JP4569971B2 - Equipment for transporting and administering therapeutic substances - Google Patents

Description

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

  A treatment technique for culturing and regenerating a patient's own cells into a sheet and transplanting the cell sheet to an affected area has been proposed (for example, Non-Patent Document 1). The field of application of treatment techniques using cell sheets is wide, and can be used, for example, for treatment of retinal defect tissue, treatment of myocardial infarction, treatment of endoscopic resection of the inner wall of the digestive tract, and the like. In the treatment with this type of cell sheet, the degree of invasiveness to the human body is low when the cell sheet is transported to the affected area, the fragile cell sheet can be protected, and the cell sheet is expanded into an appropriate shape without damaging the cell sheet at the time of transplantation. It is desirable that cell sheets can be transplanted reasonably and reliably to transplanted parts with complex shapes and movements such as the heart, and excellent workability at the time of transplantation. It was difficult to meet these requirements at a high level. For example, in the transplantation of cell sheets to the chest and abdominal organs, invasion can be suppressed by adopting an endoscopic technique rather than thoracotomy or laparotomy, but the cell sheet has reached the affected area. Sometimes it was difficult to deploy it without damage and transplant it accurately into the affected area. The same applies to the case where a cell sheet (retinal pigment epithelial cell sheet) is transplanted under the retina, and it was administered in a water stream from an injection needle inserted into the transplantation site under the eyeball retina. The shape of the sheet and the transplant site could not be controlled. In addition, there is a problem that a fragile cell sheet can be broken by a water flow, so that minimally invasive transplantation of the cell sheet is extremely difficult.

As a balloon actuator that performs a bending motion by changing a fluid pressure supplied to the inside, there is one described in Patent Document 1. This type of balloon actuator can be made of a highly safe material having both flexibility and biocompatibility, such as silicon rubber. In addition, as the drive control method, fluid pressure control using a small instrument such as a syringe is possible, and since no power source is required, the entire system can be configured in a portable and compact size. In addition, there is no risk of damage to the human body due to electric leakage and the like, and unlike a drive mechanism using a motor or the like, since it can be supplied at a low cost and can be disposable, the risk of infection by a medical instrument can be avoided. Thus, the balloon actuator has the preferable conditions as a medical instrument.
“Reconstruction of the esophagus by transendoscopically cultured oral mucosal epithelial cell sheet transplantation”, Tokyo Women's Medical University, Vol. 76, No. 4, p 179-183, April 2006 JP-A-2006-204612

  The present invention has a low degree of invasiveness to the human body when transporting a sheet-like therapeutic substance, can easily and reliably administer the therapeutic substance at the time of transplantation, and further has excellent safety. An object of the present invention is to provide a transport administration device.

  The therapeutic substance delivery / administration device of the present invention comprises an elastically deformable sheet support for supporting a sheet-like therapeutic substance, and a flat developed shape by changing the fluid pressure supplied to the inside. And a first shape control means for deforming into a cylindrical storage shape, and a second shape control means for changing the bending angle of the base end portion of the sheet support by a change in fluid pressure supplied to the inside. It is characterized by having prepared.

  Further, a tubular storage member capable of storing the sheet support in a cylindrical storage shape by the first shape control means, a position stored in the tubular storage member, and a distal end portion of the tubular storage member It is preferable to include forward / backward moving means capable of moving the sheet support forward and backward at the protruding position. This forward / backward moving means changes the fluid pressure in the guide member, a hollow cylindrical guide member having a tubular storage member at the tip, a base member that supports the sheet support and is supported so as to be able to advance and retreat in the guide member. Then, it can be configured by a forward / backward moving fluid pressure adjusting means for moving the base member forward / backward relative to the guide member.

  Further, a sheet detaching means capable of selectively applying a negative pressure for adsorbing and holding the sheet-like therapeutic substance to the sheet support and a positive pressure for releasing the sheet-like therapeutic substance from the sheet support may be provided.

  The sheet support is preferably formed of silicon rubber.

