JP7265774B2 - bone marrow harvester - Google Patents

Description

The present invention relates to a bone marrow harvesting device for harvesting bone marrow tissue from human or animal bones.

The bones of the human body or animals have a structure with cortical bone made of hard bone that constitutes the outer surface, and spongy bone with many small pores and mesh-like trabeculae arranged three-dimensionally inside the cortical bone. It's becoming In large bones, a medullary cavity with poor cancellous bone is formed in the center of the bone.
"Bone marrow" refers to the tissue within a bone that fills the cancellous ostium and the medullary cavity. Cells contained in the bone marrow are roughly divided into two types. Blood cells and stromal cells that support them. Blood cells include, for example, erythroblasts and hematopoietic stem cells, and stromal cells include adipocytes, fibroblasts, endothelial cells, mesenchymal stem cells, and the like.

Of these, hematopoietic stem cells are stem cells that can differentiate into all blood cells such as red blood cells, white blood cells (lymphocytes, neutrophils, eosinophils, basophils), platelets, and blood cells. abundant in bone marrow. Stem cells refer to cells that have self-proliferation and multipotency. Bone marrow transplantation, which is performed when treating patients with hematological cancers such as leukemia, malignant lymphoma, and multiple myeloma, is mainly aimed at collecting and transplanting these hematopoietic stem cells. There are approximately 13,000 blood cancer patients per year.

"Bone marrow transplantation" is a therapeutic method in which normal bone marrow cells of a donor are intravenously injected into a patient for transplantation. In addition, there is also a therapeutic method called autologous hematopoietic stem cell transplantation, in which the patient's own hematopoietic stem cells are collected and stored in advance before chemotherapy and then transplanted to the patient after chemotherapy.

On the other hand, mesenchymal stem cells include mesenchymal cells such as osteoblasts, osteocytes, chondrocytes, adipocytes, muscle cells, endodermal cells such as gastric epithelial cells, epithelial cells, nerve cells, etc. It is a somatic stem cell that has the ability to differentiate into ectodermal cells. Mesenchymal stem cells are expected to be applied to regenerative medicine, such as reconstruction of bones, blood vessels, and myocardium, by utilizing this differentiation ability. For example, clinical application has started in regenerative medicine for bone and joint diseases. Mesenchymal stem cells can be obtained from a variety of tissues, but the tissue currently used as a cell source for clinical applications is bone marrow.
Mesenchymal stem cells are abundant in the bone marrow that fills the pores of cancellous bone.

The aspiration method has been conventionally used for bone marrow harvesting for bone marrow transplantation. Aspiration is a method of aspirating bone marrow fluid from the donor's ilium using a bone marrow collection needle.
However, in the aspiration method using a bone marrow collection needle, only about 10 ml of bone marrow can be collected with one puncture. It is necessary to puncture the bone. As a result, the physical burden on the donor, such as the invasiveness of multiple punctures and long hours of general anesthesia, was great. In addition, having to perforate the hard cortical bone 50 to 300 times was a heavy burden on the operator.

Therefore, various means for collecting a large amount of bone marrow fluid and cancellous bone fragments in a short time, efficiently and safely have been proposed (eg, Patent Documents 1 to 4, Non-Patent Document 1).

In the "bone marrow harvesting apparatus" of Patent Document 1, a rotatable and bendable soft drill having a suction function driven by a power unit is installed on a manipulator, and a suction needle is injected into the donor's ilium or the like to aspirate the bone marrow fluid. Collect. As a result, a large amount of bone marrow fluid is collected from a wide range while the soft drill punctures the bone marrow cavity passively bending along the cortical bone in one puncture.

The 'bone marrow harvesting device' of US Pat. The rigid cannula has a proximal end, a distal end, an opening, and an inner surface defining an internal passageway extending from the opening toward the proximal end. A cutting tip is axially and radially movably mounted at the distal end of the rigid cannula. A suction force is applied to the passageway to draw the destroyed bone marrow cells, blood and bone fragments into the inner passageway and collect them. The device further has a rotating shaft coaxially arranged in the internal passageway. The rotating shaft has a cutting bit for cutting and pulverizing bone tissue at its tip.

The 'Body Tissue Retrieval Device' of US Pat. The device has an aspiration system that supplies and aspirates fluid from the distal end of the cannula. Additionally, the cannula is configured to rotate or oscillate.

The "minimally invasive tissue recovery device" of Patent Document 4 includes a handpiece and a tissue recovery mechanism connected thereto. The tissue retrieval mechanism includes a cannula with an open distal tip and an outer diameter of less than 5 mm, and a rotating member having a helical thread on the distal portion. A distal portion of the rotating member lies beyond the open distal tip of the cannula and pinches tissue between the helical threads. The device is designed to draw soft tissue into the cannula as the rotating member rotates without the need for an ancillary source of suction.

The device of Non-Patent Document 1 is equipped with a speed and aspiration control, a removable rotating flexible shaft, and an ergonomic power handle, and when power is supplied, the stem cells are abundantly aspirated into the bone marrow cavity. Rotate and move the . This device is minimally invasive, painless, and can collect the required amount of bone marrow with a single insertion.

