WO2022080459A1 - シート状物質を生体内に貼付するためのデバイス - Google Patents

シート状物質を生体内に貼付するためのデバイス Download PDF

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Publication number
WO2022080459A1
WO2022080459A1 PCT/JP2021/038091 JP2021038091W WO2022080459A1 WO 2022080459 A1 WO2022080459 A1 WO 2022080459A1 JP 2021038091 W JP2021038091 W JP 2021038091W WO 2022080459 A1 WO2022080459 A1 WO 2022080459A1
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WO
WIPO (PCT)
Prior art keywords
sheet
mounting portion
outer cylinder
inner member
tip
Prior art date
Application number
PCT/JP2021/038091
Other languages
English (en)
French (fr)
Japanese (ja)
Inventor
英利 升本
裕明 長田
昭二 上杉
英樹 山下
直朗 安村
慶和 齋藤
悠人 加藤
Original Assignee
国立大学法人京都大学
日本毛織株式会社
ニプロ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 国立大学法人京都大学, 日本毛織株式会社, ニプロ株式会社 filed Critical 国立大学法人京都大学
Priority to JP2022557450A priority Critical patent/JPWO2022080459A1/ja
Publication of WO2022080459A1 publication Critical patent/WO2022080459A1/ja

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin

Definitions

  • This disclosure relates to a device for carrying and attaching a sheet-like substance into a living body.
  • thoracotomy or laparotomy is the main method for transplanting or administering a sheet-like therapeutic substance such as a cell sheet to an affected area.
  • thoracotomy or laparotomy has the disadvantages that the burden on the human body is large and it takes time to recover.
  • endoscopic surgery is a minimally invasive surgical method for the human body. Therefore, attempts have been made to administer a sheet-like therapeutic substance to a patient using endoscopic surgery.
  • the sheet-shaped therapeutic substance is fragile and easily causes self-adhesion, and it is difficult to transport the sheet-shaped therapeutic substance to the affected area while suppressing self-adhesion and the like.
  • Patent Document 1 discloses a transport administration device in which a sheet support member holding a sheet-shaped therapeutic substance is formed into a tubular shape and stored in an outer cylinder, and the sheet-shaped therapeutic substance can be transported to the affected area in that state.
  • the present disclosure provides, in one embodiment, a device capable of improving the stability of attachment (transplantation) of a sheet-shaped physiologically active substance such as a cell sheet.
  • the device of the present disclosure is not limited to such an aspect, and can be used for delivery or attachment of various therapeutic sheet-like substances into a living body based on the knowledge of those skilled in the art. Needless to say.
  • the first aspect of the present disclosure is a device for carrying and attaching a therapeutic sheet-like substance into a living body, which is a hollow outer cylinder whose tip side is inserted into the living body and is inserted into the outer cylinder.
  • a sheet mounting portion on which the sheet-like substance is placed is provided on the tip end side of the inner member, and the sheet mounting portion can be stored in the outer cylinder in a curved state.
  • the sheet mounting portion protrudes from the outer cylinder toward the tip side and can be deployed, and in the deployed state of the sheet mounting portion, the operating force input from the outside of the living body is applied to the sheet in the living body.
  • An operating force transmission mechanism that exerts on the mounting portion to deform the seat mounting portion is provided.
  • the sheet-like substance for treatment placed on the sheet placement portion is delivered to the treatment site in the living body and then attached, and then the operation force is applied.
  • the sheet-shaped substance By applying an operating force that deforms the sheet-shaped substance by the transmission mechanism, the sheet-shaped substance can be gently separated (peeled) from the sheet-shaped substance while the sheet-like substance is attached to the treatment site. ..
  • the sheet-like substance for treatment can be stably attached to the treatment site in the living body.
  • a second aspect of the present disclosure is that in the device according to the first aspect, a protruding piece projecting from the inner peripheral surface of the tubular peripheral wall to the lumen is provided at the tip end portion of the outer cylinder.
  • the sheet support surface on which the sheet mounting portion housed in the outer cylinder in a curved state is overlapped is configured to include the projecting piece.
  • the seat mounting portion when the seat mounting portion is housed in the outer cylinder, the seat mounting portion is deformed along the seat support surface, so that a protruding piece protruding into the lumen of the outer cylinder is provided.
  • the seat support surface including the projecting piece By forming the seat support surface including the projecting piece, the area of the seat support surface can be increased as compared with the case where the seat support surface is composed of, for example, only the inner peripheral surface of the outer cylinder. Therefore, a larger sheet-like substance can be adopted as the sheet-like substance stored in the outer cylinder, and even when a large sheet-like substance is adopted, the stored state in the outer cylinder can be stably realized.
  • a third aspect of the present disclosure is that in the device according to the first or second aspect, the inner member is made of synthetic resin, and at least the inner member is disposable together with the sheet mounting portion. It is a thing.
  • a disposable inner member can be easily manufactured, and the sheet resting portion that comes into contact with the living body is also disposable, so that the risk of infectious disease or the like among a plurality of patients can be easily and easily increased. It can be prevented more reliably.
  • a fourth aspect of the present disclosure is that in the device according to any one of the first to third aspects, a grip portion is provided on the base end side of the outer cylinder, and the grip portion is provided with the inside.
  • a first operation unit that moves the material relative to the outer cylinder in the axial direction and a second operation unit that deforms the sheet mounting portion via the operation force transmission mechanism are provided separately so as to be operable. Is what you are doing.
  • the operation of moving the inner member with respect to the outer cylinder by the first operation unit and the deformation operation of the seat mounting portion by the second operation unit can be performed independently, so that, for example, each operability can be performed. And the degree of freedom in setting each operation state can be improved.
  • a fifth aspect of the present disclosure is that in the device according to the fourth aspect, the operating force transmission mechanism is configured by an operation line connected to the sheet mounting portion, and the second operating portion comprises an operating line. By pulling the operation line from the base end side of the device, an operation force is applied to the sheet mounting portion via the operation line to deform the sheet mounting portion.
  • the sheet mounting portion is deformed (peeled from the sheet-like substance) by a simple mechanism of pulling the operation line connected to the sheet mounting portion from the base end side by the second operating portion. Will be possible.
  • a sixth aspect of the present disclosure is the device according to the fourth or fifth aspect, wherein the inner member has an input portion on a proximal end side portion to which a driving force in the length direction is applied.
  • One operation unit directly exerts a slide operation force in the length direction of the inner member on the input unit, and a rotation operation force is converted into a linear driving force by a gear mechanism to the input unit. It is provided with any of the rotation operation units that indirectly exert the effect.
  • the operation of moving the inner member with respect to the outer cylinder in the axial direction can be realized with good operability by the slide operation or the rotation operation in the first operation unit.
  • a seventh aspect of the present disclosure is that in the device according to any one of the first to sixth aspects, the seat is moved by the operating force transmission mechanism when the inner member moves relative to the outer cylinder in the length direction. It is equipped with an operating force holding mechanism that holds the operating force applied to the mounting unit.
  • the inner member can be relatively moved in the axial direction with respect to the outer cylinder while the seat mounting portion provided at the tip of the inner member is held in the deformed state. Therefore, for example, even when the inner member is moved relative to the outer cylinder in the axial direction after the sheet mounting portion is deformed and separated from the sheet-like substance, the deformed state of the sheet mounting portion can be maintained. Inadvertent recontact of the sheet mounting portion with the sheet-like substance can also be effectively prevented.
  • the eighth aspect of the present disclosure is a device for carrying and attaching a therapeutic sheet-like substance into a living body, which is a hollow outer cylinder whose tip side is inserted into the living body and is inserted into the outer cylinder.
  • a sheet mounting portion on which the sheet-like substance is placed is provided on the tip end side of the inner member, and the sheet mounting portion can be stored in the outer cylinder in a curved state.
  • the sheet mounting portion protrudes from the outer cylinder toward the tip side and can be deployed, and the tip portion of the outer cylinder in which the sheet mounting portion is housed is inside from the inner peripheral surface of the peripheral wall.
  • a projecting piece that protrudes into the cavity is provided, and the projecting piece has a cross-sectional shape that curves along the inner peripheral surface of the outer cylinder and protrudes in the circumferential direction, and has a cross-sectional shape that protrudes in the circumferential direction.
  • a sheet support surface on which the sheet mounting portion is overlapped is configured including a surface and a curved inner surface of the projecting piece.
  • the projecting piece is separated from the inner peripheral surface of the peripheral wall of the outer cylinder and is curved along the inner peripheral surface to project in the circumferential direction, the projecting length of the projecting piece is appropriately set.
  • the circumferential length of the seat support surface formed in cooperation with the inner peripheral surface of the outer cylinder with a large degree of freedom.
  • the protruding piece can be extended from the inner peripheral surface of the outer cylinder in a direction closer to the tangential line than the radial line of the outer cylinder, and therefore, the protruding piece can be extended from the inner peripheral surface of the outer cylinder.
  • the bending angle or the radius of curvature at the rising portion of the piece can be set small, and local bending and damage caused by the local bending of the sheet-like material superimposed on the portion can be reduced or avoided.