  According to the therapeutic substance delivery administration device of the present invention described above, when the sheet-like therapeutic substance is conveyed, the sheet support that supports the therapeutic substance has a cylindrical storage shape, so that it is inserted into the body. The hole can be made smaller. On the other hand, since the sheet support is unfolded and the angle is adjusted at the time of transplantation, the therapeutic substance can be administered easily and reliably. Further, these operations are controlled by fluid pressure, and the seat support has flexibility, so that it is excellent in safety.

  As shown in FIGS. 1 to 5, the delivery and administration device 10 of the present embodiment has an external appearance constituted by a tube support tube 11, an advance / retreat guide shaft portion 12, a grip portion 13, a sheet storage pipe 14, and the like. As shown in FIG. 5, the tube support tube 11 has a hollow portion 11a therein, and the rear end portion of the hollow portion 11a is airtightly closed except for the two tube insertion holes 11b and 11c. An advance / retreat guide shaft portion 12 is inserted and fixed on the distal end side of the hollow portion 11a, and the space between the inner peripheral surface of the tube support tube 11 (hollow portion 11a) and the outer peripheral surface of the advance / retreat guide shaft portion 12 is hermetically sealed. It is peeling. The advance / retreat guide shaft portion 12 is formed with a guide hole 12a having a cylindrical inner surface and a small-diameter hole 12b extending from the guide hole 12a toward the distal end side of the advance / retreat guide shaft portion 12. The grip portion 13 is fixed to the outer surface of the distal end of the advance / retreat guide shaft portion 12, and a sheet storage pipe 14 projects from the distal end. The sheet storage pipe 14 is a thin hollow tubular body having the same structure as the injection needle, and the internal space of the sheet storage pipe 14 and the small diameter hole 12b of the advance / retreat guide shaft portion 12 communicate with each other.

  A slide base member 15 and a manipulator 16 shown in FIG. The slide base member 15 includes a slider portion 15a having a cylindrical outer surface, a connection recess 15b located at the front portion of the slider portion 15a, and an elongated support arm 15c extending forward from the connection recess 15b. Yes. An annular groove 15d into which the O-ring 20 is fitted is formed on the outer peripheral surface of the slider portion 15a. The slider portion 15a is fitted in the guide hole 12a of the advance / retreat guide shaft portion 12 so as to be slidable in the axial direction, and the space between the slider portion 15a and the guide hole 12a is hermetically sealed by the O-ring 20 supported by the annular groove 15d. Can be removed. The support arm 15c is inserted into the small-diameter hole 12b so as to advance and retract.

  As shown in FIGS. 1 to 3, the tube 21 for advancing / retreating is inserted through the tube insertion hole 11b. The advance / retreat drive tube 21 is formed of soft rubber such as silicon rubber. When the advance / retreat drive tube 21 is inserted into the tube insertion hole 11b, the advance / retreat drive tube 21 is in a press-fitted state in which the outer skin portion is slightly crushed. The space between the tube 21 and the tube insertion hole 11b is hermetically closed. The advance / retreat driving tube 21 is connected to an advance / retreat pneumatic supply source 30. The advancing / retreating air pressure supply source 30 is a well-known air supply / suction source such as a manually operated syringe or an electrically driven inflation device, and the hollow portion 11a is connected via the advancing / retreating air pressure supply source 30 and the advancing / retreating drive tube 21. The internal air pressure can be changed. The distal end side of the hollow portion 11a is airtightly closed by the O-ring 20 as described above. Therefore, when air flows into the hollow portion 11a through the advance / retreat driving tube 21, the slide base member 15 moves in the distal direction (the direction of the sheet storage pipe 14) with respect to the advance / retreat guide shaft portion 12 due to the air pressure. Is done. On the other hand, when air is sucked from the hollow portion 11a through the advance / retreat driving tube 21, the slide base member 15 moves in the direction of the proximal end portion of the advance / retreat guide shaft portion 12 (the direction of the tube support tube 11) due to the negative pressure. Is done.

