JP2023005467A - Medical device and method for delivering sheet-like delivery object to target portion - Google Patents

Abstract

To provide a medical device for delivering a sheet-like object to a target portion while keeping its shape by a simple mechanism and an easy work.SOLUTION: The medical device for delivering a sheet-like object to a target portion comprises: a body having an arch-shaped portion; and a slider which slides so as to fold back an outer surface and inner surface of the arch-shaped portion. The slider has a low-adhesive peeling part and folds back the slider with the sheet-like delivery object placed thereon, at a tip of the body, thereby, enabling projecting the arch-shaped sheet-like delivery object toward the tip side of the body.SELECTED DRAWING: Figure 1

Description

TECHNICAL FIELD The present invention relates to a medical device and method for delivering a sheet-like delivery to a target site.

In recent years, attempts have been made to transplant various cells in order to repair damaged tissues and the like. For example, use of fetal myocardial cells, skeletal myoblasts, mesenchymal stem cells, cardiac stem cells, ES cells, iPS cells, etc. for the repair of myocardial tissue damaged by ischemic heart diseases such as angina pectoris and myocardial infarction. has been attempted (Non-Patent Document 1).

As part of such attempts, a cell structure formed using a scaffold and a sheet-like cell culture in which cells are formed into a sheet have been developed (Non-Patent Document 2).
Regarding application of sheet cell culture to treatment, use of cultured epidermal sheet for skin damage due to burns, use of corneal epithelial sheet cell culture for corneal damage, oral mucosa sheet for endoscopic resection of esophageal cancer Studies on the use of morphogenetic cell cultures are underway, and some of them have entered the stage of clinical application.

Regarding surgical methods for administering sheet-like cell cultures to target sites, endoscopic surgery is widely used as a minimally invasive surgical method for the human body. Various instruments have been proposed for
For example, the transporting and administering device described in Patent Document 1 has a sheet supporting member formed into a cylinder and stored in an outer cylinder, thereby reducing the degree of invasiveness to the human body and allowing the sheet-shaped therapeutic substance to reach the implantation site. can be transported.

The sheet sticking device described in Patent Document 2 moves a rod-shaped member arranged along the surface of the sheet supporting portion along the surface of the sheet supporting portion to peel off the sheet-like substance, thereby attaching the sheet-like substance to the target site. can be affixed to
The delivery device described in Patent Document 3 is a sheet detachable device capable of applying a negative pressure to the sheet support to adsorb and hold the sheet-shaped therapeutic substance and a positive pressure to release the sheet-shaped therapeutic substance from the sheet support. The sheet can be administered by means.
The transfer device described in Patent Document 4 includes a displacement body that is displaceably provided with respect to a main body, and a belt that is wound so as to cover the displacement body and is connected to the main body. By displacing it, the biological implant placed on the belt can be transported.

Japanese Patent Application Laid-Open No. 2009-511 JP 2016-187601 A JP 2008-173333 A JP 2012-30045 A

Haraguchi et al., Stem Cells Transl Med. 2012 Feb;1(2):136-41 Sawa et al., Surg Today. 2012 Jan;42(2):181-4

The inventors of the present invention have faced problems such as the difficulty in efficiently delivering the sheet-shaped delivery product to the target site while maintaining the shape of the delivery product as described above. Accordingly, an object of the present invention is to solve such problems and to realize a medical device for delivering a sheet-like delivery product to a target site while maintaining its shape with a simple mechanism and a simple operation. do.

In order to solve the above problems, the inventors of the present invention have made intensive research and found that by using a sliding body that slides on a main body having an arch-shaped portion, while maintaining the shape of a sheet-like delivery product, For the first time, it was found that it can be efficiently delivered to the target site, and as a result of further research based on this finding, the present invention was completed.

That is, the present invention relates to the following.
[1] A medical device for delivering a sheet-shaped delivery product to a target site, comprising a main body having an arch-shaped portion, and a sliding body that slides so as to fold back the outer surface and the inner surface of the arch-shaped portion, By sliding the sliding body on which the sheet-like delivery is placed, the sheet-like delivery can be moved between an application position where the sheet-like delivery is on the outer surface and a protection position where the sheet-like delivery is on the inner surface. Medical equipment.
[2] The medical device according to [1], wherein the sliding body has a convex portion extending in the sliding direction.
[3] The medical device according to [1] or [2], wherein the sliding body has a hole through which fluid placed between the sliding body and the main body can be released.
[4] The medical device according to any one of [1] to [3], further including an elongated body connected to the inner end of the sliding body.
[5] The medical device according to any one of [1] to [4], further including a cylinder connected to the outer end of the sliding body.

[6] The medical device according to any one of [1] to [5], wherein the sliding body can be expanded and contracted in the circumferential direction.
[7] A method for delivering a sheet-like delivery to a target site, comprising: providing the medical device according to any one of [1] to [6]; The method, comprising the steps of placing, moving the sheet delivery to a protective position, approximating the medical device to the target site, and moving the sheet delivery to an application position.
[8] The method according to [7], wherein the access to the target site is performed by inserting the medical device through a cylindrical body transperitoneally inserted into the body cavity.
[9] The method of [7] or [8] for transperitoneally inserting a sheet-like delivery product into a body cavity and delivering it to a target site.

[10] A medical device for delivering a sheet-shaped delivery product to a target site, comprising a main body having an arch-shaped portion, and a sliding body that slides so as to fold back the outer surface and the inner surface of the arch-shaped portion, The sliding body has a peeling part with low adhesion, and by folding back the peeling part on which the sheet-like delivery is placed at the tip of the main body, the arch-shaped sheet-like delivery can be protruded toward the tip of the main body. , said medical device.
[11] The medical device according to [10], wherein the exfoliation section has stretchability.
[12] The medical device according to [10] or [11], wherein the peeling section has a plurality of protrusions.
[13] The medical device according to any one of [10] to [12], wherein the peeling portion is folded back at the tip of the main body to separate from the sheet-shaped delivery product.
[14] The medical device according to any one of [10] to [13], which is configured so that a sheet-like delivery product can be placed on the inner surface of the arch-shaped portion.
[15] The medical device according to any one of [10] to [14], wherein the sliding body is expandable.

