JP6355368B2 - Jig for transporting therapeutic substances - Google Patents

Description

  The present invention relates to a jig for transporting a therapeutic substance.

  A treatment method is known in which a thin sheet-like substance (sheet-like therapeutic substance) is attached to an affected area of a patient. In particular, as a part of regenerative medicine in recent years, there is a treatment method in which a sheet (cell sheet) composed of cells cultured outside is affixed to an affected area.

  When the affected part is in a living tube such as the esophagus or the large intestine, it is required to transport (carry) the cell sheet to the affected part and apply it. As such a transporting jig (transporting instrument), for example, a cylindrical part, a balloon provided on the outer peripheral surface of the cylindrical part so as to be inflatable and inflatable, and an expansion / contraction means for expanding and contracting the balloon are provided. There is an in-vivo treatment device that is inserted into a living body duct in a state where the balloon is deflated, inflated by the expansion / contraction means and pressed against the inner wall of the living body duct, and the cell sheet is placed in the living body duct. (For example, refer to Patent Document 1).

JP 2008-148887 A JP 2008-79783 A

  However, the conventional technique described in Patent Document 1 has the following problems. That is, in the treatment apparatus (treatment device) in a living body duct described in the prior art, the therapeutic substance is placed on the balloon in a state where the balloon is in close contact with the peripheral surface of the cylindrical portion by contraction. Next, the treatment device is inserted into the biological duct through a sheath disposed in the biological duct. Then, the treatment device is projected from the distal end portion of the sheath to reach the affected area.

  The biological duct is often curved or rich in irregularities. In this case, when the treatment device is protruded from the sheath, the distal end of the treatment device may be subjected to pressure on the inner wall of the biological duct and the posture of the treatment device may change from the state before the protrusion. At this time, the distal end of the sheath or the inner wall of the living body tube may come into contact with the therapeutic substance.

  When the therapeutic substance is a cell sheet, the cell sheet is a thin and soft substance. Therefore, if the therapeutic substance is shrunk or touched due to contact with the sheath tip or a biological tube, it becomes unsuitable for application to the affected area, which is not preferable.

  An object of the present invention is to provide a jig for transporting a therapeutic substance that can prevent the therapeutic substance from coming into contact with another object through a biological duct.

The disclosed technology employs the following means in order to solve the above-described problems.
That is, the first aspect of the present invention is
A jig for transporting a therapeutic substance to a desired position in a biological tube,
A main body having an intermediate portion in which a recess is formed between one end and the other end;
An elastic membrane that covers at least the recess and forms an internal space with the body;
A fluid path that is formed at the other end in a state of communicating with the inside of the recess and through which the fluid introduced into the internal space through the recess and the fluid discharged from the internal space pass;
A therapeutic substance transporting jig, wherein a part of the elastic membrane is drawn into the recess by discharging fluid from the internal space.
According to the first aspect, it is possible to prevent the therapeutic substance from coming into contact with other substances in the biological duct.
According to a second aspect of the present invention, there is provided a therapeutic substance transporting jig in which the elastic film expands by introducing a fluid into the internal space.
According to the 2nd aspect, a therapeutic substance can be pressed against the affected part in a biological tube because an elastic membrane expand | swells.
According to a third aspect of the present invention, the elastic film is formed in a cylindrical shape having two end portions, and the end portions are fixed in contact with the main body in a state of surrounding the periphery of the main body. Item 3. A jig for transporting a therapeutic substance according to Item 1 or 2.
According to the third aspect, since the elastic film is closely fixed to the main body, when the fluid is introduced into and discharged from the internal space, the elastic film can be shrunk without leaking the fluid to the outside. .
A fourth aspect of the present invention is a therapeutic substance transporting jig in which an index indicating the position of the recess is formed on an end face of the other end.
According to the 4th aspect, the direction in which the recessed part is formed can be recognized from the end surface side of the other end part by the indicator.
According to a fifth aspect of the present invention, there is provided a therapeutic substance transporting jig further comprising: a first pipe connected to the fluid path; and a second pipe having a predetermined outer diameter that covers the first pipe. is there.
According to the fifth aspect, it is possible to perform the rotation operation in the circumferential direction of the main body by the first pipe and to introduce and discharge the fluid into the internal space of the main body, and the operability of the first pipe by the second pipe. Can be improved.
In a sixth aspect of the present invention, a connector, at least a part of which is inserted into the fluid path, is connected to the tip of the first pipe.
At least one convex portion is formed on one of the outer surface of the insertion portion of the connector and the inner surface of the fluid path,
A therapeutic substance transporting jig in which a groove into which the convex portion is fitted is formed on the other of the outer surface of the insertion portion of the connector and the inner surface of the fluid path when the connector is inserted into the fluid path. It is.
According to the sixth aspect, the main body and the first tube are unlikely to come off during the transportation of the therapeutic substance.
A seventh aspect of the present invention is the therapeutic substance transporting jig, wherein the intermediate portion includes a groove formed in a bottom surface of the concave portion.
According to the seventh aspect, the fluid in the internal space can be discharged by the groove.
An eighth aspect of the present invention is the therapeutic substance transporting jig, wherein the intermediate portion includes a fluid passage that communicates a bottom surface of the concave portion and an outer surface of the intermediate portion.
According to the eighth aspect, it is possible to discharge the fluid between the outer surface of the intermediate portion and the elastic membrane through the fluid passage by the fluid passage.