  • a ninth aspect of the present disclosure is provided at a cylindrical outer cylinder, a cylindrical inner member, a sheet mounting portion provided at the tip of the inner member, and a base end portion of the inner member.
  • the present invention relates to a device for attaching a sheet-shaped physiologically active substance having an operation unit into a living body.
  • the inner member is provided inside the outer cylinder so as to have an axial length longer than the axial length of the outer cylinder and to be movable in the axial direction of the outer cylinder.
  • the sheet mounting portion is configured to be exposed in a state of protruding outward from one end side of the outer cylinder, and when the inner member is moved toward the base end portion side along the axial direction of the outer cylinder, the outer portion is formed. It is elastically deformed into a shape along the inside of the cylinder and can be stored in the outer cylinder, and the operation portion can be used to bend the seat mounting portion and / or to fix the seat mounting portion to the inner member. It is configured so that the force adjustment can be operated.
  • a tenth aspect of the present disclosure further comprises an operation line in the device according to the ninth aspect, one end of which is connected to the tip end side of the sheet mounting portion and the other end of which is connected to the operation portion.
  • the operation line is configured so that the seat mounting portion can be bent by pulling the operation line by operating the operation unit.
  • the eleventh aspect of the present disclosure is the device according to the ninth or tenth aspect, in which the connecting member connecting the sheet mounting portion and the inner member, and the connecting member and the operating portion are connected to each other. It further has an operation line, and the connection member and the operation line are configured so that the fixing force between the seat mounting portion and the inner member can be adjusted in conjunction with the operation of the operation portion. It is a thing.
  • a twelfth aspect of the present disclosure is that in the device according to any one of the ninth to eleventh aspects, an elastically deformable reinforcing member is provided on a surface of the sheet mounting portion opposite to the sheet mounting surface. It is something that has been done.
  • a thirteenth aspect of the present disclosure further comprises a tube having a discharge port at the tip of the device according to any one of the ninth to twelfth aspects, and the tube is inserted into the inner member.
  • the tip of the discharge port is arranged on the seat mounting surface side of the seat mounting portion in a state of protruding from the tip of the inner member.
  • the sheet-like substance can be stably attached (implanted) to the affected area.
  • the device after the sheet-like substance is placed (implanted) in a predetermined position, the device (sheet mounting portion) is provided while the sheet-like substance is held in the position. It can be peeled off gently.
  • FIG. 1 is a diagram showing an embodiment (first embodiment) of the device of the present disclosure, showing a state in which the sheet mounting portion 13 protrudes from the tip of the outer cylinder 11.
  • FIG. 2 is a diagram showing an embodiment of the device of the present disclosure, and is a diagram showing a state in which the sheet mounting portion 13 is housed in the outer cylinder 11.
  • FIG. 3 is a plan view of the device in a state where the sheet mounting portion 13 of FIG. 1 protrudes from the tip of the outer cylinder 11.
  • FIG. 4 is a side view of the device in a state where the sheet mounting portion 13 of FIG. 1 protrudes from the tip of the outer cylinder 11.
  • FIG. 5A to 5C are partial perspective views showing a state in which the seat mounting portion 13 protrudes from the tip of the outer cylinder 11 and is stored in the outer cylinder 11.
  • FIG. 6 is a partial perspective view showing the operation unit 14.
  • 7A and 7B are partial perspective views showing a state in which the seat mounting portion 13 is curved, FIG. 7A shows a state in which the seat mounting portion 13 is expanded, and FIG. 7B shows an operation line 15 being pulled.
  • the seat mounting surface 13a side of the seat mounting portion 13 is curved toward the outside.
  • 8A and 8B are partial perspective views showing a state in which the fixing force between the seat mounting portion 13 and the inner member 12 is adjusted in another embodiment (second embodiment) of the device of the present disclosure.
  • FIG. 8A shows a state in which the fixing force between the seat mounting portion 13 and the inner member 12 is strengthened
  • FIG. 8B shows a state in which the fixing force between the seat mounting portion 13 and the inner member 12 is weakened.
  • 9A and 9B are partial perspective views showing a state in which the reinforcing member 18 is installed on the surface 13d of the seat mounting portion 13 opposite to the seat mounting surface 13a
  • FIG. 9B is a seat mounting portion. The state where the sheet mounting surface 13a of 13 is pressed against the affected part (the part to be transplanted) is shown.
  • FIG. 10 is a diagram showing still another embodiment (third embodiment) of the device of the present disclosure.
  • FIG. 11 is a perspective view showing still another embodiment (fourth embodiment) of the device of the present disclosure, and is a view showing a deployed state in which the sheet mounting portion protrudes from the tip of the outer cylinder.
  • FIG. 12 is a plan view of the device shown in FIG.
  • FIG. 13 is a bottom view of the device shown in FIG.
  • FIG. 14 is an exploded perspective view of the device shown in FIG.
  • FIG. 15 is an enlarged vertical cross-sectional view showing the XV-XV cross section in FIG.
  • FIG. 16 is an enlarged cross-sectional view showing the XVI-XVI cross section in FIG.
  • FIG. 17 is an enlarged cross-sectional view showing the XVII-XVII cross section in FIG.
  • FIG. 12 is a plan view of the device shown in FIG.
  • FIG. 13 is a bottom view of the device shown in FIG.
  • FIG. 14 is an exploded perspective view of the device shown in FIG.
  • FIG. 15 is an enlarged vertical cross-section
  • FIG. 18 is an enlarged cross-sectional view showing the XVIII-XVIII cross section in FIG.
  • FIG. 19 is a perspective view showing a stored state in which the seat mounting portion is housed in the outer cylinder in the device shown in FIG.
  • FIG. 20 is an enlarged view showing a cross section of the device shown in FIG. 19, which is cut at a cross section corresponding to the XVI-XVI cross section in FIG. 12, and is a view corresponding to FIG.
  • FIG. 21 is a perspective view showing still another embodiment (fifth embodiment) of the device of the present disclosure, and is a view showing a deployed state in which the sheet mounting portion protrudes from the tip of the outer cylinder.
  • FIG. 20 is an enlarged view showing a cross section of the device shown in FIG. 19, which is cut at a cross section corresponding to the XVI-XVI cross section in FIG. 12, and is a view corresponding to FIG.
  • FIG. 21 is a perspective view showing still another embodiment (fifth embodiment) of
  • FIG. 22 is an enlarged vertical sectional view showing a vertical sectional view of the device shown in FIG. 21.
  • FIG. 23 is a perspective view showing still another embodiment (sixth embodiment) of the device of the present disclosure, and is a view showing a deployed state in which the sheet mounting portion protrudes from the tip of the outer cylinder.
  • FIG. 24 is an enlarged vertical sectional view showing a vertical sectional view of the device shown in FIG. 23.
  • FIG. 25 is a perspective view showing still another embodiment (seventh embodiment) of the device of the present disclosure, and is a view showing a deployed state in which the sheet mounting portion protrudes from the tip of the outer cylinder.
  • FIG. 26 is an enlarged vertical sectional view showing a vertical sectional view of the device shown in FIG. 25.
  • FIG. 27 is a perspective view showing a stored state in which the seat mounting portion is housed in the outer cylinder in the device shown in FIG. 25.
  • FIG. 28 is an enlarged vertical sectional view showing a vertical sectional view of the device shown in FIG. 27.
  • FIG. 29 is a photograph showing MSC sheet transplantation using a heart model.
  • FIG. 30 is a photograph showing MSC sheet transplantation into a pig heart.
  • 31 is an enlarged perspective view showing a seat mounting portion of the device according to another aspect of the present disclosure, FIG. 31A shows a state in which the seat mounting portion is expanded, and FIG. 31B is a seat mounting portion. Shows the deformed state of the part.
  • FIG. 32 is an explanatory diagram for modeling a gun-type device according to another aspect of the present disclosure.
  • the device of the present disclosure is a device for attaching a sheet-shaped bioactive substance into a living body, and is provided with a cylindrical outer cylinder, a cylindrical inner member, and a sheet provided at the tip of the inner member. It has a mounting portion and an operating portion provided at the base end portion of the inner member.
  • the inner member is provided inside the outer cylinder so as to have an axial length longer than the axial length of the outer cylinder and to be movable in the axial direction of the outer cylinder.
  • the sheet mounting portion is configured to be exposed in a state of protruding outward from one end side of the outer cylinder, and when the inner member is moved toward the base end portion side along the axial direction of the outer cylinder, the outer portion is formed.
  • the operation portion can be used to bend the seat mounting portion and / or to fix the seat mounting portion to the inner member. It is configured so that the force adjustment can be operated.
  • the device of the present disclosure is used in one or more embodiments to attach (transplant) a sheet of bioactive substance to a predetermined position in a living body.
  • breakage or dislocation of the sheet-shaped bioactive substance at the time of application (transplantation) of the sheet-shaped bioactive substance can be reduced, and the sheet-shaped bioactive substance can be reduced. It is possible to improve the stability of sticking (transplantation) and increase the certainty.
  • a sheet-like bioactive substance can be carried and / or attached (transplanted) into a living body with minimal invasiveness. Therefore, according to the device of the present disclosure, in one or more embodiments, the sheet-shaped bioactive substance is attached (implanted) to a desired position in the living body with less burden on the human body, stable and highly accurate. can do.