JP-A-2004-154296 U.S. Patent Application Publication No. 2004/0191897 U.S. Patent Application Publication No. 2007/0276352 U.S. Patent Application Publication No. 2005/0209530

“MarrowMiner: REGENMED TECHNOLOGY”, [online], [searched on October 23, 2019], Internet <URL: https://www. regenmed systems. com/technology>

Bone marrow harvesting serves two different purposes. The first purpose is treatment of leukemia, in which hematopoietic stem cells are collected as bone marrow fluid. A second purpose is to regenerate bones, internal organs, blood vessels, and other organs, and in this case, mesenchymal stem cells are collected.
As described above, hematopoietic stem cells are mainly contained in the bone marrow fluid within the marrow cavity, and mesenchymal stem cells are mainly contained in the bone marrow that fills the trabecular bone pores.

For the purpose of collecting mesenchymal stem cells, the prior art described above has the following problems.
(1) Bone marrow fluid is a jelly-like liquid, whereas spongy bone is spongy bone in which thin, hard bone trabeculae are spread three-dimensionally in a mesh-like manner. Therefore, in the aspiration method using a bone marrow collection needle, in order for the operator to advance the puncture needle into the bone, the operator must twist the hard needle and push it with a strong force to break the trabecular bone while advancing the needle. In addition, there is a possibility that it may penetrate with too much force and damage other tissues.
(2) When a flexible tube such as a flexible shaft is used as a cannula, when the tip reaches the spongy bone (a spongy solid) from the medullary cavity, the tube bends even if the distal end is pushed with a strong force. cannot be inserted into the cancellous bone.
(3) In order to insert the tip of the cannula into cancellous bone, if the distal part has a drill, a cutting tip, a stirring member, a rotating member, etc., mesenchymal stem cells (cells with a size of about 30 μm) There is a high possibility that the cells will be crushed due to the shear force acting on them.
(4) More mesenchymal stem cells are present in the trabecular bone foramen than in the marrow cavity. The cancellous bone ostia are small and surrounded by hard trabeculae. On the other hand, in order to use mesenchymal stem cells for bone marrow transplantation or regenerative medicine, it is necessary to carefully collect the cells so that they are not crushed by excessive suction force, shearing force, or the like. Therefore, in order to collect mesenchymal stem cells without destroying them, it was necessary to crush the trabecular bone of the cancellous bone and collect the bone marrow in the ostia together with the small pieces of the cancellous bone.

The present invention was created to solve the above problems. That is, the object of the present invention is to collect a large amount of bone marrow fluid or cancellous bone chips with a single insertion, and to efficiently collect mesenchymal stem cells without crushing them. To provide a bone marrow harvesting device with little damage.

According to the present invention, a bone marrow harvesting device for harvesting bone marrow fluid and cancellous bone chips from a human body or animal,
a flexible screw tube having a hollow interior and a helical unevenness on the hollow wall of the distal portion;
a rotary drive device that rotates the proximal portion of the screw tube around its axis;
an aspiration device for aspirating liquid containing solids from the distal end thereof through the hollow interior of the screw tube;
A bone marrow harvesting device is provided, wherein the screw tube has a swivel blade provided at the distal end for annularly cutting cancellous bone, and a suction opening provided inside or near the swivel blade to allow the solid matter to pass through. be.

According to another embodiment of the present invention, there is provided a bone marrow harvesting device for harvesting bone marrow fluid and cancellous bone chips from a human or animal, comprising:
a flexible screw tube having a hollow interior and a helical unevenness on the hollow wall of the distal portion;
a rotary drive device that rotates the proximal portion of the screw tube around its axis;
an aspiration device for aspirating liquid containing solids from the distal end thereof through the hollow interior of the screw tube;
The screw tube has a spindle portion provided at the distal portion and having a spindle shape and having the distal end drawn, and a liquid collection hole provided at the side surface of the screw tube and communicating the hollow inside and the outer surface. A bone marrow harvest device is provided, comprising:

According to the present invention, the inside of the screw tube is hollow, and the hollow wall of the distal portion has a helical uneven portion. Retreat is possible.

In addition, although the screw tube is flexible, the distal helical uneven part is held by cancellous bone, so even if the tip reaches the cancellous bone (cancellous solid), can flexibly follow and advance through the cancellous bone.
Therefore, according to the present invention, a large amount of bone marrow fluid and cancellous bone chips can be collected with a single insertion.

Furthermore, since the distal end of the screw tube is provided with a turning blade that cuts the cancellous bone in a ring shape, when the distal end reaches the cancellous bone (cancellous solid), the turning blade cuts the cancellous bone in a ring shape. can be cut to

Also, the rotary blade provided at the distal portion of the screw tube cuts the cancellous bone in an annular shape by a combination of rotation and advancement of the screw tube. Therefore, no shearing force acts on the mesenchymal stem cells (cells with a size of about 30 μm), thereby preventing crushing (cell damage) of the mesenchymal stem cells.

Furthermore, since the screw tube has a suction opening through which solids pass inside or near the turning blade, liquid containing solids can be sucked through the hollow interior of the screw tube by the suction device from its proximal end. can. As a result, the mesenchymal stem cells of cancellous bone can be collected efficiently without crushing.

