JP7355764B2 - Implant placement device - Google Patents

Description

The present invention relates to an implant indwelling device for indwelling an implant in the body by puncturing the skin.

In order to treat tissues whose functions have deteriorated, various treatment methods have been proposed in which an implant that promotes tissue regeneration is placed at the relevant site. For example, a method has been proposed in which porous collagen fibers with numerous pores formed inside are implanted into a damaged site (Japanese Patent Publication No. 2012-500203). When such collagen fibers are implanted, cells gather around them, which has the effect of promoting the regeneration of damaged tissue.

Generally, implants are implanted by incising the skin tissue to expose the damaged tissue, and then fixing the implanted collagen fibers to the damaged tissue using ligation clips or tissue adhesive. However, such techniques are highly invasive and place a heavy burden on the patient, so there is a need for a less invasive technique.

SUMMARY OF THE INVENTION Therefore, an object of the present invention is to provide an implant indwelling device that can easily indwell an implant in a damaged site with minimal invasion.

An implant indwelling device according to one aspect of the present invention has a size larger in the width direction than in the thickness direction, and is formed to extend long in a longitudinal direction perpendicular to the thickness direction and the width direction, and has cells. It has an implant that has the ability to promote tissue regeneration by adhering to it, and an insertion hole that extends through the implant in the axial direction from the distal end to the proximal end, and the implant can be stored in the insertion hole. an implant indwelling device comprising: a tubular body having a space; and an elongated body having a puncture part that can be inserted into subcutaneous tissue, and at least a portion of which is configured to be accommodated in the insertion hole of the tubular body. It is in.

The implant indwelling device according to the present invention allows the implant to be indwelled in a relatively wide area with one implantation, and can be easily and minimally invasively indwelled at the injured site.

FIG. 1A is a plan perspective view of the implant indwelling device according to the first embodiment of the present invention, FIG. 1B is a sectional view taken along line IB-IB in FIG. 1A, and FIG. 1C is a cross-sectional view of the IC in FIG. - It is a cross-sectional view along the IC line. 2A is an enlarged side view of the puncture section of the elongated body of FIG. 1A, and FIG. 2B is an enlarged bottom view of the puncture section of the elongated body of FIG. 1A. 3A is a side view of the elongated body of FIG. 1A with the implant and the implant fixing member attached, and FIG. 3B is a side view of the elongated body of FIG. 1A with the implant and the fixing member attached. It is a bottom view showing a state where it is attached. FIG. 4A is an enlarged plan view of the distal end of the implant according to the first embodiment, FIG. 4B is a side view of the implant, and FIG. 4C is an enlarged plan view of the implant according to a modification of FIG. 4B. FIG. FIG. 5A is an explanatory diagram showing an operation of puncturing the implant indwelling device of FIG. 1A, and FIG. 5B is an explanatory diagram showing an operation of removing a spacer of the implant indwelling device of FIG. 5A. FIG. 6A is an explanatory diagram showing the operation of protruding the elongated body of the implant indwelling tool from the tubular body in FIG. 5B, and FIG. 6B is an explanatory diagram showing the operation of pulling out the implant fixing member of FIG. 6A. . FIG. 7A is an explanatory diagram showing the operation of pulling out the elongated body and tubular body of FIG. 6B, and FIG. 7B is an explanatory diagram showing the operation of cutting the protruding portion of the implanted body. FIG. 7 is a diagram showing an implant indwelling device according to a second embodiment. 9A is a sectional view in the thickness direction of the tubular body unit in FIG. 8, and FIG. 9B is a sectional view taken along line IXB-IXB in FIG. 9A. 10A is a side view of the pushing body in FIG. 8, FIG. 10B is an enlarged view of the vicinity of the tip of the pushing body in FIG. 8, and FIG. 10C is a bottom view of the vicinity of the tip of the pushing body. FIG. 11A is an explanatory diagram showing the operation of puncturing the tubular body unit of FIG. 8, and FIG. 11B is an explanatory diagram showing the operation of pulling out the elongated body of FIG. 11A. FIG. 12A is an explanatory diagram showing the operation of inserting the pushing body into the tubular body from which the elongated body has been pulled out in FIG. 11B, and FIG. 12B is an explanatory diagram showing the operation of causing the pushing part of the pushing body to protrude from the tubular body. . FIG. 13A is an explanatory diagram showing the operation of removing the implant fixing member from the pushing body in FIG. 12B, and FIG. 13B is an explanatory diagram showing the operation of pulling out the tubular body and the pushing part while leaving the implant in FIG. 13A. be. FIG. 14A is a plan view of the implant according to the first aspect of the third embodiment, and FIG. 14B is a plan view of the implant according to the second aspect of the third embodiment.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.