  • minimally invasive means that the burden on the patient is less than that of thoracotomy or laparotomy.
  • miniimally invasive surgery includes, in one or more embodiments, a method of inserting an instrument into the body or organ lumen through a small incision formed in the body surface, including endoscopic surgery and laparoscopic surgery. Surgery and the like can be mentioned.
  • sheet-like bioactive substance refers to, in one or more embodiments, the treatment, prevention, reduction of severity, reduction of likelihood of onset or suppression of progression, or action of a disease in one or more embodiments.
  • Sheet-like bioactive substances include, in one or more embodiments, cell sheets, implants, cell membranes, biodegradable biomaterials and the like.
  • a cell aggregate (cell sheet) containing cells and an extracellular matrix, and a cell sheet further containing a biodegradable substance or a non-biodegradable substance are laminated. (Cell aggregate) and the like.
  • Biodegradable biomaterials include, in one or more embodiments, polylactic acid, polyglycolic acid, poly (DL-lactide-co-glycolide) or poly (lactic acid-co-glycolic acid) and derivatives thereof. Examples thereof include synthetic polymer materials and natural polymer materials such as gelatin, collagen, alginic acid, hyaluronic acid, agarose, chitosan, fibrin and fibroin.
  • the biodegradable biomaterial may or may not contain one or more bioactive substances in one or more embodiments.
  • the device of the present disclosure further has an operation line connected to the seat mounting portion and the operation portion in order to operate the bending operation of the seat member.
  • the operation line is attached to one end of the seat mounting portion and the other end is connected to the operation portion, and the seat is placed by pulling the operation line by the operation of the operation portion. It is configured so that the portion can be bent, in other words, the seat mounting portion can be bent in the direction opposite to the seat mounting surface.
  • a sheet-shaped bioactive substance is placed (contacted) on the affected area using a device, and then the sheet-shaped bioactive substance is placed on the sheet while being held in the affected area. The placement portion can be peeled off more slowly, and the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance can be further improved.
  • one end of the operation line is attached near the tip of the seat mounting portion, and the other end is the surface of the seat mounting portion opposite to the seat mounting surface and the inner member. It is attached to the operation unit through the inside.
  • the operation unit is rotatably connected to the base end portion of the inner member. According to this aspect, it becomes easier to control the bending motion of the sheet mounting portion, the sheet mounting portion can be peeled more slowly from the affected area, and the stability and reliability of the application (transplantation) of the sheet-shaped bioactive substance can be performed. The sex can be further improved.
  • the connection between the operation portion and the inner member is not particularly limited as long as it is a structure that can be tightened male and female, and in one or a plurality of embodiments, a female screw thread is formed on the inner surface of the base end portion of the inner member. , A male screw thread is formed on the outer surface of the operation part, and vice versa is possible.
  • the above aspect is merely an example, and the structure of the operating portion is not particularly limited as long as it can pull or relax the operating line.
  • the device of the present disclosure further includes a connecting member that connects the seat mounting portion and the inner member, and an operation line that connects the connecting member and the operating portion.
  • the connecting member and the operation line are configured so that the fixing force between the seat mounting portion and the inner member can be adjusted in conjunction with the operation of the operation portion.
  • Examples of the connecting member include hinges and the like in one or more embodiments.
  • the fixing force between the seat mounting portion and the inner member when tension is applied to the wire by operating the operation portion, the fixing force between the seat mounting portion and the inner member can be strengthened and the tension is released. If this is the case, the fixing force between the seat mounting portion and the inner member can be weakened.
  • the device of the present disclosure further includes, in one aspect, a connecting member that connects the operating unit and the operating line.
  • the connecting member has a movable portion that can be swiveled in the axial direction of the inner member (operating portion). As a result, it is possible to prevent twisting of the operation line due to the operation (rotational operation) of the operation portion, movement (shift) of the position of the seat mounting portion, and the like.
  • the connecting member include a swivel-like tip-side swivel joint and the like.
  • a reinforcing member that can be elastically deformed is provided on a surface of the sheet mounting portion opposite to the seat mounting surface.
  • the pressure of the sheet-mounted member when the sheet-shaped bioactive substance is brought into contact with the affected area can be increased, and the sheet-shaped bioactive substance is attached (implanted). ) Can be further improved in stability and certainty.
  • the reinforcing member is not particularly limited as long as the seat mounting portion has a shape that can be stored in the outer cylinder in one or a plurality of embodiments. Examples of the reinforcing member include, in one or a plurality of embodiments, a strip-shaped reinforcing member extending from the tip end side to the base end portion side of the seat mounting portion.
  • the device of the present disclosure further comprises a liquid supply means in one embodiment.
  • the liquid supply means include a tube having a discharge port at the tip thereof in one or a plurality of embodiments, and the tube is inserted into the inner member and mounted on a sheet with the discharge port protruding from the tip of the inner member. It is arranged on the sheet mounting surface side of the placing portion.
  • the present inventors have a sheet-shaped bioactive substance when the sheet-shaped bioactive substance is brought into contact with the affected area (the site to be transplanted) and / or the wet state of the affected area (the site to be transplanted) is a sheet-shaped bioactive substance. It was found that it contributes to the stability and certainty of the application (transplantation) of.
  • both the sheet-shaped bioactive substance and the affected area (the site to be transplanted) are brought into a wet state, so that the sheet-like physiologically active substance is brought into a wet state with high accuracy. It was found that the sheet-placed part can be peeled off from the affected part while retaining the physiologically active substance in the affected part.
  • a sheet-like bioactive substance is placed (contacted) on the affected area using a device, and then a liquid is supplied to the contact surface to place the sheet on the contact surface. The peeling of the placement portion can be performed more slowly, and the stability and certainty of the application (transplantation) of the sheet-shaped bioactive substance can be further improved.
  • FIG. 1 and 2 are views showing the device 1 according to the first embodiment of the present disclosure
  • FIG. 1 is a view showing a state in which the seat mounting portion 13 protrudes from the tip of the outer cylinder 11.
  • 2 is a diagram showing a state in which the seat mounting portion 13 is housed in the outer cylinder 11.
  • FIG. 3 is a plan view of the device 1
  • FIG. 4 is a side view of the device 1.
  • the seat mounting portion 13 side of the device 1 is the tip end side
  • the side opposite to the seat mounting portion 13 (operation portion 14 side) is the base end portion
  • the "axial direction" is the outer cylinder 11. It means the axial direction (longitudinal direction).
  • the device 1 in the first embodiment includes an outer cylinder 11, an inner member 12, a seat mounting portion 13, an operation portion 14, and an operation line 15.
  • the outer cylinder 11 is a hollow cylindrical member that extends straight, and the inner member 12 can be inserted inside.
  • the material of the outer cylinder 11 may be a metal material such as stainless steel or a resin material in one or more embodiments.
  • the outer diameter of the outer cylinder 11 is 30 mm or less from the viewpoint that the size of the incision hole can be reduced and the burden on the human body can be further reduced in one or more embodiments.
  • the inner diameter of the outer cylinder 11 can be appropriately determined according to the size of the sheet-shaped bioactive substance held in the sheet mounting portion 13.
  • the inner diameter of the outer cylinder 11 is 7 mm or more, or 28 mm or less in one or more embodiments.
  • the inner member 12 is a hollow cylindrical member that extends straight.
  • the inner member 12 is provided inside the outer cylinder 11 coaxially with the outer cylinder 11 and axially separated from the outer cylinder 11.
  • the inner member 12 can move forward and backward in the axial direction of the outer cylinder 11.
  • the seat mounting portion 13 is attached to one end (tip portion) of the inner member 12, and the operation portion 14 is attached to the other end (base end portion).
  • the material of the inner member 12 may be a metal material such as stainless steel or a resin material in one or a plurality of embodiments.
  • the outer diameter of the inner member 12 can be appropriately determined according to the inner diameter of the outer cylinder 11 in one or more embodiments.
  • the outer diameter of the inner member 12 is 5 mm or more or 15 mm or less from the viewpoint of operability in one or more embodiments.
  • the sheet placing portion 13 holds a sheet-shaped bioactive substance.
  • the sheet mounting portion 13 has a sheet mounting surface 13a capable of holding a sheet-shaped physiologically active substance.
  • a through hole 13b for fixing the tip of the operation line 15 is formed at the tip of the sheet mounting portion 13, and a through hole 13c for passing the operation line 15 is formed at the base end.
  • the seat mounting portion 13 is attached to the inner member 12.
  • the seat mounting portion 13 can be attached to the inner member 12 so that the base end portion of the seat mounting portion 13 is fitted inside the inner member 12.
  • the seat mounting portion 13 is a plate-shaped member having flexibility and elastically deformable.
  • the material of the sheet mounting portion 13 is not particularly limited as long as it is a material having rubber elasticity in one or a plurality of embodiments, and may be an elastomer or a non-elastomer.
  • Examples of the material of the sheet mounting portion 13 include polyethylene, nylon, polyurethane, polyethylene terephthalate (PET), ethylene vinyl acetate (EVA), and silicone rubber in one or more embodiments.