Alternatively, the distal end of the screw tube is provided with a fusiform spindle portion whose distal end is drawn, and the side surface of the screw tube is provided with a liquid collection hole that communicates the hollow inside and the outer surface. . By screwing the spindle into the cancellous bone, the cancellous bone ostium is destroyed. A mixture of bone marrow is present. Here, by further advancing the screw tube, the convex portion of the spiral uneven portion presses the mixture of crushed trabecular bone and bone marrow against the inner wall of the tunnel, and the exuded bone marrow fluid is aspirated from the fluid collection hole.
As a result, the bone marrow harvesting device can selectively aspirate the bone marrow fluid in the small holes of the cancellous bone while removing the cancellous bone fragments that cannot pass through the fluid collecting holes.

1 is an overall configuration diagram of a bone marrow harvesting apparatus according to the present invention; FIG. 1 is an overall configuration diagram of a first embodiment of a handle device; FIG. It is a whole block diagram of a screw tube. FIG. 11 is a first embodiment view of the distal portion of the screw tube; FIG. 10 is a second embodiment view of the distal portion of the screw tube; FIG. 11 is a view of a third embodiment of the distal portion of the screw tube; FIG. 10 is a fourth embodiment of the distal portion of the screw tube; FIG. 5 is an overall configuration diagram of a second embodiment of the handle device; FIG. 4 is an explanatory view showing how to use the bone marrow harvesting device according to the present invention;

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. In addition, the same code|symbol is attached|subjected to the part which is common in each figure, and the overlapping description is abbreviate|omitted.

FIG. 1 is an overall configuration diagram of a bone marrow harvesting device 100 according to the present invention.
A bone marrow harvesting device 100 is a device for harvesting bone marrow fluid and bone marrow cancellous bone particles (PCBM) from a human body or an animal, and includes a screw tube 10, a handle device 20, and a suction device 50 in this figure.

The screw tube 10 is flexible and hollow from the tip (distal end 10a) to the proximal end (proximal end 10b, see FIG. 2). have A distal portion means a portion of the tip (distal end 10a).
The screw tube 10 preferably has a diameter of 2 to 20 mm and a total length of 50 to 200 mm. Also, the material is preferably a metal or alloy used for medical or surgical purposes. For example, it may be made of stainless steel, titanium, or a titanium alloy.
The flexibility of the screw tube 10 is preferably such that it can be reasonably bent within the elastic range along the inner surface of the cortical bone in the ilium. In other words, this flexibility is preferably hard enough to cut cancellous bone but not to perforate cortical bone from within the ilium. This flexibility can be set by the wall thickness (for example, 0.2 to 0.6 mm) of the screw tube 10 and the depth and pitch P of the spiral uneven portion 12 .
Details of the screw tube 10 will be described later.

The handle device 20 is a device that is gripped by an operator to operate the bone marrow harvesting device 100 .
A proximal portion 14 (the distal portion on the right in the figure) of the screw tube 10 is secured to the handle device 20 .

Aspiration device 50 includes an aspiration pump 52 , a collection pot 54 and a hollow flexible plastic tube 56 .
The suction pump 52 suctions the inside of the collection pot 54 to a negative pressure (negative pressure).
The soft plastic tube 56 connects the suction tube 22 (see FIG. 2) provided in the handle device 20 and the inside of the collection pot 54, and negative pressure suction is applied to the hollow inside 10c of the screw tube 10 (negative pressure). do. Flexible plastic tube 56 is preferably made of flexible plastic.
With this configuration, the suction device 50 can suck liquid containing solids from its tip (distal end 10 a ) through the hollow interior 10 c of the screw tube 10 and collect it in the collection pot 54 .

FIG. 2 is an overall configuration diagram of the first embodiment of the handle device 20. As shown in FIG.
In this figure, the handle device 20 has a rotary drive device 30 , a suction tube 22 and a rotary joint 24 .

In FIG. 2, the proximal portion 14 (terminal portion) of the screw tube 10 is a hollow circular tube without the helical uneven portion 12, and is centered on its axis by a plurality of bearings 25a and 25b inside the main body of the handle device 20. rotatably supported on the
A gear 32 is fixed to the proximal portion 14 of the screw tube 10 concentrically with the axis of the screw tube 10 .

The rotary drive device 30 has a gear 32 , a motor 34 with a reduction gear that rotationally drives the gear 32 , and a battery 36 that supplies power to the motor 34 with a reduction gear.
With this configuration, the torque can be transmitted to the screw tube 10 via the gear 32 by the motor 34 with a speed reducer.

It is preferable that the motor 34 with a reduction gear has a torque limiter 35 capable of setting the maximum value of the rotational torque acting on the screw tube 10 .
By setting the maximum value of the rotational torque by the torque limiter 35, cutting hard tissue such as cortical bone with the rotary blade 16 can be prevented.

The rotation driving device 30 further includes a right rotation switch 37a for right rotation of the screw tube 10, a left rotation switch 37b for left rotation, a right rotation indicator light 38a for indicating right rotation, and a left rotation indicator light for indicating left rotation. 38b.
The main body 28 of the handle device 20 has a grip portion shaped so that the operator can easily operate the right rotation switch 37a or the left rotation switch 37b with one hand.