  According to the disclosed technology, it is possible to provide a jig for transporting a therapeutic substance that can prevent contact between the therapeutic substance and a biological duct.

FIG. 1 is a diagram illustrating a configuration example of a therapeutic substance transport jig according to an embodiment. FIG. 2 is a perspective view illustrating a configuration example of the main body. FIG. 3 is a diagram illustrating a configuration example of a therapeutic substance transport jig according to the present embodiment. FIG. 4A is a diagram illustrating a configuration example of a therapeutic substance transport jig in the embodiment. FIG. 4B is a diagram illustrating a configuration example of a therapeutic substance transport jig in the embodiment. FIG. 5 is a diagram illustrating the use of a combination of a transportation jig and an endoscope system. FIG. 6 is a diagram illustrating a configuration example of a therapeutic substance transport jig according to the embodiment. FIG. 7 is a diagram illustrating a configuration example of a therapeutic substance transport jig in the embodiment. FIG. 8 is a diagram illustrating a usage example of the therapeutic substance transport jig according to the embodiment. FIG. 9 is a diagram illustrating a configuration example of a therapeutic substance transport jig in the embodiment. FIG. 10 is a diagram illustrating a usage example of the therapeutic substance transport jig according to the embodiment. FIG. 11 is a diagram for explaining the reason why the main body of the therapeutic substance carrying jig is formed in an elliptical shape. FIG. 12 is a diagram illustrating a modification of the embodiment. FIG. 13A is a diagram illustrating a modification of the embodiment. FIG. 13B is a diagram illustrating a modification of the embodiment. FIG. 13C is a diagram illustrating a modification of the embodiment.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. The configuration of the embodiment is an exemplification, and the configuration of the present invention is not limited to the specific configuration of the embodiment.

Embodiment
<Configuration example of therapeutic substance transport jig>
FIG. 1 is a diagram illustrating a configuration example of a therapeutic substance transport jig (also simply referred to as a transport jig 10) in the present embodiment. The carrying jig 10 includes a main body 100 in which one end portion 110, an intermediate portion 120, and the other end portion 130 are arranged in the longitudinal direction, and a balloon that covers the periphery of the intermediate portion 120 (an “elastic film”). Example) 200. Further, the carrying jig 10 is configured to supply and exhaust air to and from the internal space formed by the main body 100 and the balloon 200 and to apply a circumferential rotational force (torque) to the main body 100. An example of “first tube”, fixtures 410 and 420 for fixing the balloon 200 to the main body 100, and a cover tube 500 (an example of “second tube”) covering the air supply / exhaust tube 300.

  A cylindrical female connector 710 (connector 710) is bonded to the end face of the other end portion 130 of the main body 100 of the carrying jig 10, and a cylindrical male connector is connected to one end of the air supply / exhaust pipe 300. 720 (connector 720) is bonded. By fitting the connector 720 into the connector 710, the main body 100 and the air supply / exhaust pipe 300 are connected. The carrying jig 10 is detachable from the air supply / exhaust pipe 300.

  On the other hand, a female luer connector 600 is bonded to the other end of the air supply / exhaust pipe 300. The luer connector 600 is connected to a male connector provided in expansion / contraction means X (see FIG. 5) for supplying and exhausting air to and from the internal space and expanding and contracting the balloon 200. The expansion / contraction means X is, for example, a syringe or a pump.

Hereinafter, the detail of each component of the conveyance jig | tool 10 is demonstrated.
<< body >>
FIG. 2 is a perspective view illustrating a configuration example of the main body 100, the balloon 200, and the fixtures 410 and 420. In FIG. 2, the main body 100 has one end (front end) 110, the other end (rear end) 130, one end 110 and the other end 130 arranged in the longitudinal direction (X direction in FIG. 2). And an intermediate portion 120 having a recess A formed therebetween. The central axes of the one end portion 110, the intermediate portion 120, and the other end portion 130 are coaxial. A groove 112 that makes a round in the circumferential direction of the main body 100 is formed between the one end portion 110 and the intermediate portion 120, and a groove that makes a round in the circumferential direction of the main body 100 between the other end portion 130 and the intermediate portion 120. 134 is formed.

  In this embodiment, the cross-sectional shape of the width direction (Y direction of FIG. 2) of the one end part 110, the intermediate | middle part 120, and the other end part 130 is each formed in the ellipse, The ellipse long axis is the width | variety of the main body 100. The minor axis is arranged in the height (thickness) direction of the main body 100 (Z direction in FIG. 2). Thereby, the dimension of the height direction of the main body 100 is shorter than the dimension of the width direction.

  Moreover, in this embodiment, the recessed part A is formed because the intermediate part 120 is formed in the cylinder shape which has an opening part. As shown in FIG. 2, the intermediate portion 120 has a semi-elliptical cylindrical portion 120 a having a shape in which the upper half of the peripheral surface is removed from an elliptic cylinder with a hollow interior, and both ends of the semi-elliptical cylindrical portion 120 a. It has an oval side wall 120b and an oval side wall 120c. The side wall 120b is provided on one end side of the semi-elliptical cylindrical portion 120a on the one end portion 110 side, and the side wall 120c is provided on the other end side of the semi-elliptical cylindrical portion 120a on the other end portion 130 side ( (See FIG. 3). Thereby, an opening is formed on the upper side (height direction) of the intermediate part 120, and the inner side of the semi-elliptical cylindrical part 120 a is in a state of forming a recess A. However, the inner surface shape and the outer surface shape of the concave portion of the intermediate portion 120 are examples, and are not limited to the elliptical circumferential surface.