[16] A method for delivering a sheet-like delivery to a target site, comprising: providing the medical device according to any one of [11] to [15]; The above method, comprising the steps of placing, bringing the medical device close to the target site, and projecting the sheet-like delivery to the distal side of the main body.
[17] The method of [16], wherein the access to the target site is performed by inserting the medical device through a cylindrical body transperitoneally inserted into the body cavity.
[18] The method of [16] or [17] for transperitoneally inserting a sheet-like delivery product into a body cavity and delivering it to a target site.

[19] A medical device for delivering a sheet-shaped delivery product to a target site, comprising a main body having an arch-shaped portion, a sliding body that slides so as to fold back the outer surface and the inner surface of the arch-shaped portion, and a sliding body By attaching the support on which the sheet-shaped delivery is placed to the sliding body and sliding it, the application position where the sheet-shaped delivery is on the outer surface and the sheet-shaped delivery on the outer surface The medical device that can be moved to and from a protected position on the inner surface.
[20] The support has flexibility, one end of the support is attached to the sliding body, and by sliding the sliding body, the support can protrude toward the tip side of the main body, [19] ] The medical device described in .
[21] The medical device according to [20], wherein the support can be pivoted onto the outer surface of the main body from a state protruding toward the distal end of the main body.
[22] The support has flexibility, the lower surface of the support is attached to the sliding body, and by sliding the sliding body, the support can be folded back on the tip side of the main body. [19] medical device described in .

[23] The medical device according to any one of [19] to [22], wherein the support has pores.
[24] A method for delivering a sheet-like delivery to a target site, comprising: providing the medical device according to any one of [19] to [23]; moving the support to a protective position; approximating the medical device to the target site; and moving the sheet delivery to an application position.
[25] The method of [24], wherein the access to the target site is performed by inserting the medical device through a cylindrical body transperitoneally inserted into the body cavity.
[26] The method of [24] or [25] for transperitoneally inserting a sheet-like delivery product into a body cavity and delivering it to a target site.

According to the present invention, it is possible to efficiently deliver a sheet-shaped delivery product to a target site while maintaining its shape with a simple mechanism and simple operation, so that there are great merits in terms of workability and manufacturing cost. be.

FIG. 1 is a conceptual diagram showing a medical device according to a first embodiment of the invention. FIG. 2 is a diagram showing a usage example of the medical device according to the first embodiment of the present invention. FIG. 3 is a conceptual diagram showing a first modified example of the medical device according to the first embodiment of the present invention. FIG. 4 is a conceptual diagram showing a second modification of the medical device according to the first embodiment of the present invention. FIG. 5 is a diagram showing a usage example of the medical device according to the second embodiment of the present invention. FIG. 6 is a diagram showing a usage example of the medical device according to the third embodiment of the present invention. FIG. 7 is a diagram showing a usage example of the first modified example of the medical device of the third embodiment of the present invention. FIG. 8 is a conceptual diagram showing a modification of the medical device according to the present invention. FIG. 9 is a conceptual diagram showing a modification of the medical device according to the present invention.

In the present invention, the “sheet-shaped delivery product” means a sheet-shaped drug, a regenerative medicine product, a medical device, etc., which is delivered to a living body and used for treatment or the like. The sheet-like includes film-like and membranous (high-viscosity substance). Sheet-form pharmaceuticals include tissue adhesives, local anesthetics, and the like. Sheet-like regenerative medicine products include grafts, cell cultures, and the like. Sheet-like medical devices include anti-adhesion materials, hemostatic materials, wound dressings, and the like.
In the present invention, the term "graft" means a structure for transplantation into a living body, and particularly means a structure for transplantation containing living cells as a constituent. Examples of the graft of the present invention include, but are not limited to, sheet-like cell cultures, spheroids, cell aggregates, etc., preferably sheet-like cell cultures or spheroids, more preferably sheet-like cells. It is a culture.

In the present invention, the term "sheet-like cell culture" refers to a sheet-like cell culture formed by connecting cells to each other. Cells may be connected to each other directly (including through cellular elements such as adhesion molecules) and/or through intermediaries. The intervening substance is not particularly limited as long as it is a substance capable of at least physically (mechanically) connecting cells to each other, and examples thereof include extracellular matrix. The mediator is preferably of cell origin, in particular of cells that make up the cell culture. The cells are at least physically (mechanically) linked, but may also be functionally linked, eg chemically, electrically. Sheet-like cell cultures may be composed of one cell layer (single layer) or composed of two or more cell layers (laminated (multilayered) body, e.g., two layers, three layers, 4 layers, 5 layers, 6 layers, etc.). Moreover, the sheet-like cell culture may have a three-dimensional structure in which the cells do not exhibit a clear layered structure and have a thickness exceeding the thickness of a single cell. For example, in a vertical cross section of a sheet-like cell culture, the cells may be nonuniformly arranged (for example, in a mosaic pattern) without being evenly aligned in the horizontal direction.

The sheet-like cell culture preferably does not contain a scaffold (support). Scaffolds are sometimes used in the art to attach cells onto and/or into their surfaces and maintain the physical integrity of sheet-like cell cultures. The sheet-like cell culture of the present invention can maintain its physical integrity without such a scaffold. In addition, the sheet-like cell culture of the present invention can be coated with fibrin or the like to reinforce its physical strength.