  As shown in FIG. 8, three fluid conduits 15e, 15f, 15g are formed in the slide base member 15, and one end of these three fluid conduits 15e, 15f, 15g is connected to the connection recess 15b. Openings are respectively made in cylindrical protrusions 15h, 15i, 15j formed on the bottom surface side. The other end of each fluid conduit 15e, 15f, 15g is opened to the rear end of the slider portion 15a, and an opening / closing drive tube 22 is connected to the rear end opening of the fluid conduit 15e. A snap drive tube 23 is connected to the rear end opening of the passage 15f, and a desorption operation tube 24 is connected to the rear end opening of the fluid conduit 15g (see FIGS. 3 and 8). These three tubes 22, 23, 24 are bundled with a first outer tube 25 made of silicon rubber, and extend outward from the rear end of the tube support tube 11 through the tube insertion hole 11c. (See FIG. 2). The first outer tube 25 is press-fitted so as to airtightly close the tube insertion hole 11c. When the slide base member 15 performs the above-described advance / retreat operation due to a change in the internal pressure of the hollow portion 11a, Air leakage does not occur between the outer tube 25 and the tube insertion hole 11c. The open / close drive tube 22, the snap drive tube 23, and the detachment operation tube 24 extending outward from the tube insertion hole 11 c are an open / close drive pneumatic supply source 31, a snap drive pneumatic supply source 32, respectively. It is connected to a pneumatic supply source 33 for detachment operation. The opening / closing drive pneumatic supply source 31, the snap drive pneumatic supply source 32, and the attachment / detachment operation pneumatic supply source 33 are each composed of a known air supply / suction source such as a syringe or an inflation device. The air supply / suction source can perform air supply and suction to the open / close drive tube 22, the snap drive tube 23, and the detachment operation tube 24.

  As shown in FIG. 1, the first outer tube 25 that bundles the open / close drive tube 22, the snap drive tube 23, and the attachment / detachment operation tube 24, and the advance / retreat drive tube 21 are further divided into a second envelope. By bundling with the tube 26, the tube is gathered into one and the handling and administration device 10 is easy to handle.

  As shown in FIG. 6, the manipulator 16 includes, in order from the distal end side, a sheet support portion 16a, an elongated arm portion 16b that is narrower than the sheet support portion 16a, and a connection portion 16c that is located at the proximal end of the elongated arm portion 16b. have. Then, as shown in FIG. 9, the manipulator 16 includes an opening / closing control layer 41 having a balloon actuator 40 for opening / closing operation for bending the sheet support portion 16a into a cylindrical shape, and a bending angle of the base end portion of the sheet support portion 16a. In this structure, a snap control layer 43 including a balloon actuator 42 for snap deformation that changes the angle and a sheet detachment control layer 45 including an actuator 44 for detaching a cell sheet are stacked. In the manipulator 16, the entire opening / closing control layer 41, the snap control layer 43 and the sheet attachment / detachment control layer 45 are formed of silicon rubber, and have flexibility and stretchability.

  Both of the balloon actuators 40 and 42 cause the seat support portion 16a to perform a required bending motion by changing the internal air pressure. The balloon actuator 40 in the open / close control layer 41 includes a hollow chamber 40a disposed over substantially the entire area of the seat support portion 16a, and a connection that communicates with the hollow chamber 40a and extends through the elongated arm portion 16b toward the connection portion 16c. It has the pipe part 40b and the air inlet / outlet part 40c which is arrange | positioned in the connection part 16c and connected to this connection pipe part 40b. As shown in FIG. 9, a plurality of hollow portions 40a of the balloon actuator 40 are provided at different positions in the front-rear direction of the seat support portion 16a (direction substantially parallel to the longitudinal direction of the elongated arm portion 16b). The portion 40a is formed long in the width direction of the sheet support portion 16a (a direction substantially orthogonal to the longitudinal direction of the elongated arm portion 16b). The balloon actuator 42 in the snap control layer 43 includes a hollow chamber 42a provided in the base end portion of the seat support portion 16a (in the vicinity of the connection portion with the elongated arm portion 16b), and the elongated arm portion 16b communicating with the hollow chamber 42a. And a connecting pipe part 42b extending toward the connecting part 16c and an air inlet / outlet part 42c disposed in the connecting part 16c and connected to the connecting pipe part 42b. As shown in FIG. 9, the hollow portion 42a of the balloon actuator 42 is formed long in the front-rear direction of the seat support portion 16a. The demounting actuator 44 includes an opening 44a disposed on the outer surface of the seat support 16a, and a connection tube that communicates with the opening 44a and extends through the elongated arm 16b toward the connection 16c. A portion 44b and an air inlet / outlet portion 44c disposed in the connecting portion 16c and connected to the connecting pipe portion 44b. In the connection portion 16c, openings 46, 47, and 48 communicating with the air inlet / outlet portions 40c, 42c, and 44c, respectively, are formed.