  The one end 110 is formed in an elliptical column shape with the tip side chamfered. By chamfering the tip of the one end portion 110, the friction between the main body 100 and the biological tube or the like when inserting the biological tube of the carrying jig 100 can be reduced, and damage to the inner wall of the biological tube can be avoided.

  The other end portion 130 is formed in a flat plate shape having an elliptical end surface. The other end portion 130 is formed with a vent hole 132 (an example of “fluid path” and “fluid hole”) penetrating from the rear end surface of the other end portion 130 to the side wall 120c. It passes through the vent hole 132 (see FIG. 3). One end (front end) of the female connector 710 (connector 710) shown in FIG. 1 is in close contact with the inner wall of the vent hole 132 when inserted into the vent hole 132, so that the connector 710 is connected to the main body 100. It becomes.

  The vent hole 132 is formed with the same diameter as the outer diameter of the female connector 710 from the rear end surface of the other end portion 130 to a predetermined position. In addition, the side wall 120 c of the vent hole 132 is opened from the predetermined position with a diameter smaller than the outer diameter of the female connector 710. The female connector 710 is inserted and fixed from the rear end surface of the vent hole to the predetermined position. The female connector 710 and the inner surface of the vent hole 132 may be fixed by an adhesive (see FIG. 3).

  On the rear end surface of the other end portion 130, an index 136 indicating the position of the concave portion A of the intermediate portion 120 is provided. The indicator 136 is formed, for example, by marking the end surface (ellipse) of the other end portion 130 with a pen or the like on the side where the recess A is provided on the minor axis of the ellipse (the upper side in the present embodiment). Yes. The index 136 may be formed by partially cutting a predetermined position. Alternatively, the indicator 136 may be formed when the main body 100 is molded. By providing the index 136, the position of the recess A can be easily recognized even when the main body 100 is viewed from directly behind (when the recess A cannot be visually recognized).

  The groove 112 and the groove 134 are formed to accommodate each end portion of the balloon 200 that covers the intermediate portion 120 (details will be described later). Further, a groove 122 is formed on the bottom surface of the recess A in the longitudinal direction. In addition, a through-hole 124 that penetrates the bottom surface of the recess A and the outer surface of the intermediate portion 120 is formed in the approximate center of the bottom surface of the recess A. The groove 122 and the through hole 124 are formed in order to suitably exhaust air from the internal space S (FIG. 3) formed by the main body 100 and the balloon 200 (details will be described later).

As long as the material of the main body 100 is applicable for medical use, a metal or resin (plastic) is applicable. For example, the main body 100 may be formed by joining a plurality of components, but can be integrally formed of a resin material. Alternatively, the main body 100 can be integrally formed by a 3D printer using a medical 3D printer material.

<< balloon >>
In this embodiment, the balloon 200 is formed in a cylindrical shape using an elastic member (for example, medical rubber such as latex), and each end portion 200a, 200b is formed in a ring shape by winding the elastic member. It has become. The longitudinal dimension of the balloon 200 is shorter than the longitudinal dimension of the main body 100, and the balloon 200 passes through the inside of the balloon 200 and the one end 110 and the other end 130 are the end portions 200 a and 200 b of the balloon 200. The main body 100 is put out in a state of jumping out (protruding) from each of the above.

  The end portion 200 a of the balloon 200 is accommodated in the groove 112, and the end portion 200 b is accommodated in the groove 134. As a result, the balloon 200 is in a state of covering the intermediate portion 120 including the recess A. Further, since the end portions 200a and 200b are accommodated in the grooves 112 and 134, the end portions 200a and 200b act in a direction that hinders the movement of the carrying jig 10 in the living body tube (for example, is caught on the inner wall of the living body tube). You can avoid that. Moreover, it can avoid that the fixing position with respect to the main body 100 of the balloon 200 shifts | deviates because the edge parts 200a and 200b contact a biological tube etc. Furthermore, the depth of the grooves 112 and 134 is adjusted to the thickness of the end portions 200a and 200b. The depths of the grooves 112 and 134 and the thicknesses of the end portions 200a and 200b (the thickness of the portion around which the elastic member is wound) are matched, so that the end portions 200a and 200b accommodated in the grooves 112 and 134 and the groove It is possible to avoid a step between 112 and 134. By preventing the step from being generated, it is possible to further avoid the end portions 200a and 200b from acting in a direction that hinders the movement of the transport jig 10 in the living body tube.

  A portion inside the end portion 200 a of the balloon 200 is fixed in a state of being in close contact with the main body 100 (the bottom surface of the groove 112) by the fixing tool 410, and a portion inside the end portion 200 b is fixed by the fixing tool 420. It is fixed in close contact with the bottom surface. In the present embodiment, a medical thread (for example, a suture thread) is applied as the fixtures 410 and 420, and the balloon 200 is tied to the main body 100 with the suture thread. However, the fixtures 410 and 420 are not limited to medical threads, and fixtures other than threads, O-rings, and adhesives can be applied.

  FIG. 3 shows a cross section when the balloon 200 is fixed to the main body 100 shown in FIG. 2 and is cut along a plane in the height direction (Z direction) including the central axis of the main body 100, and the air supply / exhaust pipe 300. It is a figure which shows typically the state before connecting to the main body. FIG. 4A is a diagram showing a change from the state shown in FIG. 3 to a state where the connector 710 and the air supply / exhaust pipe 300 are connected to the main body 100 and the internal space is exhausted.