(First embodiment)
As shown in FIG. 1A, an implant indwelling device 10 according to the present embodiment is used when implanting an implant 16 having the ability to promote tissue regeneration into damaged tissue.

For example, during treatment of breast cancer, uterine cancer, etc., lymph nodes are sometimes removed to prevent metastasis, and lymphedema may occur as a sequelae. Treatment methods for lymphedema include lymphatic anastomosis and lymph node transplantation, but lymphatic anastomosis has a low improvement rate, and lymph node transplantation is highly invasive and places a heavy burden on the patient. There are other problems. On the other hand, when porous collagen fibers are implanted near lymph nodes with decreased function, cells from the surrounding area will gather, promoting the regeneration of tissues with decreased function, such as lymph vessels.

The implant indwelling device 10 of this embodiment has a tape formed wide so that the implant 16 can be efficiently installed over a wide range required for the regeneration of tissues near lymph nodes as described above. It is configured to be able to embed an implant 16 of a shape, and is configured so that the implant 16 can be implanted in a wide area with a single embedding operation.

The configuration of each part of the implant indwelling device 10 will be described below.

As shown in FIGS. 1A and 1B, the implant indwelling device 10 includes an elongate body 12 extending in the axial direction, a tubular body 14 that accommodates the elongate body 12 inside, and a body held by the elongate body 12. and an embedded body 16. Of these, the elongated body 12 has a puncture section 20 in which a needle tip 20a is formed, a shaft 24 extending from the puncture section 20 toward the proximal end, and an operating section 26 joined to the proximal end of the shaft 24. are doing.

As shown in FIGS. 2A and 2B, the puncture portion 20 of the elongated body 12 has a thickness that is larger in the width direction (direction of arrow W in the figure) than in the thickness direction (direction of arrow T in the figure). It is formed into a flat shape in the horizontal direction. The puncture section 20 is formed to taper in diameter toward the tip, and has a sharp needle tip 20a formed at the tip. The elongated body 12 can puncture the subcutaneous tissue 92 (see FIG. 5A) from the needle tip 20a. As shown in FIG. 1A, the width of the proximal end 20b of the puncture section 20 is approximately the same as the width of the tubular body 14, and as shown in FIG. The thickness is approximately the same as the thickness of the tubular body 14. Therefore, the structure is such that the tubular body 14 can be easily pushed into the subcutaneous tissue 92 of the living body (see FIG. 5A) as the puncture section 20 punctures.

As shown in FIG. 2A, a communication part 22 is provided on the proximal end side of the puncture part 20 in the axial direction (arrow S direction), and the thickness and width become smaller toward the proximal end side. A shaft 24 extends from the communication portion 22 toward the proximal end. Furthermore, a notch 23 is provided on one surface of the communication section 22 in the thickness direction (the lower surface in the figure), which is obtained by cutting out the communication section 22 in the thickness direction. As shown in FIG. 2B, a pair of notches 23 are formed at one end and the other end of the communication portion 22 in the width direction. A through hole 23a is formed between the pair of notches 23 and extends in the width direction (arrow W direction). The through hole 23a opens into the notch 23. The through hole 23a constitutes a part of the fixing structure 25 (see FIG. 3A) of the implant indwelling device 10 of this embodiment.

As shown in FIG. 1C, the shaft 24 is a rod-shaped member that is smaller in width and thickness than the puncture section 20, and extends toward the proximal end in the axial direction. As shown in FIGS. 1A and 1B, the shaft 24 is a portion that is housed in an insertion hole 30 inside the tubular body 14, and is formed to have a size smaller than the width of the insertion hole 30. Puncture portion 20 and shaft 24 may be made of metal such as stainless steel, for example. The shaft 24 has enough rigidity to transmit the operating force input from the operating section 26 to the puncturing section 20 to push the puncturing section 20 forward within the subcutaneous tissue 92 and further from the tubular body 14. There is. The cross-sectional shape of the shaft 24 can be elliptical. Note that the cross-sectional shape of the shaft 24 may be circular instead of elliptical, or may be rectangular or square.

The operating section 26 is provided on the proximal end side of the shaft 24. The operating portion 26 may be formed integrally with the shaft 24, or may be formed by joining a separate member. The operating portion 26 is a portion through which the user inputs operating force to the implant indwelling device 10, and is formed to have a diameter and length that are easy to hold in the hand. The operating portion 26 is provided with a holding mechanism (not shown) that holds a proximal end portion of an implant fixing member 34, which will be described later. When the holding mechanism is released, the implant fixing member 34 can be pulled out from the elongated body 12.