  The manipulator 16 is supported by the slide base member 15. Specifically, the elongated arm portion 16b is supported on the support arm 15c, and the connection portion 16c is fitted and supported by the connection recess 15b. At this time, the cylindrical protrusions 15h, 15i, and 15j formed in the connection recess 15b are press-fitted so as to be airtightly sealed in the openings 46, 47, and 48 of the connection portion 16c. As shown in FIG. 7, the upper surface portion of the connection recess 15 b is closed by the pressing lid 17 in a state where the connection portion 16 c is fitted, and the pressing lid 17 is fixed by the fixing tape 18 and the fixing screw 19. . The slide base member 15 is formed with a screw hole 15k into which the shaft portion of the screw 19 is screwed, and the holding cover 17 is formed with a screw insertion hole 17a through which the shaft portion of the screw 19 is inserted. In this fixed state, the three openings 46, 47, 48 on the manipulator 16 side are communicated with the fluid conduits 15e, 15f, 15g on the slide base member 15 side, respectively. That is, the opening / closing drive pneumatic pressure supply source 31 is connected to the balloon actuator 40, the snap drive pneumatic pressure supply source 32 is connected to the balloon actuator 42, and the detachment operation pneumatic pressure is applied to the detachment actuator 44. The supply source 33 is connected, and the pneumatic pressure in the balloon actuators 40 and 42 and the detachable actuator 44 can be changed by the respective pneumatic pressure supply sources. As shown in FIG. 7, in a state where the manipulator 16 is supported on the slide base member 15, the seat support portion 16 a protrudes forward from the distal end portion of the support arm 15 c, and the seat support portion 16 a of the manipulator 16 is slid. The base member 15 can be elastically deformed without being restricted.

  When the air pressure of the balloon actuator 40 is changed, the seat support portion 16a is deployed in a flat shape as shown in FIG. 12, and the storage state is such that the seat support portion 16a is curved in a cylindrical shape as shown in FIG. The manipulator 16 can be deformed. On the other hand, when the pneumatic pressure of the balloon actuator 42 is changed, the base end portion of the sheet support portion 16a is linear with respect to the elongated arm portion 16b as shown in FIG. 13, and the base end portion of the sheet support portion 16a. 14 can be changed to a snap state bent with respect to the elongated arm portion 16b as shown in FIG. These deformation amounts in the seat support portion 16a can be arbitrarily adjusted according to the magnitude of air pressure in the balloon actuators 40 and 42.

  The principle of operation of the balloon actuator that performs the bending motion by the internal fluid pressure is described in the aforementioned Patent Document 1, and the outline thereof will be briefly described with reference to FIG. The balloon actuator BA in FIG. 15 has two film bodies L1 and L2 having flexibility and stretchability. A hollow portion S is provided between the film bodies L1 and L2, and the air feeding / suction means V The internal pressure of the hollow portion S can be changed. Each of the film bodies L1 and L2 expands and contracts according to a change in the internal pressure of the hollow portion S, but the elongation ratios of the film bodies L1 are different so that the film body L1 expands more than the film body L2 under the same pressure. . In this way, in order to make the elongation rates of the film bodies L1 and L2 different, the film thickness and hardness of each film may be made different. For example, in the example of FIG. 15, the film body L1 is set to have a smaller thickness and a lower hardness than the film body L2. Then, when the hollow portion S is pressurized in a state where the film body L1 and the film body L2 are substantially planar as shown in FIG. 15, the film body L1 and the film body L2 as shown by a two-dot chain line in FIG. Are going to expand in directions away from each other, but due to the difference in elongation, the tensile stresses F1 and F2 acting on the film body L1 and the film body L2 according to the expansion have a relationship of F2> F1. Here, if one end ER of the film bodies L1 and L2 is fixed, the other end EL of the film bodies L1 and L2 is displaced downward in FIG. 15 due to the difference in the tensile stress. Bending motion occurs. When the hollow portion S is returned to the original internal pressure, this bending is released, and the film bodies L1 and L2 return to the planar form shown in FIG.