  By being fixed in close contact with the main body 100 by the fixing tool 410 and the fixing tool 420, both ends of the balloon 200 are closed, and an internal space S is formed inside the balloon 200. The pressure in the internal space S is such that the air supply / exhaust pipe 300 is connected to the main body 100 and air (an example of “fluid”) is introduced or exhausted (air supply or exhaust is performed) through the air supply / exhaust pipe 300 and the vent hole 132. Can be controlled.

  FIG. 3 shows a state where neither air supply into the internal space S nor exhaust is performed. In this state, the portion covering the concave portion A of the balloon 200 is positioned above the concave portion A due to its own elasticity (flexibility). On the other hand, when a syringe (expansion / contraction means X) is connected to the luer connector 600 and the piston of the syringe is pulled, air is discharged from the internal space S, and a negative pressure is generated in the recess A. As a result, as shown in FIG. 4A, the portion of the balloon 200 that covers the recess A is drawn into the recess A and finally comes into contact with the bottom surface of the recess A.

  Here, the reason why the groove 122 is formed will be described. When the balloon 200 is drawn into the recess A by the exhaust of the internal space S and a certain part is in close contact with the bottom of the recess A, the air in the internal space S1 on the front end side from the close contact part cannot move to the vent hole 132. Can happen. On the other hand, since the groove 122 is formed, the air existing in the internal space S1 can move to the vent hole 132 through the groove 122 and the internal space S2 on the rear end side.

  Thereby, the air in the internal space S can be properly exhausted, and the balloon 200 can be flattened in the recess A when exhaust is completed. However, the formation of the groove 122 is optional.

  As described above, the concave portion A1 of the carrying jig formed by drawing a part of the balloon 200 into the concave portion A is used as a placement portion on which the therapeutic substance 700 is placed (see FIG. 4A). . Here, the therapeutic substance 700 is, for example, a sheet-like therapeutic substance, such as a cell sheet or a sheet coated with a medicine. The therapeutic substance 700 may also include a therapeutic substance (for example, a drug) having a shape other than a sheet shape.

  The reason why the through hole 124 is formed is as follows. That is, as air continues to be sent to the internal space S, the balloon 200 starts to expand, and the air in the internal space S turns around to the outer surface side of the intermediate portion 120, so that the balloon 200 is separated from the outer surface of the intermediate portion 120. Finally, it swells in a barrel shape (see FIG. 4B).

  Thereafter, when the air is discharged from the internal space S, the balloon 200 contracts. Here, it is assumed that the through hole 124 does not exist. Under this assumption, in the internal space S, the air existing on the lower side (outer surface side) of the intermediate portion 120 moves to the vent hole 132 via the concave portion A (opening portion). For this reason, if the inner surface of the balloon 200 closes the opening (recess A) when the balloon 200 is deflated, the air remaining on the outer surface side (lower side) of the intermediate portion 120 loses escape.

  In this state, since the balloon 200 is inflated on the lower side, the upper side (the concave portion A side) of the balloon 200 is pulled. Therefore, depending on the situation, the exhaust from the internal space S may be continued. There is a possibility that a part of the balloon 200 is not sufficiently drawn into the recess A. On the other hand, if the through hole 124 is formed, the air that has circulated to the outer surface side of the intermediate portion 120 can move to the vent hole 132 through the through hole 124. The air can be properly discharged from. However, the through hole 124 is optional.

<< Air exhaust pipe and cover pipe >>
As described above, the air supply / exhaust pipe 300 is used for air supply and exhaust for pressure control in the internal space S. Further, the air supply / exhaust pipe 300 is used to apply a circumferential rotational force (torque) to the carrying jig 10. For this reason, the air supply / exhaust pipe 300 has a certain degree of rigidity while having flexibility in order to efficiently transmit torque to the conveying jig 10 attached to the front end from the rear end of the air supply / exhaust pipe 300. It is preferable. In this embodiment, a stainless steel tube, which is an example of a metal pipe, is applied as the air supply / exhaust pipe 300. However, the material of the exhaust pipe 300 is not limited as long as desired flexibility and rigidity can be obtained (other than metal).

When the outer diameter of the air supply / exhaust tube 300 is smaller (thin) than the outer diameter of the wire of the wire-driven forceps used in normal endoscopic surgery, the cover tube 500 is used by the user (physician) of the carrying jig 10. On the other hand, it is provided to provide a good feeling of use (sense of wire diameter possessed by a doctor) (to eliminate discomfort and improve operability). That is, the cover tube 500 has an inner diameter that can accommodate the air supply / exhaust tube 300 and an outer diameter that is normally applied to a wire of a wire-driven forceps. Further, the cover tube 500 has a dimension substantially equal to or shorter than that of the air supply / exhaust pipe 300, and the air supply / exhaust pipe 300 passes through the inside thereof.
In the present embodiment, an exhaust pipe 300 (stainless steel tube) having an outer diameter of 0.6 mm to 0.9 mm is used, and a cover pipe 500 having an outer diameter of 2.5 mm is used. The outer diameter of the cover tube 500 is substantially the same as the outer diameter of a forceps wire used in general endoscopic surgery. Note that a preferable range of the outer diameter of the cover tube 500 varies depending on the forceps channel of the endoscope, but is 2.0 mm to 2.6 mm for an endoscope having a forceps channel of 2.8 mm, for example.

