WO2013081071A1 - Dispositif pour une transplantation de cellules - Google Patents

Dispositif pour une transplantation de cellules Download PDF

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Publication number
WO2013081071A1
WO2013081071A1 PCT/JP2012/080983 JP2012080983W WO2013081071A1 WO 2013081071 A1 WO2013081071 A1 WO 2013081071A1 JP 2012080983 W JP2012080983 W JP 2012080983W WO 2013081071 A1 WO2013081071 A1 WO 2013081071A1
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WIPO (PCT)
Prior art keywords
expansion
cell transplantation
catheter
lumen
expansion means
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Application number
PCT/JP2012/080983
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English (en)
Japanese (ja)
Inventor
中川雄司
本間康之
畑優
Original Assignee
テルモ株式会社
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Publication of WO2013081071A1 publication Critical patent/WO2013081071A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0268—Joint distractors for the knee

Definitions

  • the present invention is a device for cell transplantation used for arthroscopic or endoscopic surgery, and includes a lumen for liquid aspiration and cell injection and a tissue between the tissues to secure a visual field of the arthroscope or endoscope. It is related with the device for cell transplantation provided with the expansion means which expands.
  • One method of regenerative treatment of cartilage damage sites is a method of transplanting cultured cells and bone marrow-derived cells prepared by concentrating collected bone marrow fluid under arthroscopy.
  • cartilage damage sites cartilage defects
  • Clinical Orthopedic Surgery Ichiro Sekiya, Vol. 45, No. 9, Medical School, September 25, 2010, p. 791-795
  • Synovial cells collected from patients are cultured for 2 weeks, and the cartilage damage site is dissected (shaved) under arthroscopy, and then 0.1 mL of cell suspension is injected into the cartilage damage site using a needle and syringe. To do.
  • US Pat. No. 6,187,023 discloses a method of expanding between joints using a retractor having a blader that can be expanded into a wedge shape. Further, the US Pat. No. 6,187,023 discloses that an endoscope is inserted through a lumen of a retractor into a space formed in a tissue by expansion of a donut-shaped braider. That is, when the retractor is used, a work space such as an arthroscope and a needle can be secured even when there is no liquid in the joint.
  • the retractor has a shape suitable for knee cartilage, and the space around the cartilage damaged part cannot always be reliably expanded.
  • transplantation devices needles, catheters, etc.
  • the present invention has been made in view of such problems, and in the case of cell transplantation surgery under arthroscopy or endoscopy, cells can be reliably and easily applied to a treatment target site without damaging tissue in the living body. It aims at providing the device for cell transplantation which can be transplanted.
  • a cell transplantation device is expanded by a catheter and an expansion fluid that is provided at the distal end portion of the catheter and supplied through an expansion lumen formed in the catheter. And at least one lumen is formed in the catheter in addition to the expansion lumen, and the lumen is expanded between the tissues in the living body by expanding the expansion means. It is characterized in that the liquid on the treatment target site is sucked directly or indirectly and the cells are injected into the treatment target site.
  • the device for cell transplantation configured as described above, it is possible to expand between the tissues in the living body by the expansion means when performing the cell transplantation operation under the arthroscope or the endoscope. Can be secured and will not hurt the tissue.
  • the remaining liquid on the treatment target site is sucked through the lumen formed in the catheter and the cells are injected into the treatment target site, the cells are reliably and easily transplanted to the treatment target site. can do.
  • the catheter includes a suction lumen having a suction port for sucking a liquid on the treatment target site, and an injection lumen having a discharge port for discharging the cells. But you can.
  • the suction port may be positioned below the discharge port.
  • the suction port when sucking the remaining liquid on the treatment target site, the suction port can be preferentially infiltrated into the remaining liquid.
  • the suction port may be positioned below the lower surface of the expansion means with the expansion means expanded.
  • the residual liquid on the treatment target site can be reliably sucked.
  • the discharge port may be positioned above the lower surface of the expansion means with the expansion means expanded.
  • the discharge port is difficult to touch the injected cells.