A spacer 18 is attached to the distal end side of the operating section 26. This spacer 18 is detachably attached between the hub body 32 of the tubular body 14 and the operating section 26. This spacer 18 maintains the operating portion 26 and the hub body 32 in a state where they are separated by a predetermined gap. Further, the spacer 18 transmits the operating force when the operating portion 26 is pushed to the tubular body 14 side. The spacer 18 is configured to prevent the puncture portion 20 of the elongated body 12 from protruding from the distal end 14a of the tubular body 14 at an unintended timing.

The tubular body 14 includes a cylindrical cylindrical portion 28 and a hub body 32 provided on the base end side of the cylindrical portion 28 . The cylindrical portion 28 is formed to extend in the axial direction, and has an insertion hole 30 extending in the axial direction inside the cylindrical portion 28 . As shown in FIG. 1C, the cylindrical portion 28 of the tubular body 14 is formed into a flat shape that is larger in the width direction than in the thickness direction. The insertion hole 30 is provided inside the cylindrical portion 28 having a constant thickness. The widthwise size of the insertion hole 30 is larger than at least the widthwise size of the tape-shaped embedded body 16.

The shaft 24 of the elongated body 12 and the embedded body 16 are housed in the insertion hole 30 of the tubular body 14 . Further, as shown in FIGS. 1A and 1B, the hub body 32 is formed to integrally extend from the cylindrical portion 28 toward the proximal end. The hub body 32 is formed so that the sizes in the width direction and thickness direction gradually increase toward the base end side. The size of the base end portion of the hub body 32 in the thickness direction and the width direction is approximately the same as the size of the operating portion 26 of the elongated body 12 in the thickness direction and width direction.

The distal end 14a of the tubular body 14 is in contact with the proximal end 20b of the puncture section 20 of the elongated body 12, and is configured to transmit the operating force in the pushing direction input via the operation section 26 to the puncture section 20. It is configured. The tubular body 14 is made of, for example, a metal material such as stainless steel or a resin material. Preferably, the tubular body 14 has a wall thickness that is sufficient to exhibit sufficient rigidity to transmit a sufficient pressing force to the puncture section 20 when the subcutaneous tissue 92 is punctured by the operation force from the operation section 26 .

As shown in FIG. 1A, the implant 16 is formed into a tape shape that is larger in width direction (width) than in thickness direction (thickness) and is elongated in the longitudinal direction (axial direction). . The implant 16 is made of, for example, porous collagen fibers, and has countless pores formed inside it, which serve as a starting point for cells to gather and settle in the tissue, thereby helping repair damaged tissue. Demonstrates the function of encouraging. Since the implant 16 is formed wide, it can be suitably used for regenerating a wide range of tissues such as lymph tissue.

As shown in FIG. 4A, the distal end portion 16a of the implant 16 is provided with a locking portion 16b for locking to the subcutaneous tissue 92. As shown in FIG. As shown in FIG. 4B, the locking portion 16b has a structure in which the tape-shaped embedded body 16 is folded back to one side in the thickness direction, and is larger than other parts of the embedded body 16 in the thickness direction. It has a prominent structure. The locking portion 16b protruding in the thickness direction in this manner locks the implant 16 into the subcutaneous tissue 92 when the implant 16 is indwelled in the subcutaneous tissue 92 and the implant retainer 10 is pulled out. Demonstrates the ability to stop.

As shown in FIG. 4A, the locking portion 16b may be formed by folding a portion in the width (W) direction a plurality of times at a predetermined distance. Further, the locking portion 16b may be formed by folding back the entire area of the embedded body 16 in the width direction. Further, as shown in FIG. 4C, the locking part 16b includes a first folded part 16b1 folded back to one side in the thickness (T) direction, and a second folded part 16b2 folded back to the other side in the thickness direction. It may be composed of

Further, as shown in FIG. 4A, a pair of holes 16h are formed in the distal end 16a of the implant 16 in the width direction for passing the implant fixing member 34 that fixes the implant 16 to the elongated body 12. are placed at a predetermined interval. The hole 16h is formed to penetrate from one surface (lower surface) to the other surface (upper surface) of the implant 16, and allows the implant fixing member 34 to be inserted from one surface to the other surface. It is composed of

The embedded body 16 described above is fixed adjacent to the lower surface side of the elongated body 12, as shown in FIG. 3A. An implant fixing member 34 is provided below the implant 16 and constitutes a part of the fixing structure 25 that fixes the implant 16 to the elongated body 12 . The implant fixing member 34 is made of, for example, a thread made of resin such as nylon, a metal wire, or the like. The implant fixing member 34 is composed of a single linear member, and one end and the other end of the implant fixing member 34 are held by the operating section 26 shown in FIG. 1A. Note that in this specification, fixing includes a method of hooking and connecting the implant 16 to the elongated body 12 (engagement), or a method of connecting by inserting a part of the implant 16 into the elongate body 12. It also includes the method (fitting), etc. Therefore, the fixing structure 25 also includes fixing means by engagement or fitting.