With the above-described configuration, the operator grips the grip portion of the main body 28 and presses the right rotation switch 37a or the left rotation switch 37b with a finger to drive the screw tube 10 to rotate clockwise or counterclockwise around its axis. can do. At the same time, the operating state can be confirmed by the clockwise rotation indicator lamp 38a or the counterclockwise rotation indicator lamp 38b.

In FIG. 2, the aspiration tube 22 is a hollow tube for aspirating and collecting cancellous bone chips and bone marrow fluid through the screw tube 10 . The suction tube 22 is a hollow circular tube having the same diameter as the proximal portion 14 of the screw tube 10 and having no helical uneven portion 12 in this example. The suction tube 22 is fixed to the main body 28 of the handle device 20 concentrically with the screw tube 10 so as not to rotate.

The rotary joint 24 liquid-tightly connects the tip 22a of the suction tube 22 and the distal end 10b of the screw tube 10 .
The tip 22a of the suction tube 22 is fixed so as not to rotate, and the distal end 10b of the screw tube 10 is driven to rotate clockwise or counterclockwise around its axis.
Therefore, the rotary joint 24 is liquid-tightly fixed to one of the suction tube 22 and the screw tube 10 (for example, the suction tube 22), and serves as a sealing portion for liquid-tightly sealing between the other (for example, the screw tube 10). have.

2, the main body 28 of the handle device 20 is provided with a hollow hole 27 surrounding the distal end 22b of the suction tube 22 so that one end of the soft plastic tube 56 can be connected to the distal end 22b of the suction tube 22. .

FIG. 3 is an overall configuration diagram of the screw tube 10. As shown in FIG. In this figure, (A) is an overall side view, (B) is an enlarged view of part B of (A), and (C) is a sectional view taken along the line CC of (B). In addition, in this figure, the hollow interior 10c of the screw tube 10 is shown in a grid pattern, and the illustration of the liquid sampling hole 19 (see FIG. 4) is omitted.

In FIG. 3A, the screw tube 10 has a tip (distal end 10a), a helical portion 13 with a helical uneven portion 12, and a proximal portion 14 without a helical uneven portion 12. In FIG. The outer diameter of the proximal portion 14 is preferably the same as the maximum diameter of the spiral portion 13 but may be smaller or larger than the maximum diameter of the spiral portion 13 .
Moreover, the spiral portion 13 and the proximal portion 14 of the screw tube 10 are preferably integrally molded from the same hollow circular tube.
The lengths of the spiral portion 13 and the proximal portion 14 can be freely set.

In FIG. 3(C), the cross-sectional shape of the screw tube 10 is a daruma shape in which the symmetrical position with respect to the axis of the thin hollow circular tube is recessed toward the axis. That is, the cross-sectional shape of the screw tube 10 is closed with a pair of convex portions 13a projecting outward and a pair of concave portions 13b projecting inward.
In this example, the helical uneven portion 12 is located at the position of the recessed portion 13b, and is formed in a right-handed screw shape with a constant pitch P on the distal end side outer surface of the screw tube 10 .

In FIG. 3(C), the width of the narrowest portion 11 of the hollow inner surface of the screw tube 10 is preferably 1 mm or more, preferably 2 to 3 mm.
With this configuration, clogging of mesenchymal stem cells (cells with a size of about 30 μm) can be prevented, and mesenchymal stem cells can be collected efficiently without being crushed.

In this example, the screw tube 10 is in the form of a double-threaded screw having two helical concave-convex portions 12 located point-symmetrically with respect to the axis. It may be in the form of a screw.

In this example, the cross-sectional shape of the spiral uneven portion 12 is an arcuate groove, but the present invention is not limited to this, and may be a rectangular groove, a triangular groove, or other shapes.
Similarly, the cross-sectional shapes of the projections 13a and the recesses 13b are arc-shaped in this example, but the present invention is not limited to this, and may be rectangular, triangular, or other shapes.

FIG. 4 is a first embodiment view of the distal portion of the screw tube 10. FIG. In this figure, (A) is a side view of the distal portion, (B) is a view taken along line BB of (A), and (C) is a partial cross-sectional view of (B) taken along line DD. In addition, the hollow inside 10c of the screw tube 10 is shown in a lattice pattern.
In this view, the screw tube 10 has a turning edge 16 and a suction opening 18 at its distal portion.

The turning blade 16 is provided at the distal portion of the screw tube 10, turns around the axis of the screw tube 10, and cuts cancellous bone into an annular shape.
The turning blade 16 is positioned forward in the rotational direction of the distal portion of the screw tube 10 when the screw tube 10 rotates forward. Moreover, as shown in FIG. 4(C), the turning blade 16 is provided with a cutting edge 16a so that chips cut when the screw tube 10 rotates forward are directed toward the center. As a result, the chips are directed toward the suction opening 18 and sucked into the suction opening 18 . For example, chips generated by the swivel blade 16 shown on the upper side in FIG. The remaining chips pass over the turning edge 16, slide on the outer surface of the screw tube 10 due to the rotation of the screw tube 10, and are sucked through the suction opening 18 at the bottom of this figure.
In FIG. 4B, the turning blade 16 is part of the projection 13a and the recess 13b located forward in the rotational direction of the cross-sectional shape of the screw tube 10 when the screw tube 10 rotates forward (advance). .
The width of the narrowest portion 11 of the turning blade 16 is preferably 1 mm or more, preferably 2 to 3 mm.
The swivel blade 16 is preferably hardened metal, such as TiN, and has a hardness suitable for cutting cancellous bone. For example, only the distal portion of the screw tube 10 having the turning edge 16 may be nitrided and hardened.