  • the shape of the sheet mounting portion 13 may be a rounded square shape or a round shape (egg shape).
  • the seat mounting portion 13 may have a symmetrical shape or an asymmetrical shape with the axis of the outer cylinder 11 interposed therebetween.
  • the seat mounting surface 13a of the sheet mounting portion 13 may be a flat surface or a gently concave surface in one or a plurality of embodiments.
  • the size of the sheet mounting portion 13 can be appropriately determined depending on the size of the sheet-shaped active substance to be attached (implanted) in one or more embodiments, and is elastically deformed into a tubular shape inside the outer cylinder 11. It suffices as long as it can be stored.
  • FIG. 6 is a partially enlarged view of the base end portion of the inner member 12, in which the operation portion 14 is a male screw and is inside the base end portion of the inner member 12 so as to be engaged with the male screw.
  • a female thread is formed on the surface.
  • the operation line 15 is provided to control the bending angle (curving operation) of the seat mounting portion.
  • One end of the operation line 15 is connected to a through hole 13b formed near the tip of the sheet mounting portion 13, and the other end is a swivel provided at the tip of the operation portion 14 (the tip side of the inner member 12). (Not shown) is connected.
  • the operation line 15 is arranged on the surface 13d of the seat mounting portion 13 on the opposite side of the seat mounting surface 13a, and further passes through the through hole 13c provided on the base end side of the seat mounting portion 13 to form the inner member 12. It is inserted inside. This makes it possible to bend (bend) the seat mounting portion 13 so that the seat mounting surface 13a warps.
  • Examples of the operation line 15 include wires, strings, and the like in one or more embodiments.
  • the operation line 15 is wound up and the length of the operation line 15 becomes shorter.
  • the sheet mounting portion 13 is elastically deformed and curved so that the seat mounting surface 13a warps, and the tip of the operating portion 14 advances in the tip direction (from the base end of the inner member to the tip direction) (direction in which the screw is tightened). ),
  • the length of the operation line 15 can be lengthened, and by returning the length of the operation line 15 to the original length, the elastic deformation of the sheet mounting portion 13 is released. It is developed in a plane.
  • a sheet-shaped bioactive substance 16 such as a cell sheet is placed on the sheet mounting surface 13a of the sheet mounting portion 13 (see FIG. 5A). At this time, the sheet mounting portion 13 is exposed in a state of protruding from the tip end side of the outer cylinder 11 (FIG. 1).
  • the sheet mounting portion 13 developed in a plane shape has a width wider than the inner diameter and the outer diameter of the outer cylinder 11.
  • the inner member 12 is slid from the tip in the proximal direction (arrow S direction in FIG. 2), and the sheet-shaped bioactive substance 16 is stored.
  • FIGS. 5A to 5C show how the sheet mounting portion 13 is housed in the outer cylinder 11 from the state of being expanded in a plane.
  • the seat mounting portion 13 comes into contact with the inside of the outer cylinder 11 and the seat mounting portion 13 is formed.
  • a force is applied to the sheet mounting portion 13 to roll the sheet into a tubular shape.
  • the sheet mounting portion 13 is elastically deformed while being rolled into a cylindrical shape along the inner shape of the outer cylinder 11 with the sheet mounting surface 13a on which the sheet-shaped physiologically active substance 16 is arranged inside. It is stored in 11. As a result, the sheet-shaped bioactive substance can be transported to a desired position while suppressing damage to the sheet-shaped bioactive substance.
  • the device 1 is inserted into the body with the seat mounting portion 13 housed in the outer cylinder 11.
  • the device 1 can be inserted via a tracal or the like previously inserted into the body during laparoscopic surgery or video-assisted thoracoscopic surgery.
  • the tip of the device 1 (outer cylinder 11) reaches the vicinity of the affected area (seat transplant target site)
  • the inner member 12 is slid from the base end toward the tip (opposite direction of the arrow S in FIG. 2) to slide the outer cylinder.
  • the sheet mounting portion 13 is exposed in a protruding state from the tip of 11. At that time, the elastic deformation of the seat mounting portion 13 is restored, and the seat resting portion 13 is in a state of being developed in a plane.
  • the orientation of the device 1 is adjusted so that the sheet-shaped bioactive substance arranged on the sheet mounting portion 13 faces the affected portion, and the sheet mounting surface 13a of the sheet mounting portion 13 is brought into contact with the affected portion. Then, with the sheet mounting surface 13a in contact with the affected portion, the seat mounting portion 13 is slowly rotated by rotating the operation portion 14 so that the tip of the operation portion 14 advances from the tip of the inner member 12 toward the proximal end. By bending (curving the sheet mounting surface 13a), the sheet mounting portion 13 can be gently removed from the affected portion while holding the sheet-shaped bioactive substance in the affected portion.
  • the inner member 12 may be slid to store the sheet mounting portion 13 in the outer cylinder 11 and the device 1 may be pulled out from the body, or the device 1 may be pulled out from the body as it is. You may pull it out.
  • the sheet-shaped bioactive substance is formed into a tubular shape and stored in the outer cylinder 11, and the affected portion (sheet transplant target site) is sheet-shaped physiologically. Since the active substance can be transported, the burden on the human body can be further reduced, and a minimally invasive procedure can be realized. In addition, it is possible to suppress damage and deformation of the sheet-shaped bioactive substance during transportation. Further, according to the device 1 of the first embodiment, after the sheet mounting portion 13 is brought into contact with the affected portion, the sheet mounting portion 13 is curved to change the bending angle so that the sheet mounting portion 13 can be removed from the affected portion. Since the sheet can be peeled off, the sheet mounting portion 13 can be peeled off more slowly from the contact surface, and the stability and certainty of sticking (transplanting) the sheet-shaped bioactive substance can be further improved.
  • ⁇ Second embodiment> 8A and 8B are partially enlarged views of the device according to the second embodiment of the present disclosure.
  • the device in the second embodiment includes a connecting member 17 that connects the seat mounting portion 13 and the inner member (not shown), and the connecting member 17 and the operating portion (not shown). ) And an operation line (not shown) to be connected.
  • the seat mounting portion 13 and the inner member (not shown) are connected via the connecting member 17, and the seat mounting portion 13 and the inner member are fixed by the operation line and the operation unit. It differs from the device of the first embodiment in that the force can be controlled.
  • the second embodiment will be described with a focus on the differences from the first embodiment.
  • the inner member 12 is integrally provided with a seat mounting portion 13 via a connecting member 17.
  • An operation line (not shown) is attached to the connecting member 17.
  • the seat mounting portion 13 is movable around the connecting member 17 in conjunction with a change in the tension of the operation line due to the operation of the operation portion 14. If the operation unit is rotated so that the tip of the operation unit advances from the tip of the inner member toward the base end, the operation line is wound up and the length of the operation line is shortened, so that the sheet mounting portion 13 and the inner member 12 By rotating the operation unit on the opposite side (from the base end to the tip of the inner member) to lengthen the length of the operation line, the seat mounting unit 13 and the inside can be strengthened. The fixing force with the material can be weakened.
  • the sheet placing portion follows the beating. Since 13 can be brought into contact with each other, a sheet-shaped bioactive substance can be attached (transplanted) while suppressing pressure and burden on the organs, and the stability and certainty of the sheet-shaped bioactive substance application (transplantation) can be achieved. The sex can be further improved.
  • the connecting member 17 include hinges and the like in one or more embodiments.
  • the method of using the device of the second embodiment will be described below.
  • the same procedure as in the first embodiment can be performed until a sheet-shaped bioactive substance is placed on the device and moved to the vicinity of the affected area (sheet transplant target site).
  • the orientation of the device 1 is adjusted so that the sheet-shaped bioactive substance placed on the sheet mounting portion 13 faces the affected area, and the fixing force between the sheet mounting portion 13 and the inner member 12 is weakened.
  • the sheet mounting surface 13a of the mounting portion 13 is brought into contact with the affected portion.
  • the fixing force between the sheet mounting portion 13 and the inner member 12 is strengthened, and the sheet mounting portion 13 is removed from the affected portion.
  • the fixing force between the sheet mounting portion 13 and the inner member 12 may be strengthened, and the seat mounting portion 13 may be curved and removed.
  • the seat mounting portion 13 is brought into contact with the affected portion more gently. Can be done. Further, even when the affected part is a pulsating organ, the sheet mounting portion 13 can be brought into contact with the affected part while suppressing pressure and burden on the affected part.
  • FIG. 10 is a diagram showing the device 2 according to the third embodiment of the present disclosure.
  • the device 1 in the third embodiment has an outer cylinder 11, an inner member 12, a seat mounting portion 13, an operation portion 14, an operation line 15, and a discharge port 21 at the tip thereof.
  • a tube 20 having a tube 20 is provided.
  • the device 2 of the third embodiment is different from the device 1 of the first embodiment in that it further has a tube 20 having a discharge port 21 at the tip thereof.
  • the third embodiment will be described with a focus on the differences from the first embodiment.