One end of the implant fixing member 34 extends below the implant 16 in parallel with the shaft 24 toward the distal end. Then, as shown in FIG. 3B, the implant fixing member 34 reaches the notch 23 through one hole 16h of the implant 16, and is folded back through the through hole 23a. The other end of the implant fixing member 34 extends below the implant 16 through the other hole 16h, and extends below the implant 16 toward the operating section 26 on the proximal end side. One end and the other end of the implant fixing member 34 are arranged below the implant 16 with a predetermined interval in the width direction.

The fixing structure 25 is constituted by the implant fixing member 34, the hole 16h of the implant 16, and the through hole 23a of the elongated body 12. The fixing structure 25 that fixes the implant 16 to the elongate body 12 fixes the implant 16 to the elongate body 12 until the implant fixing member 34 is pulled out, and the two move together. Further, the implant fixing member 34 is applied with a predetermined tension and is configured to support the implant 16 from below. On the other hand, when the holding state of the implant fixing member 34 in the operating section 26 is released, the implant fixing member 34 can be pulled out from the through hole 23a, and the fixing state of the implant 16 by the fixing structure 25 is released. Ru.

The implant indwelling device 10 of the present embodiment is configured as described above, and its operation and operation will be described below.

As shown in FIG. 5A, the implant indwelling device 10 is punctured through the skin 90 of the living body near the implantation position, and the puncture section 20 is pushed to the intended implantation position. The operating force for pushing the implant indwelling device 10 is applied via the operating section 26 at the proximal end of the elongated body 12. The operating force at that time is transmitted to the tubular body 14 via the spacer 18, and the operating force is transmitted to the puncture section 20 via the tubular body 14. At this time, the spacer 18 functions to keep the elongate body 12 in a state where it is not displaced relative to the tubular body 14. Further, the implant 16 is maintained in a state housed within the insertion hole 30 of the tubular body 14. Therefore, it is possible to prevent a problem in which tensile force acts on the implant 16 and the fine structure of the porous collagen fibers is broken, resulting in a decrease in cell fixation properties.

Thereafter, the implant 16 is implanted into the subcutaneous tissue 92. First, as shown in FIG. 5B, the spacer 18 is removed from between the elongated body 12 and the tubular body 14. This creates a predetermined gap between the tubular body 14 and the operating portion 26 of the elongated body 12, and it becomes possible to push the elongated body 12 from the tubular body 14 toward the distal end within this gap.

Next, as shown in FIG. 6A, the operating portion 26 of the elongated body 12 is pushed toward the distal end side to bring the operating portion 26 into contact with the proximal end portion of the tubular body 14. As a result, as shown in FIG. 6B, the puncture section 20 protrudes from the tubular body 14 in the distal direction and moves away, and the distal end 16a of the implant 16 is exposed to the subcutaneous tissue 92. As a result, the locking portion 16b formed at the distal end 16a of the implant 16 is caught and locked in the subcutaneous tissue 92.

Next, the holding state of the implant fixing member 34 of the operating section 26 is released. Then, the implant fixing member 34 is pulled out from the through hole 23a of the elongated body 12 and the pair of holes 16h of the implant 16. Thereby, the implanted body 16 is released from the fixed state to the elongated body 12.

Next, as shown in FIG. 7A, the tubular body 14 and the elongated body 12 are displaced toward the proximal end and pulled out. The implant 16 remains in the implanted position because the locking portion 16b is locked to the subcutaneous tissue 92. The implant 16 is left in the implantation position without being displaced toward the distal end or the proximal end, and without any strong tensile force acting on it. Therefore, damage to the fine structure of the embedded body 16 can be suppressed.

Thereafter, as shown in FIG. 7B, the tubular body 14 and the elongated body 12 are completely pulled out from the skin 90 of the living body, and the protruding portion 16e of the implant 16 from the skin 90 is cut, thereby completing the implantation. .

The implant indwelling device 10 of this embodiment has the following effects.