Cells constituting the sheet-like cell culture are not particularly limited as long as they can form the sheet-like cell culture, and include, for example, adherent cells (adherent cells). Adherent cells include, for example, adherent somatic cells (e.g., cardiomyocytes, fibroblasts, epithelial cells, endothelial cells, hepatocytes, pancreatic cells, kidney cells, adrenal cells, periodontal ligament cells, gingival cells, periosteal cells, skin cells, synovial cells, chondrocytes, etc.) and stem cells (e.g., myoblasts, tissue stem cells such as cardiac stem cells, embryonic stem cells, pluripotent stem cells such as iPS (induced pluripotent stem) cells, mesenchymal stem cells, etc.) and so on. Somatic cells may be stem cells, particularly those differentiated from iPS cells (iPS cell-derived adherent cells). Non-limiting examples of cells that make up the sheet-like cell culture include myoblasts (e.g., skeletal myoblasts), mesenchymal stem cells (e.g., bone marrow, adipose tissue, peripheral blood, skin, hair roots, muscle tissue, endometrium, placenta, umbilical cord blood-derived, etc.), cardiomyocytes, fibroblasts, cardiac stem cells, embryonic stem cells, iPS cells, synovial cells, chondrocytes, epithelial cells (e.g., oral mucosal epithelial cells) , retinal pigment epithelial cells, nasal mucosal epithelial cells, etc.), endothelial cells (e.g., vascular endothelial cells, etc.), hepatocytes (e.g., liver parenchymal cells, etc.), pancreatic cells (e.g., pancreatic islet cells, etc.), renal cells, adrenal cells , periodontal ligament cells, gingival cells, periosteal cells, skin cells, and the like. Non-limiting examples of iPS cell-derived adhesive cells include iPS cell-derived cardiomyocytes, fibroblasts, epithelial cells, endothelial cells, hepatocytes, pancreatic cells, renal cells, adrenal cells, periodontal ligament cells, gingival cells, and periosteal cells. , skin cells, synovial cells, chondrocytes, and the like.

In the present invention, "medical device" means a machine intended to be used for the diagnosis, treatment or prevention of diseases in humans or animals, or to affect the structure or function of the human or animal body. It refers to equipment, etc.

In the present invention, the term “target site” refers to the portion to which the sheet-shaped delivery product is applied (pasted). The target site includes, for example, the surface of an organ, a damaged site of an organ, an anastomosis site of an organ, and the like. The target site is typically the heart, the surface of the heart, a damaged site of the heart, an anastomotic site of the heart, or the like. Further, the target site includes a site where damage (wound) exists in a hollow organ, such as a damaged site inside the lumen wall, the opposite side of the lumen wall corresponding to the site where damage exists, and the like. "Hollow organ" means an organ with a lumen enclosed in a body cavity, i.e., an organ with a tubular or bag-like structure, such as the digestive system, circulatory system, urinary system, respiratory system, Reproductive organs and the like can be mentioned.

Gastrointestinal organs include the esophagus, stomach, duodenum, pancreas, gallbladder, bile duct, small intestine, large intestine, rectum, and the like. Among them, the duodenum is most preferable because of its thin luminal wall, high risk of perforation, and its exposure to various digestive juices, which is likely to cause damage to the duodenum.

In one aspect, the sheet delivery is immersed in a protective liquid. The “sheet-like delivery product” is not particularly limited as long as it is a liquid that can maintain the shape and function of the graft. Liquids such as culture media, water, or mixtures thereof.

In the present invention, "delivering a sheet-shaped delivery product to a target site" means moving the sheet-shaped delivery product from the proximal side of the main body to the distal side closer to the target site. The proximal side of the main body is the side of the operator who operates the medical device, and the distal side of the main body is the side opposite to the proximal side, which is closer to the target site and the side on which the sheet-shaped delivery product is delivered. .
In the present invention, the "main body" refers to a plate-like member having a surface capable of supporting a sheet-like delivery. The body has an arcuate portion (arcuate portion), the arcuate portion having an inner surface and an outer surface opposite the inner surface. For example, when the main body has a tubular shape with a quadrangular cross section formed by connecting four plate-like members, the arch-shaped portion is a square shape including a square C shape, and the inner recessed surface is the inner surface. The outer protruding surface on the opposite side is called the outer surface.

For example, when the main body has a cylindrical shape with a circular cross section obtained by rolling one plate-like member into a circular shape, the arch-shaped portion is an O shape including a C shape, and the inner surface and the outer surface are It is a curved surface. For example, when the main body has a semi-cylindrical shape with a semi-circular cross section obtained by rolling one plate-like member into a semi-circular shape, the arch-shaped portion is C-shaped, and the inner and outer surfaces are curved surfaces. That is, the arch-shaped portion refers to a square-shaped, U-shaped, O-shaped, or C-shaped arch-shaped portion of the main body. The square shape includes the U shape, and the O shape includes the C shape. In the present invention, the recessed side of the arcuate portion may be referred to as the inner surface, concave surface, inner side, inner side, and the protruding side of the arched portion may be referred to as the outer surface, convex surface, outer side, or outer side. The arch shape also includes an arc shape.

Either the inner surface or the outer surface of the arcuate portion may be planar, for example, the inner surface may be concave and the outer surface may be planar, or the inner surface may be planar and the outer surface may be convex. The main body has rigidity, and by arranging the sheet-shaped delivery on its concave surface, it is possible to protect the sheet-shaped delivery from external forces. Objects can be held convex or concave. The main body may have at least a portion of an arched portion with a concave surface and/or a convex surface, and may be a member with a semicircular, circular, square, or polygonal cross section. The main body is preferably elongated so that it can linearly support a plurality of sheet-shaped deliverables.

The material of the main body is not particularly limited, and various known materials can be used singly or in combination. Examples of such materials include metals, soft vinyl chloride resins, polyurethane resins, silicone rubbers, natural rubbers, synthetic rubbers, styrene-ethylene-butylene-styrene copolymers (SEBS), styrene-ethylene-propylene-styrene copolymers. Polymer (SEPS), ethylene vinyl acetate copolymer (EVA), polyamide resin and polyamide elastomer such as nylon, polyester resin and polyester elastomer such as polyethylene terephthalate (PET), olefin resin such as polyethylene, fluororubber, fluororesin , polystyrene, polymethyl methacrylate, polycarbonate, polyimide, polyetherimide, polyetheretherketone, etc., and one or more of these may be used in combination.