  • a suction catheter for aspirating the liquid on the treatment target site and an injection catheter for injecting cells into the treatment target site can be selectively inserted into the catheter.
  • a guide lumen may be formed.
  • the height of the distal end portion of the suction catheter when sucking the remaining liquid on the treatment target site, and the height of the distal end portion of the injection catheter when injecting cells into the treatment target site respectively. It can be easily adjusted to a suitable position.
  • the expansion means has a plurality of expansion bodies that expand in an arc shape, and when the plurality of expansion bodies expands, the expansion means has a generally annular shape as a whole, and the distal end portion of the catheter is It is preferable that the expansion means bends at a substantially center position of a substantially annular shape when expanded and is directed downward.
  • the suction port and the discharge port are positioned at substantially the center position of the circle drawn by the plurality of expansion bodies at the time of expansion, the position of the suction port and the discharge port when the contrast medium is used as the expansion fluid It is easy to grasp the above, and it is possible to reliably suck the liquid and inject cells at the target site.
  • the expansion means has a plurality of expansion bodies that expand in a curved shape, and when the plurality of expansion bodies expands, the expansion means has a substantially annular shape as a whole. It is preferable that they are connected to each other by a connecting film and have an integral structure by the connecting film at the time of expansion.
  • the expansion means when the expansion means is expanded, the shape of the expansion means is stabilized, and a space for suction and injection is suitably provided in the inner space surrounded by the plurality of expansion bodies constituting the expansion means. Can be secured.
  • the plurality of expansion bodies may be a pair of expansion bodies each having an arc shape and being arranged on the same circle during expansion.
  • the living body can be efficiently expanded.
  • the expansion means may be provided with an opening into which the imaging means can be inserted.
  • an imaging means (arthroscope, endoscope, etc.) is inserted into the opening, and the state of sucking the remaining liquid on the treatment target site and the state of cell transplantation to the treatment target site are observed. can do.
  • the expansion means may be configured to be foldable so as to be coaxial with the catheter.
  • the incision range of the skin can be reduced when the expansion means is folded and inserted into the living body percutaneously.
  • cells can be transplanted to a site to be treated surely and easily without damaging a tissue in a living body during a cell transplantation operation under an arthroscope or an endoscope.
  • FIG. 1 is a partially omitted plan view of a device for cell transplantation according to a first embodiment of the present invention.
  • FIG. 2 is a transverse sectional view taken along the line II-II of the cell transplantation device shown in FIG. It is a side view which shows the state which expanded the expansion means of the device for cell transplantation concerning 1st Embodiment. It is a side view which shows the state which folded the expansion means of the device for cell transplantation concerning 1st Embodiment, and was inserted in the joint.
  • FIG. 5A is a plan view showing the cell transplantation device according to the first embodiment in which the expansion means is expanded in the joint
  • FIG. 5B is a cross-sectional view taken along the line VB-VB in FIG. 5A.
  • FIG. 5 is a partially omitted vertical cross-sectional view of a cell transplant device according to a second embodiment of the present invention, in a state where an aspiration catheter is inserted into the cell transplant device.
  • FIG. 6 is a partially omitted vertical cross-sectional view of a cell transplant device according to a second embodiment of the present invention, in a state where an injection catheter is inserted into the cell transplant device.
  • FIG. 1 is a partially omitted plan view of a cell transplant device 10 according to a first embodiment of the present invention.
  • This cell transplantation device 10 includes a catheter 12 and an expansion means 14 provided at the distal end of the catheter 12, and expands between tissues in the living body by the expansion means 14 and sucks the liquid remaining in the treatment target site. In addition, it is configured to inject cells into a treatment target site.
  • FIG. 1 shows a state where the expansion means 14 is expanded.
  • the catheter 12 has a catheter shaft 16 constituting the main body of the catheter 12 and a plurality of hubs 28, 30, 32 connected to the proximal end portion of the catheter shaft 16.
  • the catheter shaft 16 is a flexible tubular member.