The suction opening 18 is provided inside or near the swivel blade 16 and has a size that allows solid matter to pass therethrough.
The suction opening 18 is located in front of the turning blade 16 in the rotation direction when the screw tube 10 rotates forward.
4A and 4B, the suction opening 18 is an opening positioned in front of the turning blade 16 in the rotational direction when the screw tube 10 rotates forward (advance).

The screw tube 10 has a plurality of liquid sampling holes 19 provided on its side surface and communicating between the hollow interior 10c and the outer surface. A liquid sampling hole 19 is provided in the convex portion 13a. The liquid collection hole 19 of the present embodiment preferably has a size through which a cancellous bone fragment can pass, but the cancellous bone fragment does not have to pass therethrough. As a result, the convex portion 13a having a plurality of liquid collection holes 19 is pressed and rubbed against the inner surface of the tunnel in the cancellous bone formed by the screw tube 10, so that the liquid flows toward the outer surface of the screw tube 10. The chips can be efficiently sucked from the liquid sampling hole 19. - 特許庁
The liquid sampling hole 19 is preferably formed by drilling. The shape of the liquid sampling hole 19 may be circular, elliptical, or slit-like. Moreover, it is preferable that the liquid sampling holes 19 are arranged in a reverse spiral shape (for example, on a two-dot chain line in this figure) that intersects the spiral direction of the spiral uneven portion 12 . As a result, many liquid collection holes 19 can be provided while maintaining the strength of the screw tube 10 .
The liquid collection hole 19 may be arranged from 5 cm from the distal end 10 a of the screw tube 10 to half the length of the screw tube 10 . The liquid collection hole 19 may be configured to be larger toward the tip of the screw tube 10 .

The above-described screw tube 10 advances in the cancellous bone by converting the rotational force of the rotary drive device 30 into a linear driving force due to the pitch P of the helical uneven portion 12 . With this configuration of the swivel blade 16, the speed at which the screw tube 10 advances in the cancellous bone and the speed at which the swivel blade 16 scrapes the cancellous bone are the same, so cells in the bone marrow can be harvested without being crushed. In addition, since a suction opening 18 having a size through which cancellous bone fragments pass is opened in front of the turning blade 16 in the forward rotation direction at the distal end 10a of the screw tube 10, the turning blade 16 was used to cut. The cancellous bone chips and bone marrow fluid can be aspirated from the aspiration opening 18 into the hollow interior 10c of the screw tube 10 by negative pressure aspiration.
Therefore, the bone marrow harvesting by the screw tube 10 of the present embodiment causes little cell damage, so that bone marrow tissue containing many cells in good condition, which can be used for bone marrow transplantation or regenerative medicine, can be harvested. In addition, since the screw tube 10 of the present embodiment can collectively collect cancellous bone fragments and the surrounding bone marrow tissue, it is possible not only to collect hematopoietic stem cells but also to collect bone marrow for the purpose of collecting mesenchymal stem cells. can also be used.

FIG. 5 is a second embodiment of the distal portion of the screw tube 10. FIG. In this figure, (A) is a side view of the distal part, and (B) is a BB arrow view of (A). In addition, the hollow inside 10c of the screw tube 10 is shown in a lattice pattern.
In this example, the turning blade 16 is a helical cutting blade provided within a range of one pitch (for example, half the pitch P) from the tip (distal end 10a) of the screw tube 10. It revolves around its axis and cuts the cancellous bone in an annular shape.
In FIG. 5(B), the turning blade 16 is part of the protrusion 13a and the recess 13b located on the rotational downstream side of the cross-sectional shape of the screw tube 10 when the screw tube 10 rotates forward (advance).

The suction opening 18 is provided inside or near the swivel blade 16 and has a size that allows solid matter to pass therethrough. 5(A) and (B), the suction opening 18 is located between the turning blades 16 and is within a range of 1 pitch (for example, half the pitch P) from the tip (distal end 10a) of the screw tube 10. It is an opening provided.
Other configurations of the distal portion are the same as those of the first embodiment.

According to the second embodiment of the distal part described above, when the rotational force of the rotary drive device 30 is converted into a linear driving force to advance in the cancellous bone, the spongy bone fragments cut by the swivel blade 16 and the bone marrow fluid. can be sucked from the suction opening 18 into the hollow interior 10c of the screw tube 10 by negative pressure suction.
Other effects of the distal end 10a of the second embodiment of the screw tube 10 are the same as those of the first embodiment.

FIG. 6 is a third embodiment of the distal portion of the screw tube 10. FIG. In this figure, (A) is a side view of the distal part, and (B) is a BB arrow view of (A). In addition, the hollow inside 10c of the screw tube 10 is shown in a lattice pattern.
As in this example, the screw tube 10 has a deeper thread drawing toward the tip, and the inscribed circle 17 between the turning blades 16 is made smaller than the narrowest portion 11, thereby preventing clogging inside the screw tube 10. good too.
Other configurations and effects of the distal portion are the same as those of the first embodiment.