  • the tube 20 is inserted inside the inner member 12 through a hole 19 provided on the side surface of the inner member 12, and the sheet mounting portion is in a state where the discharge port 21 at the tip of the tube 20 protrudes from the tip of the inner member 12. It is arranged on the base end side of the sheet mounting surface 13a of 13.
  • a syringe 22 is attached to the other end of the tube 20 via a connecting portion 23.
  • the method of using the device 2 of the third embodiment will be described below.
  • the same procedure as in the first embodiment can be performed until a sheet-shaped bioactive substance is placed on the device and moved to the vicinity of the affected area (sheet transplant target site).
  • the orientation of the device 1 is adjusted so that the sheet arranged on the sheet mounting portion 13 faces the affected portion, and the liquid is supplied from the discharge port 21 to the sheet-shaped bioactive substance arranged on the sheet mounting portion 13.
  • the sheet-shaped bioactive substance placed on the sheet placing portion 13 is moistened.
  • a liquid such as physiological saline can be used.
  • the sheet mounting surface 13a of the sheet mounting portion 13 is brought into contact with the affected portion.
  • the liquid may be supplied to the affected portion to which the sheet-shaped bioactive substance is transplanted, and the sheet mounting surface 13a of the sheet mounting portion 13 may be brought into contact with the affected portion in a state where the affected portion is moistened.
  • the operation unit 14 is rotated so that the tip of the operation unit 14 advances from the tip of the inner member 12 toward the proximal end in a state where the sheet mounting surface 13a is in contact with the affected portion.
  • the sheet mounting portion 13 can be gently removed from the affected portion while holding the sheet-shaped bioactive substance in the affected portion.
  • the liquid is supplied to the sheet-shaped bioactive substance before transplantation to the affected part, and the sheet-shaped bioactive substance is brought into contact with the affected part in a moistened state. Therefore, the sheet mounting portion 13 can be peeled off more slowly from the contact surface, and the stability and certainty of sticking (transplanting) the sheet-shaped bioactive substance can be further improved.
  • the sheet-shaped bioactive substance when the sheet-shaped bioactive substance is placed on the sheet mounting portion 13, between the sheet-shaped bioactive substance and the sheet-mounted surface 13a.
  • a sheet (for example, nylon mesh) different from the sheet-shaped bioactive substance may be placed in the sheet, and the sheet bioactive substance may be brought into contact with the affected portion together with the sheet. This makes it possible to further reduce breakage, deformation, dislocation, etc. of the sheet-shaped bioactive substance at the time of transplantation, and further improve the stability and certainty of attachment (transplantation) of the sheet-shaped bioactive substance.
  • the case where the outer cylinder and the inner member have a straight extending shape has been described as an example, but the shapes of the outer cylinder and the inner member are not limited to this.
  • the outer cylinder and the inner member may have a curved shape or a bendable structure in one or more embodiments.
  • the material of the outer cylinder and the inner member may be an elastic material in one or more embodiments.
  • the second embodiment and the third embodiment may be combined.
  • the present disclosure relates to, as another aspect, a method for attaching a sheet-shaped therapeutic substance.
  • the method of applying the sheet-shaped therapeutic substance of the present disclosure can be carried out in one or more embodiments using the device of the present disclosure.
  • the method for attaching the sheet-shaped therapeutic substance of the present disclosure is, in one or a plurality of embodiments, in a state where the sheet-shaped physiologically active substance is held in the sheet-mounted portion of the device of the present disclosure, and the sheet of the sheet-shaped therapeutic substance is attached. This includes bringing the mounting surface into contact with the affected area (the site to be transplanted with the sheet), and peeling the sheet mounting surface from the contact surface by bending the sheet mounting portion.
  • the sheet mounting portion can be peeled off more slowly from the contact surface, and the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance can be further improved.
  • the sheet mounting surface of the sheet mounting portion is set to the affected portion (in a state where the fixing force between the sheet mounting portion and the inner member is weakened). Further includes contacting with the sheet transplant target site). This makes it possible to further reduce breakage, deformation, dislocation, etc. of the sheet-shaped bioactive substance at the time of transplantation, and further improve the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance.
  • the method for applying the sheet-shaped therapeutic substance of the present disclosure is, in one or more embodiments, supplying a liquid to the sheet-shaped bioactive substance held in the sheet resting portion, and supplying and moistening the liquid. It further includes contacting the affected part (the site to be transplanted with the sheet) with the sheet-shaped bioactive substance in the state of being in contact with the affected part. This makes it possible to further reduce breakage, deformation, dislocation, etc. of the sheet-shaped bioactive substance at the time of transplantation, and further improve the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance.
  • the method for applying the sheet-shaped therapeutic substance of the present disclosure is, in one or more embodiments, supplying a liquid to the affected area (the site to be transplanted with the sheet) and supplying the liquid prior to contact with the sheet-shaped bioactive substance. It further includes contacting the affected part (the site to be transplanted with the sheet) in a moistened state with a sheet-shaped bioactive substance. This makes it possible to further reduce breakage, deformation, dislocation, etc. of the sheet-shaped bioactive substance at the time of transplantation, and further improve the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance.
  • the method for applying the sheet-shaped therapeutic substance of the present disclosure is to supply a liquid to the sheet-shaped bioactive substance held in the sheet resting portion and the affected area (sheet transplantation target site) in one or more embodiments. Further, the present invention further comprises bringing the liquid-supplied and moistened sheet-like bioactive substance into contact with the liquid-supplied and moistened affected area (sheet transplant target site). This makes it possible to further reduce breakage, deformation, dislocation, etc. of the sheet-shaped bioactive substance at the time of transplantation, and further improve the stability and certainty of application (transplantation) of the sheet-shaped bioactive substance.
  • the method of applying the sheet-shaped therapeutic substance of the present disclosure includes using the device of the present disclosure in combination with an endoscope in one or more embodiments.
  • the present disclosure relates to a method of operating a device for attaching a sheet-shaped bioactive substance into a living body.
  • the method of operating the device of the present disclosure is a method of operating a device consisting of a device for attaching a sheet-shaped bioactive substance into a living body and a device for remotely controlling the device with a manipulator.
  • the device is The tip portion has a seat mounting means and an operating means for controlling the bending operation of the seat mounting portion of the seat mounting means.
  • a receiving means for receiving an operation signal from a remote control device is provided.
  • a method of operating a microsurgical robot system comprising a step of the device receiving an operation signal from a remote control device by a receiving means and a step of operating the seat mounting means and the operating means of the device based on the received signal. ..
  • the operation step is a step of operating the sheet mounting means so that the sheet-like bioactive substance held by the sheet mounting means of the device comes into contact with the affected portion based on the received signal, and the sheet mounting. It includes a step of operating the sheet mounting means so as to peel off the sheet mounting portion from the affected portion while bending the sheet mounting surface of the placing portion outward.
  • the device further has a liquid supply means at the tip thereof.
  • the operating step includes, based on the received signal, operating the liquid supplying means to supply the liquid to the sheet-like bioactive substance and / or the affected area held by the sheet placing means.
  • a device for attaching a sheet-shaped bioactive substance into a living body With a cylindrical outer cylinder, Cylindrical inner member and A sheet mounting portion provided at the tip of the inner member and It has an operation unit provided at the base end portion of the inner member, and has.
  • the inner member has an axial length longer than the axial length of the outer cylinder, and is provided inside the outer cylinder so as to be movable in the axial direction of the outer cylinder.
  • the sheet mounting portion is configured to be exposed in a state of protruding outward from one end side of the outer cylinder, and when the inner member is moved toward the base end portion side along the axial direction of the outer cylinder, the outer portion is exposed.
  • the operation unit is a device configured to be able to operate the bending operation of the seat mounting portion and / or the adjustment of the fixing force between the seat mounting portion and the internal member.
  • One end is connected to the tip end side of the seat mounting portion, and the other end further has an operation line connected to the operation portion.
  • the device according to [1], wherein the operation line is configured so that the seat mounting portion can be bent by pulling the operation line by operating the operation unit.
  • connection member that connects the seat mounting portion and the inner member, and Further having an operation line connecting the connection member and the operation unit,
  • the connection member and the operation line are configured in [1] or [2] so that the fixing force between the seat mounting portion and the inner member can be adjusted in conjunction with the operation of the operation portion.
  • the device described. [4] The device according to any one of [1] to [3], wherein an elastically deformable reinforcing member is provided on a surface of the sheet mounting portion opposite to the sheet mounting surface.
  • FIGS. 11 to 18 show the device 30 as the fourth embodiment of the present disclosure.
  • the device 30 is a device for carrying and attaching a therapeutic sheet-like substance 32 into a living body.
  • the device 30 has a hollow outer cylinder 34 whose tip end side is inserted into the living body, and an inner member 36 inserted into the outer cylinder 34. Further, a sheet mounting portion 38 on which the sheet-like substance 32 is mounted is provided on the tip end side of the inner member 36.
  • the vertical direction means the vertical direction in FIG. Further, in the drawings referred to in the following description, the dimensions of some members may be exaggerated for the sake of clarity.
  • the outer cylinder 34 has a cylindrical straight peripheral wall 40.
  • the outer cylinder 34 is formed of a hard member such as metal or synthetic resin.