  • the size of the catheter shaft 16 is appropriately selected according to the living body in which the catheter shaft 16 is used and the size of the treatment target site. In particular, when the catheter shaft 16 is used for arthroscopic surgery at the knee joint, The diameter is preferably set to about 1 to 10 mm and the total length to about 20 to 300 cm.
  • the catheter shaft 16 includes an expansion lumen 20 communicating with the inside of the expansion means 14, a suction lumen 22 for aspirating residual liquid from the treatment target site, and cells (cells) in the treatment target site.
  • An infusion lumen 24 for supplying (suspension) is formed in parallel along the axis of the catheter 12. Even if the catheter shaft 16 having such a plurality of lumens has a configuration in which a plurality of lumens are formed on the catheter shaft 16 itself, a plurality of tubes having the expansion lumen 20, the suction lumen 22, and the injection lumen 24 are heated.
  • the structure may be integrated with a shrink tube or the like.
  • the expansion means 14 is connected to the distal end portion of the expansion lumen 20 so that the expansion lumen 20 communicates with the inside of the expansion means 14.
  • the expansion means 14 includes a pair of expansion bodies 26, and two expansion lumens 20 are provided corresponding to the expansion bodies 26.
  • the two expansion lumens 20 are connected to each other on the base end side to become one common lumen 20a, and an inflator for supplying expansion fluid to the expansion lumen 20 is provided at the base end portion of the common lumen 20a.
  • a hub 28 is provided which can be connected to a pressure application device (not shown).
  • an expansion fluid for example, gas, liquid, air, water, physiological saline, contrast agent, gel, etc.
  • an expansion fluid for example, gas, liquid, air, water, physiological saline, contrast agent, gel, etc.
  • the tip of the suction lumen 22 is opened as a suction port 23 for sucking the liquid (residual liquid) on the treatment target site.
  • a hub 30 to which suction means (not shown) can be connected is provided at the proximal end portion of the suction lumen 22.
  • a suction means for example, a mechanism including a vacuum pump and a collection container, or a syringe can be applied.
  • the tip of the injection lumen 24 is opened as a discharge port 25 for discharging cells.
  • a hub 32 that can be connected to an injection tool (for example, a syringe 33 filled with a cell suspension) for supplying (filling) the cell suspension to the injection lumen 24 is provided at the proximal end portion of the injection lumen 24. It has been.
  • FIG. 2 is a cross-sectional view taken along line II-II in FIG.
  • the distal end portion of the suction lumen 22 and the distal end portion of the injection lumen 24 are bent and directed downward at a substantially annular center position when the two expansion bodies 26 are expanded.
  • the suction port 23 is located below the discharge port 25. With this configuration, when the remaining liquid on the treatment target site is sucked, the tip of the suction lumen 22 can be preferentially infiltrated into the remaining liquid.
  • the height from the discharge port 25 to the suction port 23 is preferably about 0.5 to 19.5 mm.
  • the catheter shaft 16 is rotated by inserting a guide wire into the injection lumen 24 that runs parallel to the suction lumen 22 and rotating it. It is possible to adjust the direction of the suction port 23 of the suction lumen 22 by elastically deforming the distal end of the suction lumen 22. Moreover, you may comprise so that the direction of the front-end
  • the direction of the distal end portion of the suction lumen 22 is adjusted by inserting a guide wire into the suction lumen 22 and rotating the suction lumen 22. It is possible to retract the distal end portion from the treatment target site.
  • the suction port 23 of the suction lumen 22 is lower than the lower surface of the expansion means 14 in a state where the expansion means 14 is expanded, as shown in FIG. Good location.
  • the protruding length of the suction port 23 from the lower surface of the expansion means 14 is preferably about 1 to 20 mm.
  • the discharge port 25 of the injection lumen 24 be positioned above the lower surface of the expansion means 14 in a state where the expansion means 14 is expanded.