  Further, when the doctor pinches the air supply / exhaust pipe 300 over the cover pipe 500, the cover pipe 500 is deformed and can hold the air supply / exhaust pipe 300 well (the pressing force of the doctor's finger directly pinches the air supply / exhaust pipe 300). The inner peripheral surface of the air supply / exhaust pipe 300 accommodated in the cover pipe 500 is in close contact with the outer peripheral surface of the cover pipe 500 (the outer diameter of the air supply / exhaust pipe 300 is the cover pipe). Or an inner diameter of 500 or more), or a state in which a part thereof is in contact (the outer diameter of the air supply / exhaust pipe 300 is less than the inner diameter of the cover pipe 500). In the present embodiment, the cover pipe 500 is attached to the air supply / exhaust pipe 300 in a slidable state between the connector 720 and the luer connector 600.

  As the cover tube 500, for example, a resin tube can be applied, and for example, a PTFE (polytetrafluoroethylene) tube can be applied. However, the PTFE pipe is an example, and a resin pipe other than PTFE can be applied.

<Usage example>
Next, a usage example of the carrying jig 10 will be described. The carrying jig 10 is used in combination with an endoscope system. FIG. 5 is an explanatory diagram of use in the combination of the carrying jig 10 and the endoscope system.

  In FIG. 5, an endoscope (video scope) 1000 includes an operation unit 1001 provided with an angle knob, a button, and the like operated by a doctor in an operation method, an insertion unit 1002 inserted into a patient's body, and a connection unit 1003. (Universal code). An irradiation lens that irradiates illumination light on the distal end surface of the insertion unit 1002, and an objective lens that collects reflected light of the illumination light and transmits it to an image sensor (CCD, CMOS: not shown) in the insertion unit 1002. Is provided.

  The connection unit 1003 converts the electrical signal captured by the image sensor into a video signal and displays it on a display device (not shown), and transmits light from the light source to the tip of the insertion unit 1002 (not shown). It is connected to a light source device (not shown) that transmits to an illumination lens.

  Furthermore, a forceps channel 1100 for passing forceps (wire) from the operation unit 1001 to the insertion unit 1002 is formed inside the endoscope 1000. An inlet 1101 of the forceps channel 1100 is formed on the outer surface of the operation unit 1101, and an outlet (forceps port) 1102 of the forceps channel 1100 is formed on the distal end surface of the insertion unit 1002.

  The carrying jig 10 inserts the distal end (connector 720) of the air supply / exhaust pipe 300 to which the cover pipe 500 is attached into the inlet 1101 of the forceps channel 1100 with the main body 100 and the balloon 200 removed from the air supply / exhaust pipe 300. The tip is sent to the outlet 1102. At this time, an operator (for example, a doctor) can perform the feeding operation with a good feeling of operation by pinching the cover tube 500 and sending the air supply / exhaust tube 300.

When the tip (connector 720) of the air supply / exhaust pipe 300 protrudes from the outlet 1102, the main body 100 is attached to the air supply / exhaust pipe 300 by connecting the connector 720 and the connector 710 (the main body 100 is connected to the air supply / exhaust pipe). 300 is fixed to the tip of 300).

  Subsequently, the piston of the expansion / contraction means X (syringe) connected to the luer connector 600 is pulled to exhaust the internal space S. As a result, the concave portion A1 used as a placement portion is formed on the surface of the balloon 200 drawn into the concave portion A. As a result, the state shown in FIG. 6 is obtained.

  In this state, the doctor or the doctor's assistant places an appropriate therapeutic substance 700 in the recess A1. In the present embodiment, it is assumed that the therapeutic substance 700 is a cell sheet (an example of a “sheet-like therapeutic substance”). The therapeutic substance 700 is placed in a state of being spread on the surface of the recess A1 (see FIG. 7). However, the therapeutic substance 700 may be placed before exhausting from the internal space S, and the therapeutic substance 700 may be drawn into the recess A by exhausting the internal space S. However, by placing the therapeutic substance 700 after forming the recess A1 by exhausting from the internal space S, it is possible to avoid erroneous measurement of the placement location and the therapeutic substance 700 from protruding from the recess A1.

  Next, the doctor inserts the main body 100 and the insertion portion 1002 into a sheath (guide tube: not shown) set in advance in the biological tube of the patient, and sends the insertion portion 1002 (main body 100) to the vicinity of the distal end of the sheath. At this time, it is assumed that illumination light irradiation and video display on the display device are continuously performed. That is, it is assumed that the display device displays an image obtained by viewing the main body 100 from the rear by the image sensor.

  Next, the doctor 100 grasps the air supply / exhaust tube 300 (hereinafter referred to as “operation tube”) provided with the cover tube 500 and further feeds the operation tube into the forceps channel 1100, whereby the main body 100 is connected to the distal end of the insertion portion 1002. It leaves | separates from the part 1004, and comes out of a sheath soon.

  FIG. 8 is a diagram schematically showing the transporting jig 10 placed in the biological tube C (out of the sheath). FIG. 8 shows a state in which the transport jig 10 is transporting the therapeutic substance 700 (cell sheet) in the living tube C. The therapeutic substance 700 is placed on the bottom surface of the recess A <b> 1 formed by drawing the balloon 200. For this reason, the inner wall of the living body tube C and the distal end of the sheath around the concave portion A1 only come into contact with the upper edge portion 120d of the intermediate portion 120, and are difficult to come into contact with the therapeutic substance 700 in the concave portion A1. This suppresses the therapeutic substance from coming into contact with the biological tube or the like.