The implant indwelling device 10 of this embodiment is larger in the width direction than in the thickness direction, and is formed to extend long in the longitudinal direction perpendicular to the thickness direction and the width direction, so that cells can adhere to the implant indwelling device 10. It has an implant 16 that has the ability to promote tissue regeneration, and an insertion hole 30 that extends through the implant 16 in the axial direction from the distal end to the proximal end, and provides a space in the insertion hole 30 in which the implant 16 can be accommodated. and an elongated body 12 having a puncture section 20 that can be inserted into the subcutaneous tissue 92 and at least a portion of which can be accommodated in the insertion hole 30 of the tubular body 14.

With the above-described configuration, the implant indwelling device 10 can implant the implant 16, which has the ability to promote regeneration of damaged tissue, subcutaneously in a minimally invasive manner. In addition, the implant 16 can be placed in a relatively wide area by one implantation without having to be implanted multiple times. Furthermore, when the implant 16 is pushed into the indwelling position, since the implant 16 is housed inside the tubular body 14, no stress is applied to the implant 16, and the microstructure of the implant 16 is It is possible to suppress the decline in tissue regeneration promoting function due to destruction.

In the implant indwelling device 10, the elongated body 12 is formed to be movable along the insertion hole 30, and as the tubular body 14 is retreated, the distal end 16a of the implant 16 is moved along the tubular body 14. It may be exposed from the insertion hole 30 of the. With this configuration, the tubular body 14 can be pulled out while leaving the distal end 16a of the implant 16 at a desired position within the tissue.

The implant indwelling device 10 may be provided with a fixing structure 25 that detachably fixes the puncture section 20 of the elongated body 12 and the distal end 16a of the implant 16. With this configuration, the implant 16 can be pushed in integrally with the puncture section 20 of the elongated body 12, and by releasing the fixation at a desired position, the implant 16 can be inserted into the desired position. can.

In the implant indwelling device 10, the distal end portion 16a of the implant 16 may be formed with a locking portion 16b that protrudes in the thickness direction and can be locked to the subcutaneous tissue 92. With this configuration, displacement of the implant 16 can be prevented, and the implant 16 can be reliably implanted in the intended position.

In the implant indwelling device 10, the fixing structure 25 includes a through hole 23a formed in the puncture section 20, and a linear implant that is inserted into the through hole 23a and extends proximally along the implant 16. It may also be configured with a built-in body fixing member 34. Thereby, the embedded body 16 can be fixed to the elongated body 12 with a simple configuration.

Moreover, the implant 16 of this embodiment may be a sheet-like material whose main component is collagen. By using such an implant 16, regeneration of a wide range of tissues can be promoted with one implantation.

In the implantation method using the implant indwelling device 10 of the present embodiment, the implant indwelling device 10 is formed to have a size larger in the width direction than in the thickness direction, and to extend long in the longitudinal direction perpendicular to the thickness direction and the width direction. It has an implant 16 that has the ability to promote tissue regeneration by adhering cells, and an insertion hole 30 that extends through the insertion hole 30 in the axial direction from the distal end to the proximal end. 16; and an elongated body 12 having a puncture section 20 that can be inserted into the subcutaneous tissue 92 and at least a portion of which can be accommodated in the insertion hole 30 of the tubular body 14. This is an implantation method using the implant indwelling device 10 equipped with the device, in which the puncture part 20 is punctured into the subcutaneous tissue 92 while the implant 16 is covered with the tubular body 14, and the tubular body 14 is pushed to the indwelling position. a step of protruding the elongated body 12 from the insertion hole 30 of the tubular body 14 and bringing the implant 16 into contact with the subcutaneous tissue 92; and withdrawing from the tissue 92. According to this configuration, no stress is applied when the implant 16 is inserted, so that functional deterioration due to the operation of inserting the implant 16 can be suppressed. Furthermore, the implant 16 can be placed over a wide range with one implantation operation.

In the implantation method using the implant indwelling device 10 of this embodiment, the size in the width direction is larger than that in the thickness direction, and it is formed to extend longer in the longitudinal direction perpendicular to the thickness direction and the width direction. an implant 16; a tubular body 14 having an insertion hole 30 extending axially from the distal end to the proximal end, and having a space in which the implant 16 can be accommodated; An implantation method using an implant indwelling device 10 equipped with a puncture section 20 that can be inserted into subcutaneous tissue 92, the puncture section 20 is inserted into the subcutaneous tissue while the implant 16 is covered with a tubular body 14. 92 and pushing the tubular body 14 to the indwelling position; bringing the implant 16 into contact with the subcutaneous tissue 92; and withdrawing the tubular body 14 from the subcutaneous tissue 92, leaving the implant 16 behind. May have.