  • the catheter 12 has a structure having moderate flexibility and moderate rigidity so that the operator can place the distal end portion of the cell transplant device 10 at a treatment target site in the living body while grasping and operating the proximal end side. It is preferable that Therefore, the catheter 12 is formed of various materials such as polyamide, polyester, polyurethane, polyethylene, polypropylene, and polyvinyl chloride. In particular, polyamide and polyester are preferable from the viewpoints of heat processability and pressure resistance.
  • the expansion means 14 includes a pair of expansion bodies 26 (balloons) that expand in a curved shape.
  • Each expansion body 26 is configured to be foldable (shrinkable) and expanded by supplying and discharging the expansion fluid.
  • a base end portion of each expansion body 26 is joined to the catheter shaft 16 in a fluid-tight manner, and the inside of the expansion body 26 and the expansion lumen 20 communicate with each other.
  • the expansion body 26 and the catheter shaft 16 only need to be fixed in a liquid-tight manner, and are joined by, for example, adhesion or heat fusion.
  • the pair of expansion bodies 26 are arranged so as to form a substantially annular shape as a whole when expanded, and have a one-piece structure with a coupling film 36.
  • the “substantially annular” of the expansion body 26 includes not only a shape that makes a round without a break, but also a shape that is partially opened and opened but is annular as a whole.
  • the outer peripheral edge portion of the coupling film 36 is coupled to the curved inner peripheral portion of each expansion body 26.
  • the expansion body 26 has an arc shape (so-called banana shape) at the time of expansion and is configured to have a substantially annular shape as a whole. That is, the expansion body 26 is configured to be arranged on the same circle during expansion.
  • the size of the expansion body 26 is appropriately selected according to the living body in which the expansion body 26 is used and the size of the treatment target site. In particular, when the expansion body 26 is used for arthroscopic surgery at the knee joint, the expansion body 26 is expanded.
  • the body 26 preferably has an outer diameter of 1 to 20 mm, a length of 10 to 30 mm, and a diameter of a circumscribed circle when the two expansion bodies 26 are expanded to about 10 to 50 mm.
  • expansion body 26 is not limited to the shape shown in FIG. 1 and may be configured to have an elliptical shape as a whole during expansion.
  • Such an expansion body 26 is required to have appropriate flexibility so that expansion and contraction can be performed by supplying and discharging a fluid to the inside of the expansion body 26, and also ensures a space in the living body in which a treatment target site exists.
  • the material may be the same as the constituent material of the catheter exemplified above, or may be another material.
  • an opening 34 is provided through which an arthroscope or endoscope can be inserted.
  • the opening 34 is formed by a gap between the end portions on the distal end side of the two expansion bodies 26.
  • the interval (width) of the opening 34 when the expansion body 26 is expanded is set larger than the outer diameter of the arthroscope or endoscope assumed to be inserted, For example, about 1 to 20 mm is preferable.
  • connection film 36 is provided so as to connect the two expansion bodies 26 to the inner side (annular inner side) of the expansion means 14 that has a substantially annular shape during expansion.
  • connection film 36 is an opening provided in the expansion means 14.
  • a notch 37 that communicates with the portion 34 and extends in the axial direction of the catheter 12 is provided.
  • the cutout portion 37 extends to a position closer to the base end side (rear end side) than the suction port 23 and the discharge port 25 in a plan view, and the distal end portion of the catheter shaft 16 is directed downward through the opening 34. Can be seen.
  • the cell transplant device 10 can be in a state in which the expansion means 14 is folded so as to be coaxial with the catheter 12 by winding the expansion means 14 in a spiral shape as shown in FIG.
  • the incision range of the skin can be reduced when it is inserted into the living body (in the knee joint or the like) percutaneously.
  • the cell transplant device 10 can be inserted into the lumen of a cannula or dilator and inserted into a living body (such as in a knee joint).
  • the expansion body 26 constituting the expansion means 14 and the catheter shaft 16 constituting the catheter 12 can be manufactured by an existing method.
  • the expansion body 26 can be manufactured by integral molding such as inflation molding or a method of molding two or more resin films by heat or the like.
  • the catheter shaft 16 can be produced by extrusion molding or the like.