  • the outer cylinder 34 is made of stainless steel.
  • the diameter of the outer cylinder 34 is not limited, but it is preferable that the outer diameter of the outer cylinder 34 is ⁇ 15 mm or less, for example, ⁇ 6 mm or more.
  • at least a portion of the outer cylinder 34 can be inserted into a port of an endoscope (not shown).
  • a coating 44 such as resin is applied over the circumference.
  • a PTFE resin coating layer is formed.
  • a protruding member 48 is fixedly positioned and arranged in the lumen 46 of the outer cylinder 34.
  • the projecting member 48 is made of a hard material such as metal or synthetic resin.
  • the projecting member 48 includes a concave groove 50 that opens upward over the entire length in the length direction.
  • the base end side of the projecting member 48 is a holding portion 52 having a substantially crescent-shaped cross section that opens upward and extends straight. In the present embodiment, the holding portion 52 extends from the base end of the projecting member 48 to substantially the center, or to the tip side slightly beyond the center.
  • the tip end side of the holding portion 52 is a projecting piece 56 which is thinner than the holding portion 52 and extends straight in a substantially J-shaped curved cross-sectional shape (see FIGS. 16 and 17). ..
  • the projecting piece 56 projects from the inner peripheral surface 42 of the peripheral wall 40 to the lumen 46 by the projecting member 48 being inserted into the lumen 46 of the outer cylinder 34 and being fixedly assembled. That is, as shown in FIGS. 16 and 17, in the cross section, the protruding piece 56 is substantially in contact with the inner peripheral surface of the outer cylinder 34 at one end in the bending direction thereof, and from there, from the inner peripheral surface of the outer cylinder 34. Apart from it, it extends in the circumferential direction along the inner peripheral surface of the outer cylinder 34.
  • a flange-shaped portion 58 projecting to the outer peripheral side is provided at the base end of the protruding member 48, and the protruding member 48 and the outer cylinder 34 are axially brought into contact with each other by the contact between the flange-shaped portion 58 and the outer cylinder 34. It is aligned.
  • the concave groove 50 in the projecting member 48 extends straight with a substantially constant cross-sectional shape over the entire length in the axial direction from the holding portion 52 to the projecting piece 56.
  • the inner member 36 inserted through the outer cylinder 34 is positioned in the concave groove 50, and is arranged so as to be movable in the axial direction while being guided by the concave groove 50.
  • the inner member 36 has a substantially circular cross section as a whole and has a rod shape extending substantially straight, and is formed of a hard member such as metal or synthetic resin.
  • the inner member 36 is made of synthetic resin.
  • the tip portion of the inner member 36 is a small diameter portion 60, and the portion on the base end side of the small diameter portion 60 is a large diameter portion 62 having a larger diameter than the small diameter portion 60.
  • the base end of the inner member 36 (base end of the large diameter portion 62) is provided with a flat surface at the upper end portion, and as will be described later, the base end portion of the inner member 36 slides in the axial direction from the outside.
  • An input unit 64 to which an operating force is exerted is configured.
  • support recesses 66, 66 opening on the outer peripheral side are provided on both sides in the left-right direction.
  • These support recesses 66, 66 extend over the entire length of the inner member 36 and are open to both end faces in the axial direction.
  • the specific shapes and sizes of the support recesses 66 and 66 are not limited and may be different from each other, but in the present embodiment, the support recesses 66 and 66 have substantially the same shape and are paired with the support recesses 66 and 66. ing.
  • Each support recess 66 is provided independently of each other, and as can be seen from FIGS.
  • a tubular tubular body is disposed in each of the support recesses 66, and the tubular body is arranged along one of the support recesses 66 (in the present embodiment, the left side in FIGS. 16 to 18).
  • the liquid feed pipe 68 and the tubular body arranged along the other support recess 66 are the insertion pipe 70 through which the operation line 78 described later is inserted.
  • the number of liquid feeding pipes 68 is not limited, and when arranging a plurality of liquid feeding pipes 68, a corresponding number of support recesses 66 may be provided, or one support recess 66 may be provided.
  • a plurality of liquid feeding tubes 68 may be arranged. Further, the use of the liquid feeding tube 68 is not limited, and can be used not only for sending or sucking a liquid such as water or physiological saline, but also for supplying a living body glue or a drug.
  • the liquid feed pipe 68 has a length dimension longer than that of the inner member 36, and when the liquid feed pipe 68 is assembled to the inner member 36, the liquid feed pipe 68 is as shown in FIGS. 13 and 15.
  • the tip of the pipe 68 projects toward the tip of the inner member 36 on the lower surface (seat mounting surface 74, which will be described later) side of the sheet mounting portion 38, and constitutes a liquid discharge port 72 that flows inside.
  • the base end of the liquid feeding pipe 68 extends to the base end from the grip portion 84 provided at the base end of the outer cylinder 34, which will be described later, and as shown in FIG. 10 described above, for example, a liquid inside. Syringe 22 and the like filled with the above are connected.
  • the insertion pipe 70 is formed to have a length dimension substantially equal to that of the inner member 36, and is open to the tip end surface and the base end surface of the inner member 36.
  • the liquid feed pipe 68 and the insertion pipe 70 are fitted into the support recesses 66 and arranged in a non-fixed state, but may be fixed with an adhesive or the like if necessary.
  • the tip portions of the liquid feed pipe 68 and the insertion pipe 70 are fixed to the tip of the inner member 36 by the connection portion 73 of the sheet mounting portion 38 described later, and when the inner member 36 described later is moved.
  • the liquid feeding pipe 68 and the insertion pipe 70 move integrally with the inner member 36.
  • the inner member 36 is shown separately as a single item, but in the present embodiment, the inner member 36 is shown.
  • the base end portion of the sheet mounting portion 38 is fixed to the tip end portion of the small diameter portion 60 of the above.
  • the sheet mounting portion 38 has a thin plate shape as a whole, is formed of an elastomer such as a soft synthetic resin or synthetic rubber, and has elasticity.
  • the material of the sheet mounting portion 38 is not limited, but for example, "Pebax (registered trademark)" manufactured by Arkema Co., Ltd., which has a relatively low shore D hardness, polyurethane, or the like is preferably used.
  • the shore D hardness of the sheet mounting portion 38 is not limited, but is preferably less than 40, more preferably 35 or less, for example.
  • the sheet mounting portion 38 By forming the sheet mounting portion 38 with a flexible material in this way, for example, even when the seat mounting portion 38 is stored and held in the outer cylinder 34 in a curved state, the sheet mounting portion 38 is unnecessary. It prevents habits and the like. Further, the sheet mounting portion 38 is preferably formed of a transparent (including translucent) material. Thereby, the peeling of the sheet mounting portion 38 from the sheet-like substance 32 can be confirmed through the camera of the endoscope.
  • the shape and size of the region on which the sheet-shaped substance 32 is placed are determined in consideration of the applied sheet-shaped substance and the in-vivo environment, including elasticity and shape retention characteristics. It is determined and is not limited, but in the present embodiment, it is a substantially hexagon that is distorted in the plan view in the deployed state shown in FIGS. 12 and 13 in consideration of the accommodation in the outer cylinder 34 and the like. ing.
  • the base end portion of the seat mounting portion 38 whose width is narrowed is a connecting portion 73 connected to the inner member 36 (small diameter portion 60).
  • the tip portion having a widened width is the seat mounting surface 74 on which the sheet-like substance 32 is placed.
  • the width dimension is gradually reduced toward the base end side, and inclined side portions 76, 76 on both the left and right sides are provided.
  • the sheet back surface 82 opposite to the sheet mounting surface 74 is shown by the center line L of the outer cylinder 34 (inner member 36) (indicated by a dashed line in FIG. 12). ), It spreads more to the right than to the left. That is, the seat mounting surface 74 (seat mounting portion 38) shown in FIG. 13 has an asymmetrical shape on the left and right with respect to the center line L of the outer cylinder 34.
  • a nylon mesh 77 (shown by a two-dot chain line in FIG. 13) is arranged between the sheet mounting surface 74 and the sheet-like substance 32.
  • the sheet-like substance 32 is supported on the nylon mesh 77 to maintain its shape, and is placed on the sheet mounting surface 74 together with the nylon mesh 77.
  • the shape and size of the nylon mesh 77 are appropriately set in consideration of the shape and size of the sheet-like substance 32 and the sheet mounting surface 74, and are not limited, but in the present embodiment. , It is formed in a size larger than the sheet-like substance 32 and smaller than the sheet mounting portion 38 (sheet mounting surface 74).
  • the connecting portion 73 located on the base end side of the seat mounting surface 74 is located slightly below the seat mounting surface 74 in a stepped manner, and is located in FIGS. 14 and 14. As shown in 16, the shape is a substantially semi-arc shape curved so as to be convex upward. Then, the connecting portion 73 is fixed to the tip portion of the inner member 36 (small diameter portion 60) including the liquid feeding pipe 68 and the insertion pipe 70 by, for example, adhesion, welding, or caulking member.
  • the seat mounting portion 38 is connected to an operation line 78 which is inserted into the insertion pipe 70 and constitutes an operation force transmission mechanism described later, and an operation force from the outside is exerted through the operation line 78.