(Second embodiment)
As shown in FIG. 8, the implant indwelling device 10A of this embodiment includes a tubular body unit 14A in which the elongated body 12A and the tubular body 14 are assembled, and a pusher body 40 to which the implant 16A is fixed. Provided as a body. In addition, in the implant indwelling device 10A of this embodiment, the same structures as the implant indwelling device 10 described with reference to FIGS. 1A to 7B are designated by the same reference numerals, and detailed description thereof will be omitted. do.

The puncture portion 20A at the distal end of the elongated body 12A of the implant retention device 10A is formed so that its widthwise size is smaller than the widthwise size of the insertion hole 30 of the tubular body 14. Further, as shown in FIGS. 9A and 9B, the size of the puncture portion 20A of the elongated body 12A in the thickness direction is smaller than the size of the insertion hole 30 of the tubular body 14 in the thickness direction. Therefore, the puncture portion 20A of the elongated body 12A can be inserted through the insertion hole 30 of the tubular body 14, and the entire elongated body 12A can be pulled out from the tubular body 14.

The operating portion 26 of the elongated body 12A is assembled so as to be in contact with the proximal end portion of the hub body 32 of the tubular body 14 without opening any gaps. When the elongated body 12A is assembled to the tubular body 14, the distal end side of the puncture portion 20A protrudes beyond the tubular body 14. That is, the needle tip 20a of the puncture section 20A protrudes toward the distal end side of the tubular body unit 14A, and the tubular body unit 14A is configured to be able to puncture the subcutaneous tissue 92 of the living body from the puncture section 20A.

As shown in FIG. 8, the pushing body 40 includes a pushing part 42 provided at the distal end, an elongated member 44 extending from the pushing part 42 toward the proximal end, and a pushing part 44 provided at the proximal end of the elongated member 44. and an operation section 46. The pushing body 40 is provided with a tape-shaped embedded body 16A arranged and fixed along the elongated member 44.

As shown in FIGS. 10B and 10C, the pushing part 42 is formed so that the size in the width direction is larger than the width of the tape-shaped embedded body 16A, and the pushing part 42 has a lower end portion where the embedded body 16A is inserted into the pushing body. A notch 43 and a through hole 43a, which constitute a part of a fixing structure 45 for fixing to 40, are provided. The cutout portion 43 is a portion of the push-in portion 42 cut out from the bottom surface upward in the thickness direction. As shown in FIG. 10C, a pair of notches 43 are provided at the base end of the lower surface of the push-in portion 42. As shown in FIG. The through hole 43a is formed to extend in the width direction, and is formed to penetrate from one notch 43 to the other notch 43. The implant fixing member 34 is inserted into the through hole 43a.

The elongated member 44 extends from the push-in portion 42 toward the proximal end, as shown in FIG. 10A. The elongated member 44 has enough rigidity to allow the distal end of the implant 16A to protrude into the subcutaneous tissue 92 when the implant 16A is implanted into the subcutaneous tissue 92. An operating section 46 is provided on the proximal end side of the elongated member 44 . The operating portion 46 is formed to have a thickness and length that are easy to hold in the hand, and the operating force of the pushing body 40 is inputted thereto. The operating force input from the operating section 46 is transmitted to the pushing section 42 via the elongated member 44, and the pushing section 42 is configured to be able to move forward or backward.

As shown in FIG. 10B, the implant 16A of this embodiment includes a locking portion 16d (tapered portion) protruding in the thickness direction at its distal end. The locking portion 16d is formed to be narrow and sharp in the thickness direction at its distal end side. Further, the proximal end side of the locking portion 16d is configured with a steep surface in the thickness direction in order to facilitate engagement with the subcutaneous tissue 92. Note that the shape of the locking portion 16d is not limited to the illustrated shape, and may be formed by folding back as shown in FIG. 4B.

Further, near the tip of the implant 16A, as shown in FIG. 10C, a pair of holes 16h are provided with a diameter that allows the linear implant fixing member 34 to be inserted therethrough. The pair of holes 16h are spaced apart in the width direction. The fixing structure 45 of the implant 16A of the present embodiment includes an implant fixing member 34, a hole 16h, and a through hole 43a provided in the pushing part 42 of the pushing body 40. One end and the other end of the implant fixing member 34 are fixed to the operating section 46, and the vicinity of the center passes through the through hole 43a of the pushing section 42 and is folded over. As shown in FIG. 10A, a portion of the implant 16A on the proximal side of the hole 16h is disposed between the implant fixing member 34 and the elongated member 44, and the implant is fixed from below. It is supported by member 34.