  • the expansion body 26 and the catheter shaft 16 manufactured in this way can be connected using heat fusion, an adhesive, or the like.
  • the cell transplant device 10 is basically configured as described above, and the operation and effect thereof will be described below.
  • a cultured cell transplantation to a knee joint cartilage injury site in an arthroscopic operation which is a typical application of the cell transplantation device 10, will be described as an example.
  • the method for using the cell transplant device 10 according to this example includes the following steps (1) to (14). 4 to 7, reference numeral 39 denotes a knee joint, reference numeral 40 denotes a femur, reference numeral 42 denotes cartilage on the inner condyle surface of the femur, and reference numeral 44 denotes a cartilage damage site generated in the cartilage 42.
  • the reference numeral 46 denotes a patella, and the reference numeral 48 denotes a cartilage inside the patella 46.
  • a liquid such as physiological saline is injected into the knee joint 39 to secure a working space, a treatment tool (dissection device) is inserted from the inside of the knee joint 39, and an arthroscope 52 is inserted from the outside of the knee joint 39. To do. Then, under arthroscopic viewing, the cartilage damaged portion 44 is dissected (shaved) and then thoroughly washed with physiological saline or the like. Thereafter, the liquid in the knee joint 39 (cleaning liquid or the like) is removed to some extent using a syringe and an injection needle.
  • the expansion means 14 After inserting the cell transplant device 10 into the knee joint 39, the expansion means 14 in a state of being folded just above the cartilage damage site 44 on the inner condyle surface of the femur is observed while checking with the arthroscope 52 A cell transplant device 10 is placed.
  • An indeflator (pressure applying device) filled with a contrast agent is connected to the hub 30 (see FIG. 1) provided at the rear end of the suction lumen 22 of the cell transplant device 10.
  • the expansion fluid filled in the indeflator is not limited to the contrast agent, and may be other fluids exemplified above.
  • the inflating body 26 is filled with the contrast medium by operating the indeflator while confirming with the arthroscope 52, and the expanding body 26 is expanded.
  • the contrast medium is used as the expansion fluid
  • the expansion state of the expansion body 26 can be confirmed by X-rays if necessary.
  • 5A is a plan view of the expansion means 14 of the cell transplantation device 10 expanded on the cartilage 42
  • FIG. 5B is a cross-sectional view taken along the line VB-VB in FIG. 5A. In this way, by expanding the expansion means 14, the tissue can be expanded by an amount corresponding to the thickness of the expansion means 14.
  • FIG. 7 is a schematic cross-sectional view showing an arrangement state of the cell transplant device 10 in the knee joint 39.
  • a syringe as a suction means (not shown) is connected to the hub provided at the rear end of the suction lumen 22 of the catheter 12.
  • a syringe 33 (see FIG. 1) filled with a liquid (cell suspension) in which cultured cells are suspended in advance is connected to a hub 32 provided at the rear end portion of the injection lumen 24 of the catheter 12.
  • (11) Operate the syringe 33 while confirming with the arthroscope 52, and inject a predetermined amount (for example, about 0.1 mL) of the cell suspension into the cartilage damage site 44 through the injection lumen 24.
  • a predetermined amount for example, about 0.1 mL
  • the direction of the distal end portion of the suction lumen 22 can be adjusted by independently rotating only the suction lumen 22, when the cell suspension is injected into the cartilage damage site 44, the suction lumen 22 By inserting and rotating the guide wire 22, the distal end portion of the suction lumen 22 may be retracted from the cartilage damage site 44 as indicated by a virtual line in FIG. 5B.
  • the cell suspension may be injected using another injection tool.
  • the cell suspension After injecting a predetermined amount of the cell suspension into the cartilage damage site 44, the cell suspension is allowed to stand as it is for a predetermined time (for example, about 10 minutes).
  • the contrast medium is removed from the expansion body 26 by operating the inflator, and the expansion means 14 is contracted.