In the present invention, the "sliding body" refers to a belt-like body on which a sheet-like delivery can be placed on a surface while maintaining its shape. The sliding body can slide along the surface shape of the main body. It deforms into a concave shape along the concave surface. The strip has a length that allows it to slide along the main body, and can support one sheet-like delivery on it, or can linearly support a plurality of sheet-like deliveries. . The sliding body slides along the longitudinal direction of the main body and is folded back at the tip of the main body, thereby moving from the inner surface to the outer surface and from the outer surface to the inner surface. That is, the sliding body is turned upside down by being folded back, and the support surface on which the sheet-like delivery is placed is also turned upside down.

The material of the sliding body is not particularly limited, and various known materials can be used singly or in combination. Examples of such materials include metals, soft vinyl chloride resins, polyurethane resins, silicone rubbers, natural rubbers, synthetic rubbers, styrene-ethylene-butylene-styrene copolymers (SEBS), styrene-ethylene-propylene-styrene copolymers. Polymer (SEPS), ethylene vinyl acetate copolymer (EVA), polyamide resin and polyamide elastomer such as nylon, polyester resin and polyester elastomer such as polyethylene terephthalate (PET), olefin resin such as polyethylene, fluororubber, fluororesin etc., and one or more of these may be used in combination.

In the present invention, the term “hole” refers to one or more through-holes provided in a support surface for placing a sheet-like delivery, such as a sliding member or a support, on the surface supporting the sheet-like delivery. By feeding the fluid from the opposite side and discharging the fluid through the holes, the sheet-like delivery can be peeled off from the support surface and attached. It is sufficient that the fluid can be ejected, and if at least one hole is provided in a portion of the support surface that is in contact with the vicinity of the edge of the sheet-shaped delivery, the sheet-shaped delivery can be peeled from the vicinity of the edge.

A plurality of holes are preferably discretely arranged on the support surface so that the peeling position of the sheet-like delivery can be adjusted. For example, by providing at least one of a plurality of holes near the edge of the sheet-like delivery, peeling the sheet-like delivery from the vicinity of the edge, and then discharging the fluid from other holes, the sheet-like The delivery can also be peeled off in stages. The arrangement of the plurality of holes can be, for example, a matrix arrangement of rows and columns such as 2×2 to 40×40, 5×5 to 20×20, etc., and the spacing between the holes is, for example, 0.05 mm to 0.05 mm. 10 mm, 0.5 mm to 2 mm, and the diameter of the hole can be, for example, 0.05 mm to 10 mm, 0.3 to 0.6 mm, but not limited to these, anyone skilled in the art For example, it can be freely selected according to the size of the sheet-like delivery, the degree of adhesion between the sheet-like delivery and the support surface, and the like. A matrix arrangement of a plurality of pores can also be achieved by structuring the support surface as a mesh structure.

In the present invention, "fluid" is a general term for gases and liquids that can be extruded and peeled off without damaging the sheet-like delivery. The liquid is composed of at least one component, and the component is not particularly limited, and is composed of, for example, liquids such as water, aqueous solutions, non-aqueous solutions, suspensions, emulsions, and the like. The components that constitute the liquid are not particularly limited as long as they have little effect on the sheet-shaped delivery product. When the sheet-like delivery product is a film made of a material derived from a living body, the component that constitutes the liquid must be biocompatible, that is, it does not cause unwanted effects such as inflammatory reactions, immune reactions, and toxic reactions on living tissues and cells. It is preferable to use a material that does not cause such an effect or at least has a small effect.

In the present invention, the term "support" refers to a flat plate-like body capable of supporting a sheet-like delivery while maintaining its shape. The support has flexibility, and can be bent while supporting the sheet-like delivery material and stored along the inside of the main body, etc., and when exposed from the main body, it can be flattened due to its resilience. be able to. The material of the support is not particularly limited, and various known materials can be used alone or in combination. Examples of such materials include metals, soft vinyl chloride resins, polyurethane resins, silicone rubbers, natural rubbers, synthetic rubbers, styrene-ethylene-butylene-styrene copolymers (SEBS), styrene-ethylene-propylene-styrene copolymers. Polymer (SEPS), ethylene vinyl acetate copolymer (EVA), polyamide resin and polyamide elastomer such as nylon, polyester resin and polyester elastomer such as polyethylene terephthalate (PET), olefin resin such as polyethylene, fluororubber, fluororesin etc., and one or more of these may be used in combination.

In the present invention, the term “cylindrical body (tubular body)” refers to a pipe-shaped elongated object having a space inside. The tubular body has openings at both ends thereof, and can deliver a delivery product to the distal side through the inner space. The tubular body is not particularly limited as long as it has a degree of rigidity that can protect the delivered product from external force, and any tubular body including commercially available tubular bodies can be used. Materials for the cylindrical body include, for example, polyethylene, polypropylene, fluororesin, polyethylene terephthalate, polymethyl methacrylate, polyamide resin, polystyrene, polycarbonate, polyimide, polyetherimide, polyetheretherketone, glass, metal (eg, iron, stainless steel, aluminum, copper, brass) and the like, but are not limited to these.

The tubular body may be made of a flexible material, in which case even if the passageway for insertion into the body is curved during laparoscopic surgery or thoracoscopic surgery, the passageway can be It can be curved according to the shape, or bent to adjust the relative angle between the tubular body and the target site. The outer diameter of the tubular body is not particularly limited, but can be, for example, 2.2 to 25 mm, preferably 5 to 20 mm. The inner diameter of the tubular body is not particularly limited, but can be, for example, 2 to 20 mm, preferably 3 to 15 mm.