  The balloon actuators 40 and 42 of this embodiment also operate on the same principle as the balloon actuator BA. In the balloon actuator 40 in the opening / closing control layer 41, the hollow chamber 40a corresponding to the hollow portion S in the balloon actuator BA of FIG. 15 is formed long in the width direction of the seat support portion 16a (see FIGS. 9 and 12). . Therefore, when the internal pressure of the hollow chamber 40a is changed by the air pressure supply source 31 for opening and closing driving, as shown in FIG. 11, the sheet supporting portions 16a are lifted on both sides and approach each other, and the front projection shape is substantially cylindrical. (I.e., so as to have a cylindrical closed shape). In the balloon actuator 42 in the snap control layer 43, the hollow chamber 42a corresponding to the hollow portion S in the balloon actuator BA of FIG. 15 is formed long in the front-rear direction of the seat support portion 16a as described above (FIG. 9). FIG. 13). Therefore, when the internal pressure of the hollow chamber 42a is changed by the snap driving pneumatic pressure supply source 32, as shown in FIG. 14, the sheet supporting portion 16a is lifted upward with respect to the elongated arm portion 16b. The base end portion of the portion 16a can be bent and deformed (snapped). In each of the balloon actuators 40 and 42, if the internal pressure of the hollow portions 40a and 42a is restored, the seat support portion 16a is moved from the cylindrical storage state of FIG. 11 or the bent state of FIG. 14 to the plane shown in FIG. Return to the state.

  In FIG. 15, one balloon actuator BA is constituted by two layers of the film bodies L1 and L2. However, when a plurality of balloon actuators 40 and 42 are stacked as in the present embodiment, each balloon actuator is The apparatus can be reduced in thickness by being configured as shown in FIG. That is, in the cross-sectional view of FIG. 16, the first recess K1 for forming the hollow chamber 40a (and the connecting pipe portion 40b and the air inlet / outlet portion 40c) in the balloon actuator 40 is formed on the surface of the first film body L10. A second concave portion K2 for forming the hollow chamber 42a (and the connecting pipe portion 42b and the air inlet / outlet portion 42c) in the balloon actuator 42 is formed on the surface of the second film body L20. Then, the first film body L10 and the second film body L20 are bonded so that the concave portions K1 and K2 do not overlap (do not communicate with each other). As a result, the second recess K2 is closed by the back surface of the first film body L10, and a hollow space corresponding to the hollow chamber 42a (and the connecting pipe portion 42b and the air inlet / outlet portion 42c) is formed. Further, the third film body L3 is bonded so as to close the first recess K1 exposed in the bonded state of the first film body L10 and the second film body L20. Then, the first recess K1 is closed by the back surface of the third film body L30, and a hollow space corresponding to the hollow chamber 40a (and the connecting pipe portion 40b and the air inlet / outlet portion 40c) is formed. The first to third film bodies L10, L20, and L30 have different tensile stresses when they are expanded and contracted with the same pressure, and when the internal pressure in the first concave portion K1 is changed, they are shown in FIGS. When the opening / closing (curving and unfolding) operation of the sheet support portion 16a occurs and the internal pressure in the second recess K2 is changed, the snap (flexion and extension) operation of the sheet support portion 16a as shown in FIGS. Occurs. If comprised in this way, the two balloon actuators 40 and 42 which perform different operation | movement can be made with a three-layer film body.

  In addition, as shown in FIG. 16, the demounting actuator 44 can be provided in the third film body L30. In the third film body L30, a plurality of openings 44a are formed on the surface side not facing the first film body L10. The opening 44a can be supplied and sucked by the aforementioned desorption operation pneumatic supply source 33, and a negative pressure is applied in a state where the cell sheet 50 is placed on the surface of the third film body L30. When the cell sheet 50 is adsorbed and held by the sheet support portion 16a and a positive pressure is applied to the cell support 50, the detachment of the cell sheet 50 from the sheet support portion 16a is promoted.