  • the following first cell transplantation method can be carried out by using the cell transplantation device 10 according to the present invention. That is, the first cell transplantation method is: A catheter 12 having a plurality of lumens, and an expansion means 14 provided at the distal end of the catheter 12 and expandable by an expansion fluid supplied through an expansion lumen 20 formed in the catheter 12.
  • Preparing a cell transplant device 10 Inserting the expansion means 14 of the cell transplant device 10 into a living body; Expanding the expansion means 14 between living tissue and disposing the expansion means 14 on a treatment target site; and A step of aspirating residual liquid of a treatment target site through a suction lumen 22 formed in the catheter 12; And a step of injecting a cell suspension into a site to be treated through an injection lumen 24 formed in the catheter 12.
  • the cell space can be expanded between the tissues in the living body by the expansion means 14 in the cell transplantation operation under the arthroscope or the endoscope. It can be secured sufficiently and does not damage the tissue.
  • the cells since the liquid remaining in the treatment target site is sucked through the suction lumen 22 formed in the catheter 12, the cells are injected into the treatment target site through the injection lumen 24. And a cell can be transplanted to a treatment object site
  • the suction port 23 is located below the discharge port 25, the tip of the suction lumen 22 can be preferentially infiltrated into the remaining liquid when the remaining liquid in the cartilage defect site is sucked. . Further, since the suction port 23 is positioned below the lower surface of the expansion means 14 in a state in which the expansion means 14 is expanded, the residual liquid in the cartilage damage site 44 can be reliably suctioned. Furthermore, since the discharge port 25 is located above the lower surface of the expansion unit 14 in a state where the expansion unit 14 is expanded, the discharge port 25 is difficult to touch the injected cell suspension.
  • the expansion means 14 has a plurality of expansion bodies 26 that expand in an arc shape, and the plurality of expansion bodies 26 expand the tip portion of the suction lumen 22 and the tip portion of the injection lumen 24.
  • the suction port 23 and the discharge port 25 are positioned substantially at the center of the circle drawn by the plurality of expansion bodies 26 at the time of expansion. To do. Therefore, when a contrast medium is used as the expansion fluid, the positions of the suction port 23 and the discharge port 25 can be easily grasped, and the liquid suction and cell injection can be reliably performed at the treatment target site.
  • the expansion means 14 includes a plurality of expansion bodies 26 that expand in a curved shape, and a connecting film 36 that connects the plurality of expansion bodies 26, and the plurality of expansion bodies 26 are expanded. In some cases, they are arranged so as to form a substantially annular shape as a whole, and the connecting film 36 forms an integral structure. Therefore, when the expansion means 14 is expanded, the shape of the expansion means 14 is stabilized, and a plurality of expansions constituting the expansion means 14 are formed. A space for performing suction and injection can be suitably secured in the inner space surrounded by the body 26. Further, since the expansion body 26 has an arc shape, the tissue can be expanded in a balanced manner.
  • the expansion means 14 is provided with an opening 34 into which the imaging means can be inserted, a state in which an arthroscope or an endoscope is inserted into the opening 34 and the residual liquid in the cartilage damage site 44 is sucked, or cartilage damage The state of injecting cells into the region 44 can be observed. Therefore, the liquid can be sucked without leaving the remaining liquid, and the cells can be accurately injected into the cell damage site.
  • the expansion means 14 of the cell transplant device 10 is configured to be foldable so as to be coaxial with the catheter 12, the expansion means 14 is folded into the knee joint 39 percutaneously. When inserting, the incision range of the skin can be reduced.
  • the catheter shaft 16 is provided with two expansion lumens 20, but the expansion means 14 is substantially a single expansion body 26 (the internal space is substantially divided without being divided into a plurality of spaces). In this case, only one dilating lumen 20 may be provided.
  • the opening 34 for inserting the arthroscope or endoscope is provided at the distal end portion of the expansion means 14, but the location near the base end of the expansion means 14 or the expansion means 14. It may be provided at any location between the distal end portion and the proximal end portion. Since the side for inserting the cell transplant device 10 and the side for inserting the arthroscope or endoscope are not always opposite to each other, the side for inserting the cell transplant device 10, What is necessary is just to select the cell transplantation device 10 in which the opening part 34 was provided in the position suitable for it according to the positional relationship with the side which inserts an endoscope.