  Thereafter, when the transporting jig 10 on which the cell sheet 700 is placed reaches the vicinity of the affected part AP (see FIG. 10), the doctor refers to the image displayed on the display device while referring to the image displayed on the display device. ) Is opposed to the affected area AP. At this time, when the therapeutic substance 700 does not face the affected area AP, the doctor applies torque to the operation tube by pinching the operation tube (the air supply / exhaust tube 300 with the cover tube 600 attached) and twisting the operation tube. The main body 100 is rotated in the circumferential direction.

  When the therapeutic substance 700 is in a state of facing the affected area AP, the doctor pushes the piston of the expansion / contraction means X (syringe) and introduces air into the internal space S.

  As a result, as shown in FIG. 9, air is introduced into the internal space S formed by the balloon 200 and the main body 100, and the balloon 200 is inflated. At this time, as shown in FIG. 4B, as described above, the bottom surface of the recess A and the outer peripheral surface of the intermediate portion 120 communicate with each other through the through hole 124. For this reason, since the air sent from the vent hole 132 can go to the outer surface side of the intermediate portion 120 through the through hole 124, the introduction of the air to the outside of the intermediate portion 120 is performed smoothly.

  FIG. 10 is a diagram illustrating an example in which a balloon that is in close contact with the main body is inflated. Since the portion of the balloon 200 that has been in contact with the therapeutic substance 700 before the expansion expands due to the expansion of the balloon 200, the portion is more easily peeled off from the surface of the balloon 200 than before the expansion. In this state, when the therapeutic substance 700 comes into contact with the affected part AP, the affected part AP is in a wet state by the body fluid, so that the therapeutic substance 700 is separated from the balloon 200 by the surface tension and is attached to the affected part AP. After the therapeutic substance 700 is placed in the affected area AP, the balloon 200 is deflated by discharging the air in the internal space S by the expansion / contraction means X. When it is confirmed that the balloon 200 is contracted to such an extent that it can be accommodated in the sheath, the carrying jig 10 is carried outside the body together with the insertion portion 1002 of the endoscope 1000 and collected.

  In the above use example, the case where the sheath (guide member) is used has been described. However, the transport jig 10 and the insertion portion 1002 may be inserted into the living body tube without using the sheath (guide member).

<Effects of Embodiment>
According to the embodiment, the therapeutic substance 700 is placed in the concave portion A1 formed by drawing a part of the balloon 200 into the concave portion A of the main body 100, and is transported through the living body tube. For this reason, it is possible to reduce the possibility that the inner wall or the like of the living body tube contacts the therapeutic substance 700 in the recess A1. That is, contact between the therapeutic substance 700 and other objects can be substantially suppressed. As a result, the therapeutic substance 700 can be pressed against the affected area in a suitable state (for example, a cell sheet can be affixed to the affected area), so that a suitable treatment effect can be expected.

  In the present embodiment, since the index 136 is provided on the rear end surface of the other end portion 130, the direction in which the recess A is formed even when the recess A <b> 1 is not visible in an image obtained by imaging the main body 100 from the rear. I can grasp it.

  Moreover, in this embodiment, the groove | channel 122 is formed, Therefore The air discharge from the internal space S can be implemented suitably. In the present embodiment, the through holes 124 are formed, so that air can be discharged from the internal space S suitably.

  Moreover, in this embodiment, it is thought that there exists the following advantage regarding expanding the balloon 200 with the uniform pressure in the circumferential direction of the main body 100 (FIG. 9). That is, even after the therapeutic substance 700 comes into contact with the affected area AP, air supply to the balloon 200 (internal space S) is continued, and the balloon 200 is inflated to the full extent of the living body tube C. It is thought that it can press more suitably.

  In the present embodiment, the reason why the main body 100 is formed in an elliptical shape will be described with reference to FIG. FIG. 11A shows a range (image sensor imaging range) where light is collected by the objective lens 1210 when the carrying jig 10 in the present embodiment is moved forward by a distance D1 from the distal end of the insertion portion 1002. Is shown schematically. FIG. 11B schematically shows a range of light collected by the objective lens 1210 when the carrying jig 10A in the comparative example is moved forward by a distance D1 as in FIG. 11A. .

The cross-sectional shape of the main body 100 of the carrying jig 10 (the shape of the rear end surface of the other end portion 130) has a major radius (half the length of the major axis) of r1 and a minor radius (half of the minor axis length) of r2 ( It is assumed that the cross-sectional shape (rear end face shape of the other end portion) of the main body of the carrying jig 10A is a circle having a radius r1, while the ellipse is r1> r2). When the carrying jig 10 and the carrying jig 10A are placed at the same distance D1, the distance d1 between the central axis L of the objective lens 1210 (the visual axis of the image sensor 1220) L and the recess A1 of the carrying jig 10 (FIG. 11A) is longer than the distance d2 from the recess A1 of the carrying jig 10A. This is because the position of the outlet 1102 of the forceps channel 1100 cannot be changed. As the peripheral surface of the main body approaches the visual axis L, the peripheral surface of the main body is hidden behind the rear end surface of the other end and becomes invisible. Therefore, in the present embodiment, the main body 100 having the long axis and the short axis is adopted, and the image captured by the image sensor located behind the main body 100 is formed so that the recess A1 is formed in the short axis direction. The peripheral surface of the main body 100 (the therapeutic substance 700 accommodated in the recess A1) is reflected so that the burden of the doctor's alignment operation can be reduced.