  The delivery device 10 having the above structure is used as follows. In addition, although the delivery administration apparatus 10 is applicable to the treatment of various cases, the transplantation operation | work of the retinal pigment epithelial cell sheet | seat into an eyeball is demonstrated as an example here.

  First, as a preparation stage, the cell sheet 50 (retinal pigment epithelial cell sheet) is supported on the sheet support portion 16 a of the manipulator 16. In this support operation, the inside of the hollow portion 11 a is pressurized by the advancing / retreating air pressure supply source 30 to push the slide base member 15 toward the front end side of the apparatus, and the sheet support portion 16 a of the manipulator 16 protrudes from the front end portion of the sheet storage pipe 14. Let me. Further, the balloon actuator 40 maintains the seat support 16a in the developed state as shown in FIG. And as shown in FIG. 16, the cell sheet 50 is mounted in the surface of the sheet | seat support part 16a in the side in which the opening part 44a of the detachable actuator 44 is formed. At this time, dropping can be prevented by adsorbing the cell sheet 50 using the detachable actuator 44 as necessary.

  When the mounting of the cell sheet 50 on the sheet support part 16a is completed, the sheet support part 16a is closed in a cylindrical shape by the balloon actuator 40 as shown in FIG. Then, the slide base member 15 is moved in the retracting direction by applying a negative pressure to the hollow portion 11a by the advancing / retreating air pressure supply source 30, and the cylindrical sheet support portion 16a is moved into the sheet storing pipe as shown in FIG. 14 to store. As a result, the cell sheet 50 is protected by the sheet storage pipe 14. In addition, as shown in FIG. 11, when the sheet | seat support part 16a is closed cylindrically, the cell sheet 50 is supported by the surface inside this sheet | seat support part 16a. Therefore, when the slide base member 15 is moved back and forth, the cell sheet 50 does not come into contact with or rub against the inner wall of the sheet storage pipe 14, and damage to the cell sheet 50 can be prevented.

  Next, as shown in FIGS. 17 and 18, physiological saline is injected under the retina 52 in the eyeball 51 with a needle pointer 53 to form a retinal dome 54, and then the sheet storage pipe 14 is connected to the retinal dome to be treated. 54 is inserted. As shown in FIGS. 10 to 14, the sheet storage pipe 14 is formed with a sharpened tip to facilitate insertion. When the front end of the sheet storage pipe 14 reaches the inside of the retinal dome 54, the inside of the hollow portion 11a is pressurized by the advancing / retreating air pressure supply source 30 to move the slide base member 15, and the sheet support portion 16a is moved to the sheet storage pipe 14. Let it protrude from the tip. Then, in the state of being stored in the sheet storage pipe 14, the sheet support portion 16 a that is closed in a cylindrical shape as shown in FIG. 11 is expanded by the balloon actuator 40 as shown in FIG. 12. FIG. 19 shows a state in which the sheet support portion 16a is developed. Further, the bending angle of the base end portion of the sheet support portion 16a is changed by using the balloon actuator 42 so that the deployed cell sheet 50 is opposed to the transplanted site (retina peeling portion). When the angle adjustment is completed so that the cell sheet 50 faces the transplant site, the cell sheet 50 is pressed against the transplant site as shown in FIG. In this case, precise positioning and pressing pressure are performed by operating the entire device by the surgeon or by pushing out the manipulator 16 by pressurizing the advancing / retreating air pressure supply source 30. Then, the cell sheet 50 is adhered to the transplant site by the action of the adhesion protein. At this time, in order to reliably detach the cell sheet 50 from the sheet support portion 16a, air may be supplied to the opening 44a of the detachable actuator 44 by the detachment operation pneumatic supply source 33 as necessary. When the transplantation of the cell sheet 50 is completed, the sheet storage pipe 14 is pulled out from the retinal dome 54 after the sheet support 16a is stored in the sheet storage pipe 14 as shown in FIG. Finally, as shown in FIG. 22, the physiological saline in the retinal dome 54 is sucked by the puncture needle 53, and the transplanting operation is completed.