  • FIG. 8 is a partially omitted vertical cross-sectional view of a cell transplant device 10a according to a second embodiment of the present invention. Note that in the cell transplant device 10a according to the second embodiment, elements having the same or similar functions and effects as those of the cell transplant device 10 according to the first embodiment are denoted by the same reference numerals, and are described in detail. Is omitted.
  • This cell transplant device 10a differs in the configuration of the catheter 60 from the configuration of the cell transplant device 10 according to the first embodiment.
  • the suction lumen 22 and the injection lumen 24 are individually formed.
  • the catheter 60 of the cell transplant device 10a according to the second embodiment is a suction catheter.
  • a guide lumen 61 is formed through which 66 and the injection catheter 70 can be selectively inserted.
  • the guide lumen 61 opens as a proximal end opening 63 at the proximal end portion of the catheter 60, and opens as a distal end opening 62 at the distal end portion of the catheter 60.
  • the catheter 60 is bent at a substantially center position of a circle including the arc of the expansion body 26 when the expansion means 14 is expanded, and the distal end portion is directed downward.
  • a portion bent near the distal end of the catheter 60 is referred to as a “bent portion 60a”.
  • the tip opening 62 is located above the lower surface of the expansion means 14.
  • the catheter 60 is provided with an expansion lumen similar to the expansion lumen 20 (see FIG. 1) of the cell transplant device 10 according to the first embodiment.
  • the cell transplant device 10a is placed in the knee joint 39 (see FIGS. 5A to 7).
  • the aspiration catheter 66 is inserted into the guide lumen 61 of the catheter 60, and the distal end of the aspiration catheter 66 provided with the aspiration port 67 is inserted into the catheter 60. It protrudes from the tip opening 62. At this time, the suction catheter 66 is forcibly bent downward by the bent portion 60a of the catheter 60 and directed toward the treatment target site. At this time, while confirming with an arthroscope or an endoscope, the distal end portion of the suction catheter 66 is moved from the lower surface of the expansion means 14 so that the distal end portion of the suction catheter 66 is surely infiltrated into the remaining liquid at the treatment target site.
  • a syringe suction means (not shown) is connected to the hub 68 provided at the proximal end portion of the suction catheter 66, and the syringe is operated while confirming with an arthroscope to remove the liquid present in the cartilage damage site 44. Aspirate completely. When the remaining liquid is completely sucked, the suction catheter 66 is removed from the guide lumen 61 of the catheter 60.
  • an injection catheter 70 for injecting cells is inserted into the guide lumen 61 of the catheter 60, and the distal end of the injection catheter 70 provided with the discharge port 73 is inserted into the distal end opening 62 of the catheter 60. Or slightly flush with the tip opening 62. In this case, the tip of the infusion catheter 70 may be positioned above the lower surface of the expansion means 14.
  • the syringe 33 filled with the cell suspension is connected to the hub 74 provided at the proximal end portion of the infusion catheter 70.
  • the injection catheter 70 to which the syringe 33 is connected may be inserted into the catheter 60.
  • the syringe 33 is operated to inject a predetermined amount (for example, about 0.1 mL) of the cell suspension into the cartilage damage site.
  • a predetermined amount for example, about 0.1 mL
  • the distal end of the injection catheter 70 since the distal end of the injection catheter 70 is positioned above the lower surface of the expansion means 14, the distal end of the injection catheter 70 does not touch the cell suspension injected into the cartilage damage site 44.
  • the following second cell transplantation method can be implemented by using the cell transplantation device 10a according to the present embodiment. That is, the second cell transplantation method is: A catheter 60 having a plurality of lumens, and an expansion means 14 provided at the distal end of the catheter 60 and expandable by an expansion fluid supplied through the expansion lumen 20 formed in the catheter 60.
