner wall 25 2nd partition walls 26 and 26a-26f 2nd accommodating part 27 2nd closing wall 28 A pair of second end walls 29 Second intermediate wall 30 Rotating means 32 Spring 34 Support shaft 40 Fixing means 41 Fixing pin 42 Large diameter part 43 Small diameter part 44 Through hole 45 Extraction part 52 First grip part 53 First Two gripping portions 54 Third gripping portion 55 Fourth gripping portion 60 Cover member 61 Extension portion 70 Bunker Needle (payload)
71 gel-like capsule 72 rear end 74a female-type electric knife 74b loop-type electric knife 74c needle-type electric knife 74d ball-type electric knife 74e tweezer-type electric knife 75 clip 76 clamp 77 medical screw 78 radiation material 80 Artificial tissue cloth (loaded)
82 Pull-out part 84 Reinforcement member 90 Holding means 92 by gel substance 92 Holding means 100 by reduced diameter part Medical supply tool

C Center line CA Tumor D1 Body outer diameter D2 Body inner diameter L Body length LC Lymphatic path LF Lymphatic flow LN Lymph node S Space ST Gastric OP Opening

Claims (10)

It is a substantially cylindrical shape having a predetermined thickness, and includes a main body portion having an opening cut and opened in the axial direction.
The main body is
Holding the endoscope detachably through the opening,
A medical supply characterized in that a plurality of accommodating portions, which are closed at one end side in the axial direction and open at the other end side, are provided between the inner wall and the outer wall of the main body portion along the circumferential direction and / or the radial direction. Ingredients.   The medical supply device according to claim 1, wherein the main body portion is provided with a fixing unit capable of closing the opening in a state where the endoscope is held.   The medical supply tool according to claim 2, wherein the fixing means is a fixing pin that fixes both ends in the circumferential direction adjacent to each other when the opening is in a closed state.   In the closed state, the main body portion is provided with a rotating means for urging and rotating the opening portion in a direction substantially wide with the fixing means sandwiching the central axis of the main body portion in a direction to widen the opening. The medical supply device according to any one of claims 1 to 3, wherein the medical supply device is a medical supply device.   The medical supply tool according to any one of claims 1 to 4, wherein one end side of the main body portion in the axial direction has a streamline shape.   The cross-sectional shape of the housing portion viewed from the axial direction is at least one of an arc shape, a fan shape, a circular shape, an elliptical shape, a C shape, and a polygonal shape. A medical supply device according to claim 1.   The medical body according to any one of claims 1 to 6, wherein the main body portion is provided with a cover member that seals an opening on the other end side in the axial direction of the housing portion. Supply tool.   The medical supply device according to any one of claims 1 to 7, wherein the storage unit is provided with a holding unit that holds an object to be stored.   The medical supply device according to claim 8, wherein the holding means is a gel-like substance and / or a reduced-diameter portion provided in the housing portion.   The medical supply tool according to any one of claims 1 to 9, wherein first and second gripping portions are provided on the outer wall on one end side and the other end side.

Images