  According to the delivery administration device 10 described above, the cell sheet 50 is formed in a cylindrical shape and stored in the sheet storage pipe 14, and the cell sheet 50 is transported to the transplant site by insertion of the sheet storage pipe 14. The degree of invasion to the human body can be suppressed to a lower level than the method of transporting in the deployed state. Moreover, since the cell sheet 50 is stored in the sheet storage pipe 14, the fragile cell sheet 50 can be protected from damage. When the cell sheet 50 reaches the vicinity of the transplant site, the cell sheet 50 is returned to the expanded state by the balloon actuator 40, and the angle of the cell sheet 50 is adjusted to a position facing the transplant site by the balloon actuator 42. Therefore, the cell sheet 50 can be transplanted to the target site very easily and reliably.

  In addition, since the manipulator 16 is made of flexible and highly biocompatible silicone rubber, the sheet support portion 16a developed when the cell sheet 50 is transplanted may damage the body tissue or cause chemical damage. Absent. Further, since the sheet support portion 16a can be flexibly deformed, the cell sheet 50 supported on the sheet support portion 16a can be flexibly adapted to the shape of the transplant site at the time of transplantation work, Higher therapeutic effects can be obtained. In particular, when the transplant site is a place where there is movement such as the myocardium, it is preferable that the sheet support 16a and the cell sheet 50 can be flexibly deformed following the movement of the transplant site.

  Furthermore, since the operation of the manipulator 16 is all performed using pneumatic pressure (fluid pressure), excellent effects can be obtained in terms of safety and cost. Specifically, the deformation movement of the sheet support portion 16a by the balloon actuators 40 and 42, the advance and retreat movement of the manipulator 16 using the slide base member 15, and the holding and detachment of the cell sheet 50 by the detachable actuator 44 are all supplied. This is done by air supply and suction by a suction source. Since the delivery device 10 is not equipped with an electric drive means such as a motor, the manufacturing cost can be kept low, and the cost is excellent, so the device can be disposable. Moreover, when the electric drive means is incorporated in the transport administration device 10, it is necessary to consider the damage to the nervous system due to electric leakage, but since the drive source is air in the transport administration device 10 of this embodiment, Such a problem does not occur and safety is high.

  The therapeutic substance delivery / administration device of the present invention is not limited to the illustrated embodiment as described above, but may be different in form without departing from the gist of the invention. is there. For example, in the embodiment, air is used as a drive source for each part of the transport administration device 10, but in the balloon actuators 40, 42 and the forward / backward movement actuator (the forward / backward pneumatic supply source 30, the hollow part 11a), other than air. A fluid can be used as a drive source. For example, incompressible liquids such as water, physiological saline, or silicone oil are hardly compressed as compared with air. Therefore, using them can improve the operation response and operability during driving.

  In the above embodiment, the transport administration device for transplantation of the retinal pigment epithelial cell sheet has been described as an example. However, the present invention is not limited to transplantation of the cell sheet under the retina, but various sheet-like or gel-like treatments. It can be applied to administration (transplantation) of substances to various sites.