  • Preparing a cell transplant device 10a Inserting the expansion means 14 of the cell transplant device 10a into a living body; Expanding the space between the tissues in the living body by expanding the expansion means 14 and disposing the expansion means 14 on a treatment target site; Inserting a suction catheter 66 into a guide lumen 61 formed in the catheter 60; Sucking the remaining liquid on the treatment target site through the suction catheter 66 inserted into the guide lumen 61; Removing the suction catheter 66 from the guide lumen 61; Inserting an infusion catheter 70 into the guide lumen 61; And a step of injecting a cell suspension into the treatment target site via the injection catheter 70 inserted into the guide lumen 61.
  • the suction catheter 66 is inserted into the guide lumen 61 when the residual liquid on the treatment target site is sucked, and the cell suspension is placed on the treatment target site. Since the injection catheter 70 is inserted into the guide lumen 61 when injecting the turbid liquid, the positions of the suction catheter 66 and the distal end portions of the injection catheter 70 (position with respect to the treatment target site) can be easily adjusted. That is, when the residual liquid on the treatment target site is aspirated, the distal end portion of the suction catheter 66 is positioned below the lower surface of the expansion means 14, and the suction catheter 66 is further in accordance with the depth of the treatment site.
  • the tip position can be arbitrarily adjusted, the remaining liquid on the treatment target site can be reliably sucked. Further, when injecting the cell suspension into the treatment target site, the position of the distal end portion of the injection catheter 70 can be arbitrarily adjusted at a position above the lower surface of the expansion means 14, so that a suitable position is obtained. Cell suspension can be injected.
  • the present invention has been described with reference to preferred embodiments. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the present invention.
  • the cell transplantation device 10 or 10a is used for the arthroscopic cell transplantation operation at the knee joint, but the present invention is not limited to this. That is, the cell transplantation device 10 or 10a according to the present invention can be applied to any surgical method that involves discharging a liquid.
  • the device for cell transplantation according to the present invention can be used for endoscopic surgery such as intracerebral, intraperitoneal, carpal tunnel, shoulder joint, elbow joint, spine, and drainage of pleural effusion and ascites.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un dispositif (10) pour une transplantation de cellules, lequel dispositif comporte un cathéter (12) et un moyen de déploiement (14). Une lumière de déploiement (20), une lumière d'aspiration (22) et une lumière d'injection (24) sont formées en parallèle dans le cathéter (12). Le moyen de déploiement (14) comporte deux corps de déploiement en forme d'arc circulaire (26) qui peuvent être déployés par un fluide de déploiement, tel qu'un milieu de contraste. Dans une intervention de transplantation de cellules, avec l'espace entre des tissus corporels déployés par déploiement des deux corps de déploiement (26), tout liquide (liquide résiduel) au niveau du site cible est aspiré par l'intermédiaire de la lumière d'aspiration (22) et une suspension de cellules est ensuite injectée dans le site cible par la lumière d'injection (24).
PCT/JP2012/080983 2011-12-02 2012-11-29 Dispositif pour une transplantation de cellules WO2013081071A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2011-264179 2011-12-02
JP2011264179 2011-12-02

Publications (1)

Publication Number Publication Date
WO2013081071A1 true WO2013081071A1 (fr) 2013-06-06

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PCT/JP2012/080983 WO2013081071A1 (fr) 2011-12-02 2012-11-29 Dispositif pour une transplantation de cellules

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WO (1) WO2013081071A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005514160A (ja) * 2002-01-11 2005-05-19 カイフォン インコーポレイテッド 内部抑制部を備え拡張可能な本体を使用する海綿骨圧迫用装置および方法
JP2007296371A (ja) * 1996-08-30 2007-11-15 Verigen Ag 自己移植のための方法、器具及びキット

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007296371A (ja) * 1996-08-30 2007-11-15 Verigen Ag 自己移植のための方法、器具及びキット
JP2005514160A (ja) * 2002-01-11 2005-05-19 カイフォン インコーポレイテッド 内部抑制部を備え拡張可能な本体を使用する海綿骨圧迫用装置および方法

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