In the present invention, the “peeling portion” refers to the portion of the sliding body on which the sheet-like delivery is placed, and the “low adhesion” means that the adhesion between the sheet-like delivery and the peeling portion is low. Say. The peeled portion of the sliding body can be realized by making it from a low-adhesion material, or by coating the surface with a low-adhesion material. The degree of low adhesion can be quantified, for example, by applying a tensile load to the sheet-shaped delivery on the peeling portion and measuring the load when peeled, and the peel load is typically 0.0001N to 0.0001N. 0.5N, preferably 0.001N to 0.1N. A person skilled in the art can find the optimum low-adhesion material by examining the adhesion between the sheet-shaped delivery product and the peeling portion using various materials.

The peeling portion with low adhesion can also be realized by processing the portion of the sliding body on which the sheet-like delivery is placed. For example, a peeling part with low adhesion can be realized by forming a plurality of projections on a part of the sliding body and reducing the contact area by contacting the sheet-like delivery with the plurality of projections. . The peeling portion with low adhesion can also be realized by imparting stretchability to the portion of the sliding body on which the sheet-like delivery is placed. That is, for example, when the stretchable peeling portion is folded back from the outside to the inside at the tip portion of the main body, the peeling portion pulled inward stretches. When the peeling portion stretches (increases in area), the non-stretching sheet-like delivery placed thereon separates from the peeling portion. The stretchable peeling portion can be configured to extend to a length of, for example, 1.1 to 5 times, 1.8 to 4 times, or 2 to 3 times the original length.
A person skilled in the art can find the most suitable stretchable material by examining the adhesiveness between the sheet-shaped delivery product and the peeling portion using various materials.

The size and materials of the main body, sliding body, projections, holes, long bodies, cylinders, supports, cylinders, etc. are determined by the size and type of the sheet-shaped delivery product to be delivered to the target site, and the size and type of the sheet-shaped delivery product to be delivered to the target site. The number of sheet-shaped deliverables, the distance from the target site, operability, weight, cost, etc., can be considered. When the sheet-like delivery product is, for example, a sheet-like cell culture with a diameter of about 60 mm, the diameter of the main body can be 2.2-25 mm, preferably 5-20 mm, more preferably 10-15 mm. .

BEST MODE FOR CARRYING OUT THE INVENTION A medical device according to a preferred embodiment of the present invention will be described in detail below with reference to the drawings.
FIG. 1 is a conceptual diagram showing a medical device according to a first embodiment of the present invention, FIG. 2 is a diagram showing a usage example of the medical device according to the first embodiment, and FIG. 3 is a medical device according to the first embodiment. FIG. 4 is a conceptual diagram showing a first modified example of the medical device of the first embodiment, FIG. 5 is a conceptual diagram showing a second modified example of the medical device according to the second embodiment of the present invention, and FIG. 6 is a diagram showing a usage example of the medical device according to the third embodiment of the present invention, and FIG. 7 is a diagram showing a usage example of the first modification of the medical device according to the third embodiment.
In addition, in each drawing in the present application, the size of each member is appropriately emphasized for ease of explanation, and each member shown does not indicate the actual size.

First Embodiment First, the first embodiment of the present invention will be described.
As shown in FIG. 1, a medical device M according to the first embodiment of the invention includes a main body 1 and a sliding body 2. As shown in FIG. The main body 1 is a long cylindrical body having a cylindrical shape, and the inner surface of the O-shaped arch-shaped portion forms a concave curved surface and the outer surface forms a convex curved surface. The sliding body 2 is a long strip-like body having a cylindrical shape, and has an inner diameter larger than the outer diameter of the main body 1 . The sliding body 2 can be slid so that the outer surface and the inner surface of the main body 1 are folded back, and deforms along the outer surface shape and the inner surface shape of the main body 1 . It is desirable that the front end of the main body 1 has an R-shaped cross section in order to allow the sliding body 2 to slide smoothly and to suppress wear of the sliding body 2 .

For example, the sliding body 2 is passed from the base end side (right side in FIG. 1) of the main body 1 to the outside, pulled in the distal direction (left direction in FIG. 1), folded back inward at the leading end of the main body 1, and the folded back portion is used as the base. The inner surface and the outer surface of the main body 1 can be covered by pulling in the end direction. By pulling the inner end portion 21 of the sliding body 2 toward the proximal end of the main body 1 , the sliding body 2 is pulled from the outer surface to the inner surface of the main body 1 , and conversely, the outer end portion 22 of the sliding body 2 is pulled toward the proximal end of the main body 1 . By pulling in the direction, the sliding body 2 can be slid so as to be folded back from the inner surface of the main body 1 to the outer surface.

The inner end 21 of the slide 2 can be connected (in the shaded area) to an elongated body 3 which can move axially back and forth inside the body 1 . The outer end 22 of the slide 2 can be connected (at the hatched portion) to a cylinder 4 which can be axially retracted outside the main body 1 . That is, the elongated body 3 and the cylindrical body 4 function as an operation part for operating the sliding body 2, and by pushing these toward the distal direction of the main body 1 or pulling them toward the proximal direction, the sliding body 2 is moved. can slide relative to the body 1 .

As shown in FIG. 1, when the sheet-like delivery product S is installed on the medical device M, first, the sheet-like delivery product S is placed on the support surface of the sliding body 2 on the outer surface of the main body 1 (mounting). position). The support surface is then drawn into the inner surface of the body 1 by pulling the elongated body 3 in the proximal direction, as shown in FIG. 2a. The support surface is turned upside down from the outer surface side to the inner surface side by being folded back at the tip of the main body 1, and the sheet-like delivery S is protected from external force on the inner surface (concave surface) while maintaining its shape. become (protected position).