<Modification>
In the present embodiment, the balloon 200 is provided so as to cover the periphery of the intermediate portion 120 of the main body 100. It is not essential that the balloon 200 is cylindrical, and the balloon 200 may be attached to the main body 100 so as to at least close the recess A, and the interior of the recess A may be formed. However, in this case, formation of the through hole 124 is not necessary.

  In the present embodiment, the elliptical columnar one end portion 110 has been described, but the one end portion 110 may be formed in an elliptical columnar shape or a columnar shape having a diameter larger than that of the intermediate portion 120. In this case, the one end part 110 advances so as to expand the living body tube in the living body tube, a space is formed between the rear intermediate portion 120 (recessed portion A) and the inner wall of the living body tube, and the therapeutic substance accommodated in the recessed portion A The possibility that the (cell sheet) comes into contact with a biological tube or the like can be reduced. Even in this case, the tip of the one end 110 is preferably chamfered.

  In this embodiment, the medical thread is exemplified as the fixtures 410 and 420 of the balloon 200 with respect to the main body 100. However, as long as the balloon 200 is fixed so as to form the internal space S, an adhesive or other mechanism is used. Can be used to fix the balloon 200.

  Moreover, in this embodiment, although air was illustrated as an example of the fluid introduce | transduced into the internal space S, gas and liquids (for example, water) other than air are applicable.

  Further, coloring or a mark may be provided on the portion of the balloon 200 that is drawn into the concave portion A so as to avoid erroneous measurement when the therapeutic substance 700 is placed before exhausting from the internal space S. .

  In the present embodiment, the female connector 710 is bonded to the main body 100. Instead of this configuration, the connector 710 may be integrally formed with the main body 100. Moreover, it replaces with the structure (FIG. 2) of embodiment, and the ventilation hole 132 may be formed so that it may have a shape as a female connector. FIG. 12 is a diagram illustrating a modification of the embodiment. As shown in FIG. 12, the front end portion 720a of the male connector 720 has a tapered shape in which the outer diameter gradually decreases from the rear end toward the front end. On the other hand, although not shown, the inner surface of the vent hole 132 is formed in a tapered shape whose diameter gradually decreases from the rear end to the front end of the connector main body 100 in accordance with the tapered shape of the male connector 720. The inner diameter of the tapered portion of the vent hole 132 is substantially the same as or slightly smaller than the outer diameter of the distal end portion 720 a of the male connector 710. Thus, when the distal end portion 720a of the male connector 720 is inserted into the vent hole 132, the distal end portion of the male connector 720 is fitted into the vent hole 132 by the taper formed on both, and the connection between the two is locked. (A state in which the male connector 710 does not easily rotate or come off). According to the modified example, by not using (omitted) the female connector 710, the configuration of the carrying jig 10 is further simplified.

Further, instead of the configuration described in the present embodiment (FIG. 2), the female connector 710 is omitted, and the male connector 720 is directly inserted into the vent hole 132, and the male connector 720 is fixed by a lock mechanism. The configuration may be adopted. As the locking mechanism, for example, one having a thread formed on the outer surface of the distal end portion of the male connector 720 is employed, and the distal end portion of the male connector 710 is inserted (screwed) into the vent hole 132 while being rotated. It is conceivable that the tip of the male connector 710 is fixed to the vent hole 132. At this time, the inner surface of the vent hole 132 may be formed with threads formed in accordance with the male connector 710.

  FIG. 13A is a diagram illustrating a perspective view of the main body 100 and the male connector 720 in another modified example in which the lock mechanism is employed. FIG. 13B is a diagram partially showing the vent hole 132 of the other end portion 130 and the distal end portion of the male connector 720. FIG. 13C is a view for explaining the relationship between the inside of the vent hole 132 and the distal end portion of the male connector 720.

  In the modification shown in FIGS. 13A to 13C, the lock mechanism that locks the male connector 720 with respect to the main body 100 is formed as follows. That is, as shown in FIG. 13A, the male connector 720 has a cylindrical shape having a distal end and a distal end, and the distal end is connected to the air supply / exhaust pipe 300. On the other hand, at the distal end portion of the male connector 720, as a portion to be inserted into the vent hole 132, a large diameter portion 720b having a predetermined outer diameter, and a small diameter portion 720c having an outer diameter smaller than the outer diameter of the large diameter portion 720b Is formed.

The large-diameter portion 720b has two protrusions (an example of convex portions) 721, 72 protruding from the outer peripheral surface thereof.
1 is provided. The protrusions 721 and 721 protrude in opposite directions in the radial direction of the male connector 720 (direction orthogonal to the axial direction), and the tip portions thereof are formed in a hemispherical shape. A knurled 722 is formed on the outer peripheral surface of the male connector 720. The knurl 722 acts as a slip stopper when the male connector 720 is fitted in the vent hole 132.

  On the other hand, as shown in FIG. 13C, the vent hole 132 has a large-diameter portion 132a having an inner diameter ro2 and a small-diameter portion 132b having an inner diameter ro1 smaller than the inner diameter ro2, and the recessed portion A extends from the rear end of the other end portion 120. The inside is penetrated. Each of the inner diameter ro1 and the inner diameter ro2 has a size that matches the outer diameter of the large-diameter portion 720b and the small-diameter portion 720c of the male connector 720.