1 is a perspective view, partly in section, illustrating one embodiment of a therapeutic substance delivery device according to the present invention. It is the perspective view which made the section a part which shows the conveyance administration apparatus of the state which remove | excluded the 2nd surrounding tube from FIG. FIG. 3 is a perspective view, partly in section, showing the delivery device in a state where the first outer tube is removed from FIG. 2. FIG. 4 is a perspective view, partly in section, showing the delivery device with the tubes removed from FIGS. 1 to 3. FIG. 5 is a perspective view, partly in section, showing the delivery device in a state where the slide base member and the manipulator are further removed from FIG. 4. It is a disassembled perspective view of the slide base member and manipulator which are built in a delivery administration apparatus. It is a perspective view of the state which combined the slide base member and the manipulator. FIG. 5 is a perspective view illustrating a fluid conduit in a slide base member as seen through. It is a disassembled perspective view of a manipulator. FIG. 6 is an enlarged perspective view of the vicinity of the front end of the sheet storage pipe, showing a state in which the sheet support portion of the manipulator is stored. It is an expansion perspective view which shows the state by which the sheet | seat support part of the manipulator protruded from the sheet | seat storage pipe front-end | tip, and was curved cylindrically. It is an expansion perspective view which shows the state by which the sheet | seat support part of the manipulator was opened by flat form with respect to the cylindrical form of FIG. FIG. 5 is an enlarged perspective view showing a state in which the sheet support portion of the manipulator protrudes from the front end of the sheet storage pipe and is substantially linear with the elongated arm portion. It is an expansion perspective view which shows the state by which the base end part of the sheet | seat support part of the manipulator was bent with respect to the linear form of FIG. It is sectional drawing which shows the operating principle of a balloon actuator. It is sectional drawing which comprised the balloon actuator mounted in the delivery administration apparatus of this embodiment based on the principle of operation shown in FIG. It is a figure which shows the state which inserted the needle pointer in the eyeball prior to transplantation of a cell sheet. It is a figure which shows the state which inject | poured the physiological saline with the needle pointer and formed the retinal dome. It is a figure which shows the state which inserted the sheet | seat storage pipe in the retina sheet | seat, protruded the sheet | seat support part from the front-end | tip of this sheet | seat storage pipe, and developed. FIG. 19 is a diagram illustrating a state in which the base end portion of the sheet support portion is further bent from the state of FIG. 18 to face the transplant site and the cell sheet is to be attached to the transplant site. It is a figure which shows the state which has extracted the sheet | seat storage pipe after the transplant of a cell sheet. It is a figure which shows the state which is attracting | sucking the physiological saline in a retinal dome with a needle pointer after drawing | extracting a sheet storage pipe.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Delivery administration instrument 11 Tube support pipe 12 Advance / retreat guide shaft part 13 Grip part 14 Sheet storage pipe 15 Slide base member 16 Manipulator 16a Sheet support part 17 Holding lid 20 O-ring 21 Advance / retreat drive tube 22 Open / close drive tube 23 Snap drive Tube 24 Desorption operation tube 25 First envelope tube 26 Second envelope tube 30 Advance / retreat pneumatic supply source 31 Open / close drive pneumatic supply source 32 Snap drive pneumatic supply source 33 Desorption operation pneumatic supply Source 40 Balloon Actuator 40a Hollow Chamber 41 Opening / Closing Control Layer 42 Balloon Actuator 42a Hollow Chamber 43 Snap Control Layer 44 Desorption Actuator 44a Opening 45 Sheet Desorption Control Layer 50 Cell Sheet 51 Eyeball 52 Retina 53 Needle Point 54 Retina Dome

Claims (5)

An elastically deformable sheet support for supporting the sheet-like therapeutic substance;
First shape control means for deforming the sheet support body into a flat developed shape and a cylindrical storage shape by a change in fluid pressure of a fluid supplied to the inside;
By changes in fluid pressure of the fluid supplied to the interior, transportation delivery device of therapeutic substance characterized by comprising a second shape control hand stage for changing the bending angle of the base end portion of the seat support . The therapeutic substance delivery device according to claim 1,
A tubular storage member capable of storing the sheet support formed into a cylindrical storage shape by the first shape control means;
A treatment comprising: an advancing / retreating means capable of advancing / retreating the sheet support at a position stored in the tubular storage member and a position protruding from a distal end portion of the tubular storage member. For transport and administration of chemicals. 3. The therapeutic substance delivery / administration device according to claim 2, wherein the advance / retreat means comprises:
A hollow cylindrical guide member having the tubular storage member at the tip;
A base member that supports the sheet support and is supported in the guide member so as to advance and retreat;
A therapeutic substance delivery / administration device comprising: an advancing / retreating fluid pressure adjusting means for changing the fluid pressure in the guide member to move the base member forward / backward relative to the guide member. The therapeutic substance delivery administration device according to any one of claims 1 to 3, wherein the sheet-like therapeutic substance is released from the sheet support and a negative pressure for adsorbing and holding the sheet-like therapeutic substance on the sheet support. A device for transporting and administering a therapeutic substance, comprising a sheet detaching means capable of selectively applying a positive pressure. The therapeutic substance delivery / administration device according to any one of claims 1 to 4, wherein the sheet support is made of silicone rubber.