Next, while the sheet-like delivery product S is held on the inner surface of the main body 1, the medical device M is transperitoneally inserted into the body cavity to reach the target site T while maintaining the shape of the sheet-like delivery product S. can be brought close. Then, as shown in FIG. 2B, the cylindrical body 4 inserted into the body cavity is gripped with fingers or the like, the elongated body 3 is pushed into the main body 1, and the supporting surface of the sliding body 2 is moved from the inside to the outside of the main body 1. After exposing (application position), the sheet-like delivery product S can be peeled off and applied to the target site T.

When applying a plurality of sheet-shaped articles S to the target site T, by placing the plurality of sheet-shaped articles S linearly in the sliding direction of the sliding body 2 and operating in the same manner as in FIG. 2a, A plurality of sheet-like deliverables S can be protected on the concave surface of the main body 1 . Then, by operating the medical device M inserted into the body cavity in the same manner as in FIG. can be applied to

To apply the sheet-shaped delivery material S to the target site T, the main body 1 is rotated so that the support surface of the sliding body 2 supporting the sheet-shaped delivery article S faces the target site T side, and the sheet-shaped delivery material S is applied to the target site T. It can be realized by pressing and peeling the delivery article S, or by separating the sheet-shaped delivery article S from the sliding body 2 using forceps C or the like, and placing it on the target site T, for example. When applying a plurality of sheet-like deliverables S to the target site T, the sheet-like deliverables S can be applied to the target site T while moving the sheet-like deliverables S one by one from the inside to the outside of the main body 1 .

The main body 1 may have any shape as long as it has a concave surface capable of protecting the sheet-like delivery S from external force. Even if the main body 1 is, for example, a plate-like member with a semicircular (C-shaped) or U-shaped cross section, and the sliding body 2 is a ribbon-shaped strip, the inner surface (concave surface) of the arch-shaped portion By using the main body 1 like a spatula to scoop up and place the sheet-like delivery S while moving the sliding body 2, it is possible to properly protect it. Then, as shown in FIG. 2a, by moving the cylinder 4 toward the distal end of the main body 1 to cover the sheet-like delivery S, the sheet-like delivery S can be protected more appropriately.

FIG. 3 is a conceptual diagram showing a first modified example of the medical device M. As shown in FIG. In this modified example, the sliding body 2 has a plurality of protrusions 23 . The sliding member 2 is reduced in diameter according to the outer diameter of the main body 1 when on the outer surface of the main body 1 and according to the inner diameter of the main body 1 when on the inner surface. That is, the sheet-like delivery S drawn into the inner surface of the main body 1 is gripped in a state in which the distance between the convex portions 23 is narrowed, so that the sheet-like delivery S is more reliably fixed to the sliding body 2 . can be done.

FIG. 4 is a conceptual diagram showing a second modification of the medical device M. As shown in FIG. In this modification, the sliding body 2 has holes 24 in the supporting surface, and the sheet-shaped delivery S is released from the sliding body 2 by feeding fluid from the side opposite to the surface supporting the sheet-shaped delivery S. can be dropped onto the target site T. 4a shows the case where the base end of the main body 1 is closed with a valve V and the fluid is fed from the port P on the side surface of the main body 1 toward the inner end 21 of the sliding body 2, and FIG. A case is shown in which the end side is closed with a valve V and the fluid is sent from the port P on the side surface of the cylindrical body 4 toward the outer end portion 22 of the sliding body 2 .

The use of the medical device M of the first embodiment can be carried out sequentially by the following steps.
(1) Providing the medical device M (2) Placing the sheet-shaped delivery article S on the sliding member 2 (3) Moving the sheet-shaped delivery article S to the protective position (4) Moving the medical device M to the target site T (5) Move the sheet-shaped delivery article S to the application position (6) Peel off the sheet-shaped delivery article S (7) Apply the sheet-shaped delivery article S to the target site T

The sheet-like delivery product S can be delivered to the target site T by steps (1) to (5). In (2), the sheet-like delivery S can be placed on the inner sliding body 2 or the outer sliding body 2 of the main body 1 . In (3), the sheet-like delivery article S can also be covered with the cylinder 4 . In (4), the medical device M can be passed through a tubular body that has been transperitoneally inserted into the body cavity to bring it closer to the target site T. In (7), the sheet-shaped delivery product S can be dropped onto the target site T for application.

As described above, according to the present invention, it is possible to efficiently deliver a sheet-shaped delivery product to a target site while maintaining its shape with a simple mechanism and a simple operation. There is a big advantage in that point.

Second Embodiment Hereinafter, a medical device according to a second preferred embodiment of the present invention will be described in detail with reference to the drawings.
As shown in FIG. 5, a medical device M according to a second embodiment of the present invention includes a main body 1 and a ribbon-shaped slider 2 . The sliding body 2 has a peeling portion for supporting the sheet-like delivery S. As shown in FIG. The peeling portion is a portion of the sliding body 2 that supports the sheet-like delivery S, and the surface thereof has low adhesiveness. As shown in FIG. 5a, when installing the sheet-shaped delivery product S on the medical device M, first, the peeling portion of the sliding body 2 is moved to the outer surface of the arch-shaped portion of the main body 1 (placement position), A sheet-like delivery S is placed on the peeling section.

As shown in FIG. 5b, pulling the elongated body 3 in the proximal direction draws the peeled portion into the inner surface of the main body 1. As shown in FIG. The peeling portion is folded back at the tip of the main body 1 and turned upside down from the outer surface side to the inner surface side, while the sheet-like delivery product S protrudes to the front end side of the main body 1 without being turned over. That is, the sheet-shaped delivery S held on the outer surface in an arch shape moves toward the distal end together with the peeling portion, and when the peeling portion is folded back at the distal end, the sheet-shaped delivery S is released from the peeling portion with low adhesion. break away. The sheet-shaped delivery article S having an arch shape and a certain strength protrudes toward the tip side of the main body 1 while maintaining its shape (applied position). In order to give the sheet-shaped delivery product S a certain strength, the sheet-shaped delivery product S may be reinforced by applying fibrin or the like.