The implant fixing member 34 passes through the pair of holes 16h of the implant 16A and is inserted into the through hole 43a. The implant fixing member 34 fixes the implant 16A to the pusher 40 by preventing displacement of the implant 16A in the distal direction or the proximal direction in the hole 16h. In addition, the structure is such that the fixed state of the implant 16A can be released by releasing the holding state of the implant fixing member 34 by the operating section 46 and pulling out the implant fixing member 34.

Hereinafter, the function of the implant indwelling device 10A of this embodiment will be explained along with its usage method.

First, as shown in FIG. 11A, the puncture section 20A of the tubular body unit 14A is punctured into the skin 90 of the living body, and further advanced within the subcutaneous tissue 92 to insert the distal end of the tubular body unit 14A into the implant 16A ( (see Figure 8).

Next, as shown in FIG. 11B, while holding the tubular body 14 of the tubular body unit 14A in the same position, the operating portion 26 of the elongated body 12A is pulled toward the proximal end, thereby changing the elongated body 12A into a tubular shape. It is pulled out through the insertion hole 30 of the body 14.

After pulling out the elongated body 12A, as shown in FIG. 12A, the pushing body 40 to which the embedded body 16A is fixed is inserted into the hub body 32 of the tubular body 14. Then, the pushing body 40 is advanced along the insertion hole 30 of the tubular body 14 toward the distal end side. Furthermore, as shown in FIG. 12B, the pushing body 40 is pushed in to cause the pushing part 42 to protrude from the tip 14a of the tubular body 14. As a result, the locking portion 16d of the implant 16A comes into contact with the subcutaneous tissue 92.

Next, as shown in FIG. 13A, the holding of the implant fixing member 34 by the operating section 46 is released, and the implant fixing member 34 is pulled out. This releases the fixation of the embedded body 16A.

Thereafter, as shown in FIG. 13B, the pushing body 40 and the tubular body 14 are pulled out from the subcutaneous tissue 92 of the living body. Thereafter, the protruding portion 16e of the implant 16A from the skin 90 is cut and removed to complete the implantation of the implant 16A.

The implant indwelling device 10A of this embodiment has the following effects.

The implant indwelling device 10A includes a pushing part 42 that holds the distal end of the implant 16A and is movable along the insertion hole 30 of the tubular body 14, and a pushing part 42 that extends from the pushing part 42 toward the proximal end. The pushing body 40 is further provided with a long member 44 that advances the pushing part 42 with respect to the tubular body 14, and the pushing body 40 is inserted into the tubular body 14 after pulling out the long body 12A and is inserted into the implanted body. 16A is configured to protrude from the insertion hole 30 in the distal direction. The same effects as the implant indwelling device 10 of the first embodiment can also be obtained with 10A of this embodiment.

The implant indwelling device 10A may include a fixing structure 45 that removably fixes the pushing part 42 of the pushing body 40 and the distal end of the implant 16A. Thereby, the implant 16A can be implanted in a desired position.

In the implant indwelling device 10A, the distal end of the implant 16A may have a locking portion 16d that can be locked to the subcutaneous tissue 92. Thereby, the implant 16A can be prevented from being pulled out when the tubular body 14 and the pusher 40 are pulled out, and can be left in a desired position.

In the implant indwelling device 10A, the fixing structure 45 includes a through hole 43a formed in the pushing part 42, and a linear implant that is inserted into the through hole 43a and extends toward the proximal end along the implant 16A. It may also include a built-in body fixing member 34. Thereby, the fixing structure 45 can be configured with a simple device configuration.

In addition, in the implantation method using the implant indwelling device 10A of this embodiment, the size in the width direction is larger than that in the thickness direction, and the implant is formed to extend long in the longitudinal direction perpendicular to the thickness direction and the width direction. The implant body 16A has the ability to promote tissue regeneration by adhering cells, and an insertion hole 30 that extends through the insertion hole 30 in the axial direction from the distal end toward the proximal end. A tubular body 14 having a space for accommodating the implant 16A, a long body 12A having a puncture portion 20A that can be inserted into the subcutaneous tissue 92, and configured to be able to be stored in the insertion hole 30 of the tubular body 14, A pushing part 42 is formed to hold the distal end of the body 16A and to be movable along the insertion hole 30 of the tubular body 14, and a pushing part 42 extends from the pushing part 42 toward the proximal end to move the pushing part 42 against the tubular body 14. An implantation method using an implant indwelling device 10A comprising a pushing body 40 having an elongated member 44 to be advanced, the step of inserting the elongated body 12A and the tubular body 14 into subcutaneous tissue 92; , a step of pulling out the elongate body 12A while leaving the tubular body 14 in the subcutaneous tissue 92, and inserting the pushing body 40 to which the implant 16A is fixed into the insertion hole 30 of the tubular body 14, and removing the distal end of the implant 16A. The method includes the steps of protruding the body from the insertion hole 30 of the tubular body 14, and pulling out the tubular body 14 and the pushing body 40 from the subcutaneous tissue 92, leaving the implant body 16A. This configuration also provides the same effects as the implantation method using the implant indwelling device 10 according to the first embodiment.