FIG. 7 is a fourth embodiment of the distal portion of the screw tube 10. FIG. In this figure, (A) is a side view of the distal part, and (B) is a BB arrow view of (A).
In this example as well, the screw tube 10 has a plurality of liquid collection holes 19 provided on its side surface and communicating between the hollow interior 10c and the outer surface, as in the first embodiment. The liquid sampling hole 19 of this embodiment has a size that prevents cancellous bone fragments from passing through.
With this configuration, bone marrow fluid can be collected more efficiently, and cancellous bone chips collected at the distal end 10a can be easily transported to the proximal portion 14 by the flow of the suction.

Also in this example, the screw tube 10 has a fusiform spindle portion 15 provided at the distal portion thereof and having a drawn distal end 10a. Alternatively, the distal end 10a of the screw tube 10 may have an opening that is sized to prevent cancellous bone chips from entering. The spindle 15 may have a truncated conical shape with a narrow tip.
The spindle portion 15 is preferably formed by constricting the distal portion of the screw tube 10 into a spindle shape.
In this case, the swivel blade 16 is not provided, but may be on the distal end 10a or on the outer surface of the spindle 15 .
With this configuration, it is possible to collect bone marrow fluid of higher purity from the fluid collection hole 19 by preventing cancellous bone fragments from entering from the distal end 10a. That is, since the distal end 10a has a fusiform or truncated conical shape without a blade, when the screw tube 10 is advanced, the side surface of the spindle 15 crushes the surrounding trabecular bone and destroys the cancellous ostium structure. will do. When the screw tube 10 is rotated and advanced as it is, the mixture of broken bone trabeculae and bone marrow in the ostium is pressed against the wall surface of the tunnel provided by the spindle 15 with the side surface of the spindle 15 and the protrusion 13a. do. The distal end 10a of the screw tube 10 is closed by drawing or the opening in the distal end 10a is sized to prevent cancellous bone chips from entering. The liquid collection hole 19 provided in the convex portion 13a is also sized so that the spongy bone fragments cannot pass through. Therefore, the bone marrow fluid containing the mesenchymal stem cells can be selectively aspirated by pressing the mixture of broken bone trabeculae and bone marrow in the ostium against the inner wall of the tunnel to squeeze out the exuded bone marrow fluid. . Therefore, the screw tube 10 of the present embodiment can be used mainly for harvesting bone marrow for the purpose of harvesting hematopoietic stem cells.

Moreover, the pitch P of the spiral uneven portion 12 described above is not limited to a constant value, and may gradually increase or decrease from the distal portion toward the proximal portion 14 .
With this configuration, by changing (gradually increasing or gradually decreasing) the pitch P of the screw tube 10, the phase of the contact surface is changed, so that the bone marrow fluid can be more efficiently squeezed from the spinal cavity.

Further, the depth of the concave portion 13b with respect to the convex portion 13a of the spiral concave-convex portion 12 may be drawn so that the distal portion is deep and the depth gradually decreases from the distal portion toward the proximal portion 14 .
With this configuration, the inscribed circle of the concave portion 13b is larger on the proximal side than on the distal side, so clogging of the inside of the screw tube 10 with cancellous bone fragments can be prevented.

FIG. 8 is an overall configuration diagram of a second embodiment of the handle device 20. As shown in FIG.
In this example, the rotary drive device 30 has a head portion 40, a drive shaft 42, and a motor 34 with a speed reducer.
The head portion 40 is configured so that the proximal portion 14 of the screw tube 10 can be attached and detached, is liquid-tight, and can be fixed.
The drive shaft 42 has a tip 42 a fixed to the head portion 40 in a liquid-tight manner and extends rightward in the figure concentrically with the screw tube 10 . The drive shaft 42 is a hollow tube, and is rotatably supported about its axis by a plurality of bearings 25a and 25b inside the main body of the handle device 20. As shown in FIG. Further, the distal end 42b of the drive shaft 42 is rotatably and fluid-tightly connected to the sampling chamber 44 by a sealing device (eg, an O-ring) not shown.
Further in this example, aspiration tube 22 is fixed to body 28 of handle device 20 in communication with collection chamber 44 .

Further, in this example, the gear 32 is fixed to the drive shaft 42 concentrically with the axis of the drive shaft 42 .
A motor 34 with a reduction gear rotationally drives a drive shaft 42 via a gear 32 .
Other configurations are the same as those of the handle device 20 of the first embodiment.

Also according to the second embodiment of the handle device 20 described above, the torque can be transmitted to the screw tube 10 via the gear 32 by the motor 34 with a speed reducer. This rotary motion is converted into forward and backward linear motion of the screw tube 10 by the screw structure of the helical uneven portion 12 .

FIG. 9 is an explanatory diagram showing how to use the bone marrow harvesting device 100 according to the present invention.
In this figure, 1 is the ilium of a human or animal. When harvesting the bone marrow, a hole is first drilled into the cortical bone on the surface of the bone.