That is, as shown in FIG. 5B, since the sheet-like delivery S is separated from the slide body 2 and protrudes toward the tip side, it can be easily grasped (sandwiched) with forceps C or the like and applied to the target site T. can be done. Further, as shown in FIG. 5c, it is also possible to rotate the main body 1 so that the sheet-like delivery product S faces the target site T and place the sheet-like delivery product S on the target site T without rotating it. The tip of the main body 1 (sheet-like delivery product S) can also be pressed against the target site T. It is also possible to further project the sheet-like delivery S from the state of FIG.

Contrary to FIG. 5a, the sheet-like delivery article S can be placed in a state in which the peeling portion of the sliding body 2 is moved to the inner surface of the arch-shaped portion of the main body 1. FIG. That is, when the arch-shaped portion of the main body 1 is partially open, such as in a U-shape or a C-shape, the main body 1 is held with a spatula while the peeling portion is moved to the inner surface (placement position). It can be used to scoop up and place the sheet-like delivery S. As a result, the sheet-like delivery article S is protected on the inner surface (protected position), and the arch-shaped sheet-like delivery article S is folded back from the inside to the outside of the main body 1 by sliding the peeling portion outward. It can also protrude to the tip side (application position). When the main body 1 is partly open, the slide body 2 is connected to the barrel 4 (not shown), and the barrel 4 is moved to the distal end side of the main body 1 to more appropriately release the sheet-like delivery. S can also be protected.

Use of the medical device M of the present invention can be carried out sequentially by the following steps.
(1) Providing the medical device M (2) Placing the sheet-shaped delivery article S on the peeling section (3) Bringing the medical device M closer to the target site T (4) Placing the sheet-shaped delivery article S (5) Apply the sheet-like delivery S to the target site T

The sheet-like delivery product S can be delivered to the target site T by steps (1) to (4). In (2), the sheet-like deliverable S can be placed on the peeling section inside or outside the main body 1 . When the sliding body 2 is connected to the cylinder 4, in (3), the cylinder 4 can be moved to the distal end side of the main body 1 to cover the sheet-like delivery S. In (3), the medical device M can be passed through a tubular body that has been transperitoneally inserted into the body cavity to bring it closer to the target site T. Between (4) and (5), (6) a step of separating the sheet-like delivery product S from the slide body 2 may be included. In (5), the sheet-shaped delivery product S can be dropped onto the target site T for application.

As described above, according to the present invention, it is possible to efficiently deliver a sheet-shaped delivery product to a target site while maintaining its shape with a simple mechanism and a simple operation. There is a big advantage in that point.

Third Embodiment Hereinafter, a medical device according to a preferred embodiment 3 of the present invention will be described in detail with reference to the drawings.
As shown in FIG. 6, a medical device M according to a third embodiment of the invention includes a main body 1, a slide body 2 and a support body 5. The sliding body 2 is a ribbon-shaped belt-like body, and is wound along the axial direction between the base end portion and the tip end portion of the main body 1 . A part of the sliding body 2 can be connected to the elongated body 3, and by moving the elongated body 3 forward and backward with respect to the main body 1, the sliding body 2 can be slid in the distal direction or the proximal direction. can be done.

The support 5 can be connected at one end to the slide 2 via a connection 51 and can slide on the outer and inner surfaces of the main body 1 so as to follow the sliding of the slide 2 . . As shown in FIG. 6a, the support 5 is flexible, and when the support 5 is protruded toward the distal end of the main body 1, it develops into a flat surface on which the sheet-like delivery material S can be placed. can be done. When placing the sheet-like delivery S, the support 5 on which the sheet-like delivery S is placed can be attached to the sliding body 2 .

Next, as shown in FIG. 6b, the support 5 is drawn into the inner surface of the arcuate portion of the main body 1 by pulling the elongate body 3 to which the slide 2 is connected in the proximal direction. The support 5 is bent by being pressed against the distal end of the main body 1 and stored on the inner surface of the main body 1 while supporting the sheet-like delivery S inside. Next, while the sheet-like delivery product S is held on the inner surface of the main body 1, the medical device M is transperitoneally inserted into the body cavity, thereby maintaining the shape of the sheet-like delivery product S and efficiently achieving the intended purpose. It can be brought close to the site T.

Then, as shown in FIG. 6c, the elongated body 3 to which the slide body 2 is connected is pushed into the main body 1, and the support body 5 is protruded toward the distal end of the main body 1 and expanded, thereby forming a sheet-like delivery product S. It can be applied to the target site T (application position). Further, as shown in FIG. 6d, the elongated body 3 is further pushed toward the distal end of the main body 1, and one end (connecting portion 51) of the support body 5 connected to the sliding body 2 is pushed outside the arch-shaped portion of the main body 1. As shown in FIG. , the support 5 can also be pivoted onto the outer surface of the body 1 (application position).

As shown in FIG. 6c, when the support 5 is on the outer surface of the main body 1, the sheet-like delivery S faces the target site T, so there is no need to rotate the main body 1 and the operation is simple. be. The support 5 may have holes (not shown), and by discharging fluid through the holes from the side opposite to the surface of the support 5 that supports the sheet-like delivery S, the sheet-like material can be formed. It is also possible to release the delivered article S from the support 5 and drop it onto the target site T. FIG.

FIG. 7 is a conceptual diagram showing a first modification of the medical device M of the third embodiment. In this modification, the support body 5 has flexibility, and the connection portions 51 at both ends thereof can be connected to the slide body 2 . As shown in FIG. 7a, when placing the sheet-like delivery S, the sliding body 2 (supporting body 5) is moved and placed on the outer surface of the main body 1 (placement position). Next, as shown in FIG. 7c, the sliding member 2 to which the supporting member 5 is connected is pulled into the inner surface of the main body 1, so that the sheet-like delivery S is protected on the inner surface (protection position). .