  • the material of the operation line 78 is not limited, but in the present embodiment, a silk thread generally used as a surgical suture is adopted.
  • the operation line is inserted into the insertion pipe 70 and extends back and forth by a predetermined length, respectively, and the operation force exerted on the proximal end side can be transmitted to the seat mounting portion 38 on the distal end side as a tensile force.
  • the specific structure is not limited, but in the present embodiment, the operation line 78 in which both ends of the silk thread are tied to form an endless annular shape is adopted.
  • two silk threads extend between the proximal end side and the distal end side, and the folded end of the silk thread extends on the proximal end side, and the winding portion of the second operating portion 120 described later. While fixed to 110, the folded portion of the silk thread on the tip side is connected to the sheet mounting portion 38 by being inserted into the through holes 80, 80 formed near the tip of the sheet mounting portion 38. ..
  • the operation line 78 extending from the tip of the insertion pipe 70 extends on the back surface 82 side of the seat opposite to the seat mounting surface 74, and the tensile force exerted through the operation line 78 causes the seat mounting portion 38 to extend.
  • the tip portion is pulled toward the back surface side (the side opposite to the seat mounting surface 74) to be curved and deformed downward.
  • each operation line 78 extending from the tip of the insertion tube 70 is located at the base end portion of the sheet mounting portion 38. It is passed from the sheet mounting surface 74 side to the sheet back surface 82 side through each of the provided insertion holes, and reaches the through holes 80 and 80 provided at the tip portion of the sheet mounting portion 38 along the sheet back surface 82.
  • the operation line 78 extends from the vicinity of the base end of the seat mounting portion 38 to the vicinity of the tip end, but what is exposed to the seat mounting surface 74 side is other than the base end of the seat mounting portion 38. , Only the folded portion of the operation line 78 between the through holes 80 and 80 on the tip side. Since the operation line 78 does not exist in the central portion of the sheet mounting surface 74 as described above, the mounting surface of the sheet-like substance 32 is secured with a wide area area while avoiding the adverse effect of the operation line 78. It is possible.
  • the tensile force exerted by the operation line 78 is exerted on two points of the through holes 80 and 80 separated in the width direction, so that the operation line 78 can be provided at only one point, for example.
  • the tensile force can be efficiently applied in the deformation direction that causes the sheet mounting portion 38 to warp, so that the sheet mounting portion 38 can be deformed more stably.
  • the operation lines 78 and 78 extending from the insertion pipe 70 are inclined on the back surface 82 of the sheet so as to be separated from each other from the center line L toward both sides in the left-right width direction, and the sheet width. It is inserted through the through holes 80, 80 separated in the direction.
  • the pair of through holes 80, 80 through which the operation line 78 is inserted and the operation force is applied via the operation line 78 are substantially symmetrical with respect to the center line L. ing.
  • the operation lines 78 on both sides extending from the pair of through holes 80 and 80 become symmetrical, and the transmission efficiency of the operation force can be improved.
  • the positions of the through holes 80 and 80 in the sheet mounting portion 38 are not limited.
  • the center line M extending in the widthwise center of the tip portion of the sheet mounting portion 38 is substantially evenly separated on both sides in the left-right width direction.
  • a pair of positioned through holes 81, 81 may be provided, and the folded portion on the tip end side of the operation line 78 may be inserted through the through holes 81, 81.
  • the enlarged view is based on the partially enlarged view of FIG. 12, and the through holes 80 and 80 and the operation line 78 inserted therein show those of the device 30 as the fourth embodiment.
  • the tensile force via the operation line 78 can be efficiently applied to substantially the center of the tip portion of the sheet mounting portion 38 in the width direction. , The stability of the deformation mode of the sheet mounting portion 38 can be improved.
  • a grip portion 84 for gripping and operating the device 30 is provided on the base end side of the outer cylinder 34.
  • the grip portion 84 has a hollow substantially longitudinal rectangular box shape extending in the length direction of the outer cylinder 34.
  • the grip portion 84 includes a hard housing 86 made of synthetic resin or metal, and in the present embodiment, the first housing 88 and the second housing 90 are overlapped in the left-right width direction and fixed by a fixing pin 92. By doing so, the housing 86 is configured.
  • an operation line 78 and a storage space 94 for accommodating a winding portion 110 for winding the operation line 78, which will be described later, are provided, and an internal member is provided at the tip portion of the housing 86.
  • An insertion hole 96 through which the base end portion of the 36 is inserted is formed.
  • the grip portion 84 includes a slide operation portion 100 that can slide in the length direction of the grip portion 84 (the length direction of the outer cylinder 34) at the upper end portion.
  • the slide operation unit 100 is arranged on the outside of the upper wall portion of the housing 86.
  • the outer surface of the slide operation unit 100 can be slid by overlapping the thumbs of the hands holding the grip portion 84 with the palm.
  • the operation surface 106 is set.
  • a leg portion 104 projecting downward is integrally formed in the slide operation portion 100, and the leg portion 104 is inserted into the accommodation space 94 through the insertion window 102 formed in the upper wall portion of the housing 86. It stands out. Then, in the leg portion 104, the slide operation portion 100 is engaged with and connected to the base end portion of the inner member 36. That is, the leg portion 104 is connected to the input portion 64 of the inner member 36 extending into the accommodation space 94 through the insertion hole 96 formed in the front wall of the housing 86, so that the base end portion of the inner member 36 is connected.
  • a slide operation unit 100 is attached to the slide operation unit 100.
  • the insertion window 102 of the housing 86 extends in a slit shape in the length direction of the housing 86. Then, the leg portion 104 and thus the slide operation portion 100 are movable along the insertion window 102, and the inner member 36 is shafted with respect to the housing 86 and thus the outer cylinder 34 as the slide operation portion 100 moves. It is designed to move relative to each other in the direction.
  • a compression type coil spring 108 is arranged between the tip portion of the slide operation portion 100 and the input portion 64 of the inner member 36. Based on the elastic force of the coil spring 108, a sliding resistance due to contact is generated between the slide operation portion 100 and the upper wall of the housing 86. Then, the slide resistance exerted on the slide operation unit 100 prevents the slide operation unit 100 and thus the inner member 36 from being inadvertently moved, and the slide operation unit 100 and the inner member 36 are moved in the axial direction with a predetermined resistance. You can do it.
  • the slit-shaped insertion window 102 is engaged with the inner surfaces of the walls on both sides in the width direction so as to open to the inner surface of the housing 86 near the tip and the rear end.
  • the recesses 109a and 109b are formed, respectively.
  • the leg portion 104 of the slide operation portion 100 inserted into the insertion window 102 is formed with a plate-shaped portion that prevents the leg portion 104 from coming out of the insertion window 102 by spreading on both sides in the width direction in the housing 86.
  • the plate-shaped portion is formed with an engaging protrusion 105 that projects upward toward the inner surface of the wall on both sides in the width direction of the insertion window 102.
  • the slide operating portion 100 moves toward the front end side (protruding expansion position of the seat mounting portion 38) and toward the rear end side.
  • a sense of moderation is given to the operator and a positioning action is exerted, respectively.
  • the urging force of the coil spring 108 arranged between the slide operation portion 100 and the inner member 36 (input portion 64) is exerted in the direction of pressing the plate-shaped portion of the leg portion 104 against the inner surface of the housing 86. Therefore, the locking action of holding the engaging state of the engaging protrusion 105 with the engaging recesses 109a and 109b is exerted.
  • the operator pushes the slide operation portion 100 downward (on the housing 86 side) with his / her fingers to release the engaging protrusion 105 from being engaged with the engaging recesses 109a and 109b.
  • the slide operation unit 100 is slid along the insertion window 102. Therefore, the positioning action of the slide operation unit 100 toward the front end side and the rear end side in the slide operation direction can be more effectively exerted.
  • the accommodation space 94 of the housing 86 is provided with a winding unit 110 for winding the operation line 78.
  • the take-up portion 110 has a substantially disk-shaped reel disk structure, and has a take-up shaft portion 112 on a rotation center axis extending in the left-right width direction of the housing 86.
  • the shaft portion 112 is non-rotatably connected to the dial portion 114 mounted on the outer surface of the side wall of the housing 86 by a connecting shaft penetrating the side wall of the housing 86.
  • the dial portion 114 is arranged unevenly forward on one of the left and right side walls of the housing 86, and can be rotated by the thumb or index finger of the hand holding the grip portion 84 with the palm.
  • the folded end of the operation line 78 is fixed to the outer peripheral surface of the shaft portion 112, and the operation line 78 is wound or sent out by rotating the take-up portion 110 by rotating the dial portion 114. It has become like.
  • protrusions, rollers, tubes, etc. for guiding the operation line 78 are provided as necessary, and extend from the opening on the base end side of the insertion tube 70 in the housing 86.
  • a wiring path from the opening of the insertion pipe 70 to the take-up portion 110 is set. By appropriately setting such a wiring path, it is possible to suppress the slackening of the operation line 78 and to secure the operation amount by winding and pulling out the operation line 78 accurately and stably.