Next, the distal portion of the screw tube 10 is inserted into the cancellous bone through this hole, and the proximal portion 14 of the screw tube 10 is rotated clockwise about its axis by the right rotation switch 37a. Due to this rotation, the pitch P of the helical uneven portion 12 converts the rotational force of the rotary drive device 30 into a linear driving force, and the screw tube 10 advances while cutting into the cancellous bone without applying excessive force. can be made
In addition, by rotating the proximal portion 14 of the screw tube 10 counterclockwise about its axis by the left rotation switch 37b, the pitch P of the helical concave-convex portion 12 allows the screw tube 10 to rotate without applying excessive force. can be retracted from within the cancellous bone.

Aspiration device 50 is preferably on at all times when bone marrow harvesting device 100 is in use.
The swivel blade 16 cuts the cancellous bone annularly by a combination of rotation and advancement of the screw tube 10 .
The suction device 50 simultaneously collects the spongy bone fragments cut by the turning blade 16 and the bone marrow fluid from the suction opening 18 by negative pressure suction.

According to the above-described embodiment of the present invention, the inside of the screw tube 10 is hollow, and the hollow wall of the distal portion has the helical concave-convex portion 12, so that the rotational force of the rotary driving device 30 is converted into a linear driving force. can be advanced or retracted through cancellous bone.

In addition, although the screw tube 10 is flexible, the distal helical concave-convex portion 12 is held by cancellous bone, so even if the tip 10a reaches the cancellous bone, the screw tube 10 remains flexible. can be advanced through the cancellous bone by following.

Further, since the distal end 10a of the screw tube 10 is provided with a turning blade 16 for cutting cancellous bone in an annular shape, when the distal end 10a reaches the cancellous bone (cancellous solid), the turning blade 16 The cancellous bone can be cut into an annular shape.

Therefore, according to the present invention, a large amount of bone marrow fluid and cancellous bone chips can be collected with a single insertion. As a result, the time required for collection can be shortened, the risks associated with surgery, anesthesia, etc. can be reduced, the patient is minimally invasive, and the patient's pain can be reduced.

Also, the rotary blade 16 provided at the distal portion of the screw tube 10 cuts the cancellous bone in an annular shape by a combination of rotation and advancement of the screw tube 10 . Therefore, no shearing force acts on the mesenchymal stem cells (cells with a size of about 30 μm), thereby preventing crushing (cell damage) of the mesenchymal stem cells.

Furthermore, since the screw tube 10 has a suction opening 18 through which solids pass inside or near the turning blade 16, the liquid containing solids is sucked from the end 10b through the hollow interior 10c of the screw tube 10 by the suction device 50. be able to. As a result, mesenchymal stem cells in cancellous bone fragments can be efficiently collected without crushing.
As a result, less damaged stem cells can be collected.

Alternatively, the distal end 10a of the screw tube 10 is provided with a fusiform spindle portion 15 whose distal end is drawn, and the side surface of the screw tube 10 is provided with a liquid collection hole that communicates the hollow interior 10c with the outer surface. 19 are provided. By screwing the spindle portion 15 into the cancellous bone, the ostium of the cancellous bone is destroyed. A mixture of bone marrow is present. Here, by further advancing the screw tube 10, the convex portion 13a of the spiral uneven portion 12 presses the mixture of crushed trabecular bone and bone marrow against the inner wall of the tunnel, and the exuded bone marrow fluid is discharged from the fluid collection hole 19. Suction.
As a result, the bone marrow harvesting apparatus 100 can selectively aspirate the bone marrow fluid in the cancellous bone ostia while removing the cancellous bone fragments that cannot pass through the fluid collection hole 19 .

The present invention is not limited to the above-described embodiments, but is indicated by the description of the scope of claims, and further includes all modifications within the meaning and scope equivalent to the description of the scope of claims.
For example, the shape of the distal end 10a of the screw tube 10 is not limited to that described above, and a screw-shaped or propeller-shaped tip may be detachably attached to the tip of the screw tube 10.

The bone marrow harvesting device 100 may also be used for bone drilling (microfracture method) for cartilage regeneration. In this case, a perforation is made in the cartilage with the screw tube 10, and then the hollow hole 27 of the screw tube 10 is filled with a mixture of a drug that promotes cartilage regeneration and the collected cancellous bone pieces, and instead of the suction device 50 A pressurized pump connected to the handle assembly 20 may deliver a mixture of harvested cancellous bone chips and a drug that promotes cartilage regeneration into the perforation.
As a result, the screw tube 10 can continuously supply the bone marrow fluid to the target site for regeneration of the cartilage defect.

The bone marrow harvesting device 100 may also be used for drilling elastic materials, such as rubber, or soft, brittle materials (gel-like). Since the cutting edge 16a is shaped to discharge chips toward the inside of the screw tube 10 (suction opening 18), it is possible to prevent rubber or gel-like chips from getting entangled in the screw tube 10. I can. Therefore, by using this screw tube 10, it is possible to perform drilling with a clean cut surface.