By transperitoneally inserting the medical device M into the body cavity while the sheet-like delivery product S is held on the inner surface of the main body 1, the sheet-like delivery product S can be efficiently delivered to the target site T while maintaining the shape of the sheet-like delivery product S. can be brought close. Then, as shown in FIG. 7e, the elongated body 3 is pushed toward the distal end of the main body 1, and the support 5 is turned over onto the outer surface of the main body 1 (application position), thereby peeling off the sheet-like delivery S. can be applied to the target site T.

In FIG. 6d the flexible support 5 pivots largely as indicated by the arrows, whereas in FIGS. , and following it, the flexible support 5 makes a small turn (folds back) as indicated by the arrow. By turning the support 5 slightly, it is possible to prevent the support 5 from inadvertently damaging the target site T or the like.

The use of the medical device M of the third embodiment can be performed sequentially by the following steps.
(1) Providing the medical device M (2) Placing the sheet-like delivery S on the support 5 (3) Moving the support 5 to a protective position (4) Bringing the medical device M closer to the target site T (5) Move the sheet-shaped delivery article S to the application position (6) Peel off the sheet-shaped delivery article S (7) Apply the sheet-shaped delivery article S to the target site T

The sheet-like delivery product S can be delivered to the target site T by steps (1) to (5). In (2), the support 5 on which the sheet-shaped delivery S is placed may be attached to the slide 2, or the sheet may You may put the delivery thing S of shape. In (3), the support 5 can also be covered with the cylinder 4 . In (4), the medical device M can be passed through a tubular body that has been transperitoneally inserted into the body cavity to bring it closer to the target site T.

In (6), the sheet-like delivery article S can be peeled off from the support 5 by ejecting the fluid from the holes provided in the support 5 . In (7), the sheet-shaped delivery product S can be dropped onto the target site T for application. Between (5) and (6), (8) a step of grasping the support 5 with forceps C or the like and removing it from the slide 2 may be included. In (7), the removed support 5 may be dropped onto the target site T to apply the sheet-like delivery product S.

When one end of the support 5 is connected, the application position in (5) is the state in which the support 5 protrudes toward the distal end of the main body 1 (FIG. 6c), or the support 5 is pivoted on the outer surface of the main body 1. state (FIG. 6d). When the fluid is ejected from the holes provided in the support 5, it is preferable that the support 5 is protruding toward the tip side of the main body 1. FIG. When both ends of the support 5 are connected, the application position is such that the support 5 is pivoted on the outer surface of the main body 1 (Fig. 7e), so that the support 1 side of the main body 1 is pressed against the target site T. , the sheet-like delivery product S can be applied.

As described above, according to the present invention, it is possible to efficiently deliver a sheet-shaped delivery product to a target site while maintaining its shape with a simple mechanism and a simple operation. There is a big advantage in that point.

Although the present invention has been described above with reference to the illustrated embodiments, the present invention is not limited thereto. The configurations of the first to third embodiments can be combined as appropriate.
In the present invention, each component can be replaced with any one capable of exhibiting a similar function, or any component can be added.

As a modification, for example, as shown in FIG. 8a, the outer periphery of the sliding body 2 can be expanded to be larger than the diameter of the sheet-like delivery S, and the sheet-like delivery S can be placed or applied. can also Then, as shown in FIG. 8b, by contracting the sliding body 2 to reduce the outer diameter, a minimally invasive medical device M can be realized. Since it is necessary to inject fluid in order to expand the sliding body 2, a valve body V is provided on the long body 3 and the cylindrical body 4, and an injection port P is provided on at least one of them.

In addition, as a modification, the slide body 2 whose diameter is greatly expanded from the outer diameter of the main body 1 and the placed large-area sheet-like delivery S are efficiently accommodated on the inner surface of the main body 1 (Fig. 8c). ), as shown in FIG. 9, by providing the tip of the main body 1 with jagged wave-like projections and recesses, the sliding body 2 can be accommodated so that the inner surface of the main body 1 wrinkles in a sliding star shape. A similar effect can be achieved by making the cross section of the inner surface of the main body 1 jagged (not shown).

Reference Signs List 1 Main body 2 Slider 21 Inner end 22 Outer end 23 Convex portion 24 Hole 3 Elongated body 4 Cylindrical body 5 Support body 51 Connection part S Sheet-like delivery article T Target site C Forceps

Claims (9)

A medical device for delivering a sheet-like delivery to a target site, comprising a main body having an arch-shaped portion, and a sliding body that slides so as to fold back the outer surface and the inner surface of the arch-shaped portion, wherein the sliding body The above-mentioned medical treatment, which has a peeling part with low adhesion, and by folding back the peeling part on which the sheet-shaped delivery is placed at the front end of the main body, the arch-shaped sheet-shaped delivery can be protruded to the front end side of the main body. machine. The medical device according to claim 1, wherein the peeling portion has elasticity. The medical device according to claim 1 or 2, wherein the peeling section has a plurality of protrusions. 4. The medical device according to any one of claims 1 to 3, wherein the peeling portion is separated from the sheet-like delivery by folding back at the tip of the main body. The medical device according to any one of claims 1 to 4, which is configured so that a sheet-like delivery can be placed on the inner surface of the arch-shaped portion. The medical device of any one of claims 1-5, wherein the slide is expandable. A method for delivering a sheet-like delivery to a target site, comprising:
providing a medical device according to any one of claims 1-6,
placing the sheet-like delivery on the peeling unit;
The above method, comprising the steps of: bringing the medical device close to the target site; 8. The method according to claim 7, wherein the access to the target site is performed by passing the medical device through a tubular body inserted transperitoneally into the body cavity. 9. The method according to claim 7 or 8, wherein the sheet-shaped delivery product is transperitoneally inserted into a body cavity and delivered to a target site.

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