  Two grooves 140 and 140 for guiding the protrusions 721 and 721 are formed in the large diameter portion 132a. Each of the grooves 140 and 140 is formed by a guide groove 141 formed in the axial direction of the vent hole 132 and a locking groove 142 formed in the circumferential direction. However, FIG. 13A illustrates guide grooves 141 and 141, and FIGS. 13B and 13C illustrate only the guide groove 141 and the locking groove 142 included in one (right side of the main body) groove 140, while the other The groove 140 is not shown.

  The guide grooves 141 and 141 are formed in accordance with the protrusions 721 and 721 and define a rotation angle when the male connector 720 is inserted into the vent hole 132. The guide grooves 141 and 141 have a predetermined length in the axial direction of the vent hole 132, and the tip portions of the guide grooves 141 and 141 are connected to the corresponding locking grooves 142.

  The start end portion of the locking groove 142 (connection portion with the guide groove 141) is formed so as to be able to accommodate the tip of the protrusion 721, and is formed so as to become gradually shallower toward the end of the locking groove 142. Yes. Further, as shown in FIGS. 13B and 13C, the right side locking groove 142 of the main body 100 extends downward from the starting end portion, whereas the left side locking groove 142 (not shown) is formed. , Extending upward from the starting end portion.

Using the locking mechanism as described above, the male connector 720 and the main body 100 are joined as follows. That is, the distal end of the male connector 720 is inserted into the vent hole 132 in a state where the protrusions 721 and 721 and the guide grooves 141 and 141 are aligned. When the male connector 720 is inserted, each of the protrusions 721 and 721 advances through the guide grooves 141 and 141 and fits in the start end portions of the locking grooves 142 and 142. Then, the male connector 720 cannot be inserted any more. At this time, the tip (small diameter portion 720c) of the male connector 720 is fitted into the small diameter portion 132b in a state of closing the small diameter portion 132b, and the inside of the male connector 720 and the recess A communicate with each other via the small diameter portion 132b. It will be in the state.

  When the male connector 710 is rotated clockwise in such a state, the protrusions 721 and 721 are gradually collapsed in the corresponding locking grooves 142 and 142 to restrict the rotation of the male connector 720, and finally Thus, the male connector 720 can no longer be rotated clockwise. At this time, the projections 721 and 721 are in a state of being bitten (fitted) into the corresponding locking grooves 142 and 142. As a result, the movement of the male connector 720 in the axial direction of the main body 100 is restricted. Further, the counterclockwise rotation of the male connector 720 is mainly regulated by the knurl 721. In this way, the male connector 720 and the main body 100 are connected in a state where the relative movement of the male connector 720 with respect to the main body 100 is locked, and the main body 100 and the male connector 720 are not easily separated. .

  According to the above modification, the main body 100 can be fixed to the air supply / exhaust pipe 300 via the male connector 720 without using an adhesive. The relationship between the protrusions 721 and 721 and the grooves 140 and 140 may be reversed. Further, the number of the protrusions 721 and the grooves 140 may be 1 or 3 or more. The configurations of the above-described embodiments can be appropriately combined without departing from the object of the present invention.

DESCRIPTION OF SYMBOLS 10 Treatment substance conveyance jig | tool 100 Main body 110 One end part 120 Middle part 122 Groove | move 124 Through-hole 130 Other end part 132 Vent hole 136 Index | index 200 Balloon (elastic membrane)
300 Exhaust pipe 500 Cover pipe
A recess
S internal space

Claims (8)

A jig for transporting a sheet-like therapeutic substance to a desired position in a biological tube,
A main body having an intermediate portion formed with a concave portion that is curved in a concave shape in a direction orthogonal to the direction from the one end portion to the other end portion, between the one end portion and the other end portion;
An elastic membrane that covers at least the recess and forms an internal space with the body;
A fluid path that is formed at the other end in a state of communicating with the inside of the recess and through which the fluid introduced into the internal space through the recess and the fluid discharged from the internal space pass;
A portion of the elastic membrane is drawn into the recess by the discharge of fluid from the internal space ;
When transporting the therapeutic agent, the fluid in the interior space is discharged, the therapeutic agent is an outer side of the elastic membrane covering the recess, and wherein the Rukoto placed in the recess therapy Material transport jig. The jig for transporting a therapeutic substance according to claim 1, wherein the elastic membrane expands by introducing a fluid into the internal space. The therapeutic substance according to claim 1 or 2, wherein the elastic film is formed in a cylindrical shape having two end portions, and is fixed with the end portions in close contact with the main body in a state of surrounding the periphery of the main body. Jig for transportation. The therapeutic substance transporting jig according to any one of claims 1 to 3, wherein an index indicating the position of the concave portion is formed on an end surface of the other end portion. A first pipe connected to the fluid path;
A second pipe having a predetermined outer diameter that covers the first pipe;
The jig for transporting a therapeutic substance according to any one of claims 1 to 4. A connector, at least a part of which is inserted into the fluid path, is connected to the tip of the first pipe,
At least one convex portion is formed on one of the outer surface of the insertion portion of the connector and the inner surface of the fluid path,
The treatment according to claim 5, wherein a groove into which the convex portion is fitted is formed in the other of the outer surface of the insertion portion of the connector and the inner surface of the fluid path when the connector is inserted into the fluid path. Material transport jig. The intermediate portion includes a groove formed on the bottom surface of the recess.
The jig for transporting a therapeutic substance according to any one of claims 1 to 6. The said intermediate | middle part is a jig | tool for the conveyance of the therapeutic substance of any one of Claim 1 to 7 containing the fluid channel | path which connects the bottom face of the said recessed part, and the outer surface of the said intermediate part.

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