(Third embodiment)
In this embodiment, a modification of the implant 16 will be described. As shown in FIG. 14A, the implant 16B according to the first aspect of the present embodiment is a flat tape-shaped mesh structure 161 of biodegradable threads whose size in the width direction is larger than the size in the thickness direction. It is equipped with A plurality of filamentous materials 162 made of collagen fibers having the ability to promote regeneration of damaged tissue are arranged and bonded to one or both surfaces of the mesh structure 161, extending in the width direction. Each filament 162 extends in the longitudinal direction of the implant 16B.

In the implant 16B according to the first aspect of the present embodiment, a plurality of filamentous materials 162 having the ability to promote regeneration of damaged tissue are arranged to spread in the width direction. Therefore, by embedding the implant 16B once, collagen fibers can be embedded over a wide area. This eliminates the need to implant filamentous collagen fibers multiple times, and the implant 16B can be easily and minimally invasively implanted.

As shown in FIG. 14B, an implant 16C according to the second aspect of the present embodiment has a biodegradable thread mesh structure 164 laminated on a sheet body 163 made of porous collagen fibers formed into a tape shape. It has a structure. The sheet body 163 is made of porous collagen fibers in which many fine holes are formed, and has the ability to promote regeneration of damaged tissue.

Also with the implant body 16C according to the second aspect of the present embodiment, collagen fibers can be implanted over a wide range by one implantation. This eliminates the need to implant filamentous collagen fibers multiple times, and the implant 16C can be easily and minimally invasively implanted.

Although the present invention has been described above with reference to preferred embodiments, it goes without saying that the present invention is not limited to the above-mentioned embodiments, and that various modifications can be made without departing from the spirit of the present invention. stomach.

Claims (11)

An implant having a size larger in the width direction than in the thickness direction, extending long in a longitudinal direction perpendicular to the thickness direction and the width direction, and having the ability to promote tissue regeneration by attaching cells. and,
a tubular body having an insertion hole extending axially from the distal end toward the proximal end, and having a space in which the implant can be stored in the insertion hole;
an elongated body having a puncture part that can be inserted into subcutaneous tissue, and at least a portion of which is configured to be accommodated in the insertion hole of the tubular body;
Implant indwelling device equipped with 2. The implant indwelling device according to claim 1, wherein the elongate body is formed to be movable along the insertion hole, and the distal end of the implant is moved as the tubular body is retreated. An implant indwelling device having a portion exposed from the insertion hole of the tubular body. The implant indwelling device according to claim 2, comprising a fixing structure for removably fixing the puncture section of the elongated body and the distal end of the implant. 3. The implant indwelling device according to claim 2, wherein the distal end of the implant has a locking part that protrudes in the thickness direction and can be locked to the subcutaneous tissue. Indwelling device. 4. The implant indwelling device according to claim 3, wherein the fixing structure is inserted into a through hole formed in the puncture section and into the through hole, and extends along the implant toward the proximal end. An implant indwelling device comprising an extending linear implant fixing member. 2. The implant indwelling device according to claim 1, further comprising: a pushing part that holds the distal end of the implant and is movable along the insertion hole of the tubular body; The pushing body further includes an elongated member that extends toward the proximal end and advances the pushing part relative to the tubular body, and the pushing body is inserted into the tubular body after the elongated body is pulled out. An implant indwelling device that causes the implant to protrude from the insertion hole in a distal direction. 7. The implant indwelling device according to claim 6, comprising a fixing structure for removably fixing the pushing part of the pushing body and the distal end of the implant. 7. The implant indwelling device according to claim 6, wherein the implant has a locking portion at a distal end thereof that can be locked to the subcutaneous tissue. 8. The implant indwelling device according to claim 7, wherein the fixing structure is inserted into a through hole formed in the pushing part and inserted into the through hole, and extends along the implant toward the proximal end. An implant indwelling device comprising an extending linear implant fixing member. The implant indwelling device according to claim 1, wherein the implant is a sheet-like material whose main component is collagen. 2. The implant indwelling device according to claim 1, wherein the implant includes a plurality of filamentous materials whose main component is collagen and a network structure whose main component is a biodegradable material. Indwelling device.

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