P pitch, 1 ilium, 10 screw tube,
10a tip (distal end), 10b end (proximal end), 10c hollow interior,
11 narrowest portion, 12 spiral uneven portion,
13 spiral portion, 13a convex portion, 13b concave portion,
14 proximal portion (terminal portion), 15 spindle portion, 16 turning blade, 16a cutting blade,
17 inscribed circle, 18 suction opening, 19 liquid sampling hole,
20 handle device, 22 suction tube, 22a distal end, 22b distal end,
24 rotary joint, 25a, 25b bearing, 27 hollow hole, 28 body,
30 rotation drive device, 32 gear, 34 motor with reduction gear,
35 torque limiter, 36 battery, 37a clockwise rotation switch,
37b left rotation switch, 38a right rotation indicator light, 38b left rotation indicator light,
40 head portion, 42 drive shaft, 42a distal end, 42b distal end,
44 collection chamber, 50 suction device, 52 suction pump,
54 collection pot, 56 flexible plastic tube,
100 bone marrow harvesting device

Claims (10)

A bone marrow collection device for collecting bone marrow fluid and cancellous bone chips from a human body or animal,
a flexible screw tube which is a thin-walled hollow circular tube with a hollow interior and has a helical uneven portion on the hollow wall of the distal portion;
a rotary drive device that rotates the proximal portion of the screw tube around its axis;
an aspiration device for aspirating liquid containing solids from the distal end thereof through the hollow interior of the screw tube;
The screw tube has a swivel blade provided at the distal end for cutting cancellous bone in an annular shape, and a suction opening provided inside or near the swivel blade through which the solid material passes,
The cross-sectional shape of the distal portion of the screw tube along a plane orthogonal to the axis includes a plurality of recesses formed by recessing the thin hollow wall toward the axis and the maximum diameter of the distal portion. It has a closed shape in which multiple convex parts at the position are alternately arranged,
The bone marrow harvesting device, wherein the helical concave-convex portion is the concave portion and the convex portion that spirally extend around the axis to form a screw shape. A bone marrow collection device for collecting bone marrow fluid and cancellous bone chips from a human body or animal,
a flexible screw tube which is a thin-walled hollow circular tube with a hollow interior and has a helical uneven portion on the hollow wall of the distal portion;
a rotary drive device that rotates the proximal portion of the screw tube around its axis;
an aspiration device for aspirating liquid containing solids from the distal end thereof through the hollow interior of the screw tube;
The screw tube has a spindle portion provided at the distal portion and having a spindle shape and having the distal end drawn, and a liquid collection hole provided at the side surface of the screw tube and communicating the hollow inside and the outer surface. , has
The cross-sectional shape of the distal portion of the screw tube along a plane orthogonal to the axis includes a plurality of recesses formed by recessing the thin hollow wall toward the axis and the maximum diameter of the distal portion. It has a closed shape in which multiple convex parts at the position are alternately arranged,
The bone marrow harvesting device, wherein the helical concave-convex portion is the concave portion and the convex portion that spirally extend around the axis to form a screw shape. The turning blade forms an acute angle with the distal end of the outer surface of the distal portion and the distal end of the outer surface in front of the outer surface in the direction of rotation during forward rotation of the screw tube. a cutting edge having an inclined surface extending toward the part side;
2. The suction opening is positioned in front of the turning blade in the direction of rotation of the screw tube when the screw tube rotates forward, and extends from the distal end of the screw tube to a range within one pitch of the helical concave-convex portion. The bone marrow harvesting device according to . The screw tube can be advanced or retracted in the bone marrow by converting the rotational force of the rotary drive device into a linear driving force due to the pitch of the helical uneven part,
The turning blade can circularly cut the cancellous bone by a combination of rotation and advancement of the screw tube,
2. The bone marrow harvesting apparatus according to claim 1, wherein the suction device simultaneously collects the cancellous bone pieces cut by the turning blade and the bone marrow fluid from the suction opening by negative pressure suction. During forward rotation of the screw tube,
2. The bone marrow harvesting device of claim 1, wherein the pivot blade is located forward in the rotational direction of the distal portion of the screw tube. 3. The bone marrow harvesting apparatus according to claim 1, wherein the screw tube has a liquid collection hole provided in a convex portion of the spiral concave-convex portion of the side surface of the screw tube and communicating between the hollow interior and the outer surface. the proximal portion of the screw tube comprises a lockable handle device;
3. The bone marrow according to claim 1 or 2, wherein the handle device comprises the rotation drive device and an aspiration tube for aspirating and collecting the cancellous bone strip and the bone marrow fluid through the screw tube. harvesting device. The rotary drive device includes a head portion that detachably and liquid-tightly fixes the proximal portion of the screw tube, and a hollow drive shaft whose tip is liquid-tightly fixed to the head portion and extends concentrically with the screw tube. 8. The bone marrow harvesting apparatus according to claim 7, further comprising: a motor with a speed reducer for rotationally driving the drive shaft. 3. The bone marrow harvesting device according to claim 1 or 2, wherein the pitch of the helical uneven portion is constant or gradually increases or decreases from the distal portion toward the proximal portion. 3. The spiral concave-convex portion according to claim 1 or 2, wherein the depth of the concave portion with respect to the convex portion of the spiral concave-convex portion is formed such that the depth of the concave portion is deep at the distal portion and is gradually reduced from the distal portion toward the proximal portion. bone marrow harvester.

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