  • a nylon mesh 77 or the like is used on the sheet mounting portion 38 (sheet mounting surface 74) of the device 30 in the initial state shown in FIG. 11 or the like, if necessary.
  • the supported sheet-like substance 32 is placed.
  • the sheet-like substance 32 is, for example, intended to be attached to an affected area in a living body for treatment, and includes the above-mentioned sheet-like physiologically active substance, a cell sheet (MSC sheet), an anticancer agent gel sheet, and the like. Examples include therapeutic sheets.
  • the slide operation unit 100 is moved toward the base end side, and the inner member 36 is moved in the axial direction so as to be pulled into the outer cylinder 34.
  • the sheet mounting portion 38 mounted on the tip of the inner member 36 moves to the base end side together with the inner member 36, and is stored in the outer cylinder 34 with the sheet-like substance 32 mounted. ..
  • the grip portion 84 is provided with a first operation portion 116 (slide operation portion 100) that moves the inner member 36, which is an inner member, in the axial direction with respect to the outer cylinder 34, and is provided with a base end of the inner member 36.
  • a first operation portion 116 segment operation portion 100
  • the inner member 36 which is an inner member, in the axial direction with respect to the outer cylinder 34
  • a base end of the inner member 36 On the side, an input unit 64 to which a driving force in the length direction is applied is provided. Then, the slide operation force of the slide operation unit 100 is directly exerted on the input unit 64 of the inner member 36.
  • a protruding piece 56 protruding from the inner peripheral surface 42 into the lumen 46 is provided at the tip portion of the lumen 46 of the outer cylinder 34, and the sheet mounting portion 38 is housed in the outer cylinder 34.
  • the outer cylinder 34 peripheral wall 40
  • the inner peripheral surface 42 specifically, the inner peripheral surface of the coating 44
  • the projecting piece 56 and stored in a curved state. It has become so. Therefore, the seat support surface 118 on which the seat mounting portion 38 housed in the curved state in the lumen 46, which is the hollow inside of the outer cylinder 34, is overlapped, is not only the inner peripheral surface 42 of the peripheral wall 40 but also the protruding piece 56. It is configured to include the inner peripheral surface.
  • inclined side portions 76 and 76 are provided at the base end of the seat mounting surface 74, and the inner member 36 is slid toward the base end side with respect to the outer cylinder 34 to slide the seat mounting portion 38.
  • the inclined side portions 76 and 76 abut on the opening peripheral edge portion of the outer cylinder 34 so as to be smoothly deformed.
  • the sheet mounting portion 38 that greatly bulges on one side in the left-right width direction with respect to the center line L (on the right side rather than the left side in the present embodiment) is located on one end side (in the present embodiment) in the left-right width direction. Then, on the left end side), it is overlapped with and supported by the curved inner surface of the protruding piece 56.
  • the outer cylinder 34 avoids that both ends of the sheet-like substance 32 in the width direction directly overlap each other. It is possible to stably support the outer cylinder 34 and the protruding piece 56 on the inner peripheral surface under the accommodation state. Moreover, the support surface by the protruding piece 56 has a smaller inclination angle in the circumferential direction from the inner peripheral surface of the outer cylinder 34 than the support surface protruding in the radial direction of the outer cylinder 34 (for example, the tangential direction of the inner peripheral surface of the outer cylinder 34).
  • the bending angle or the radius of curvature of the support surface at the rising portion of the protruding piece 56 from the inner peripheral surface of the outer cylinder 34 can be set small, and the local part of the sheet-like substance 32 superimposed on the portion can be set. Bending and damage caused by the bending can be prevented, and normal and stable delivery of the sheet-like substance 32 can be easily realized.
  • the outer cylinder 34 of the device 30 is an endoscope (not shown) in a state where the sheet mounting portion 38 is housed in the outer cylinder 34 with the sheet-like substance 32 placed.
  • the tip of the outer cylinder 34 is delivered to the vicinity of the treatment site in the living body by being inserted into the camera port of.
  • the inner member 36 slides toward the tip side together with the slide operation unit 100 with respect to the outer cylinder 34.
  • the seat mounting portion 38 moves toward the tip end side together with the inner member 36, and the seat mounting portion 38 projects toward the tip end side from the outer cylinder 34.
  • the sheet mounting portion 38 is brought into the initial unfolded state shown in FIG. 11 or the like in the living body by elastic restoration deformation while the sheet-like substance 32 is placed.
  • the device 30 is tilted as necessary to superimpose and attach the sheet-like substance 32 placed on the sheet placing portion 38 to the treatment site in the living body.
  • water, physiological saline, or the like filled in the syringe 22 or the like is discharged from the discharge port 72 through the liquid feeding tube 68 to moisten the treatment site.
  • the sheet-like substance 32 may be easily attached due to the surface tension of the liquid or the like.
  • the thumb placed on the slide operation surface 106 is moved to the dial portion 114, and the dial portion 114 is rotated around the central axis to rotate the operation line.
  • the 78 is wound around the winding unit 110.
  • the operation line 78 whose tip side is connected to the sheet mounting portion 38 is pulled toward the base end side, and the sheet mounting portion 38 is deformed so as to warp toward the back surface side, and the sheet-like substance attached to the treatment site.
  • the sheet mounting portion 38 is peeled off from 32. In this way, the application of the sheet-like substance 32 to the treatment site is completed.
  • the nylon mesh 77 may remain on the sheet mounting portion 38 side, or the sheet-like substance 32 may be attached to the living body together with the sheet-like substance 32 and the sheet may be attached after the fact if necessary. Nylon mesh 77 may be peeled off and recovered from the state substance 32.
  • the operation is input from outside the living body in a state where the sheet-like substance 32 placed on the sheet mounting portion 38 is attached to the treatment site in the living body with the sheet mounting portion 38 in the expanded state.
  • An operating force transmission mechanism is provided that applies a force to the seat mounting portion 38 in the living body to deform the seat mounting portion 38.
  • the operating force transmission mechanism is configured by an operating line 78 connected to the seat mounting portion 38.
  • the second operation unit 120 that deforms the seat mounting unit 38 via the operation force transmission mechanism (operation line 78) includes the dial unit 114 and the winding unit 110.
  • the seat mounting portion 38 is deformed via the first operation unit 116 that moves the inner member 36 relative to the outer cylinder 34 in the axial direction and the operation force transmission mechanism (operation line 78).
  • a second operation unit 120 to be operated is provided separately in the grip portion 84 so as to be operable.
  • the operation line 78 is sent out by, for example, rotating the dial portion 114 in the reverse direction, so that the sheet mounting portion 38 is elastic. It is also possible to return to the initial unfolded state shown in FIG. 11 and the like along with the restoration deformation. It is also possible to re-store it in 34. Then, the device 30 may be pulled out from the camera port of the endoscope in a state where the seat mounting portion 38 is re-stored in the outer cylinder 34.
  • the device 30 may be pulled out from the camera port of the endoscope (while remaining in the expanded state protruding from 34), or the device 30 may be pulled out from the patient together with the endoscope.
  • the device 30 taken out from the patient may be discarded as a whole, but it can be disassembled into, for example, a sheet mounting portion 38, an inner member 36, a liquid feed pipe 68, an insertion pipe 70, an operation line 78, and the like.
  • the outer cylinder 34, the protruding member 48, the housing 86, and the like made of metal may be sterilized and reused.
  • the device 30 of the present embodiment having the above-mentioned structure exhibits the same effects as those of the above-described embodiment.
  • a projecting piece 56 projecting from the inner peripheral surface 42 of the outer cylinder 34 into the lumen 46 is provided, and the sheet support including the projecting piece 56 on which the sheet mounting portion 38 is overlapped.
  • the surface 118 is configured. Therefore, compared to the case where only the inner peripheral surface of the outer cylinder is used as the seat support surface, for example, it is possible to secure a large area of the seat support surface while suppressing the outer diameter size of the outer cylinder 34. Even when a large sheet-like substance 32 is used, it can be stored in the outer cylinder 34 without overlapping.
  • the protruding piece 56 extends along the inner peripheral surface 42 of the outer cylinder 34, the length of the protruding piece 56 in the circumferential direction (the protruding length from the inner peripheral surface 42 of the outer cylinder 34) can be freely set. The degree is large. Therefore, it is possible to appropriately set the protruding length of the protruding piece 56 or the like according to the size of the sheet mounting portion 38 to be adopted in the left-right width direction, in other words, the sheet mounting portions 38 of various sizes can be set. It will also be easy to adopt.
  • the inner member 36 is made of synthetic resin, and is disposable together with the sheet mounting portion 38 that comes into contact with the patient. That is, it is economical because the portion formed at low cost is disposable, and it is also hygienic because the portion in contact with the patient is also disposable.
  • the grip portion 84 has a first operation portion 116 that moves the inner member 36 with respect to the outer cylinder 34 in the axial direction, and a second operation portion 38 that deforms the seat mounting portion 38 via an operation force transmission mechanism (operation line 78).
  • the operation unit 120 is provided so as to be operable separately. Therefore, the operation reliability of each operation can be improved.
  • the first operation portion 116 is provided above the grip portion 84, and the second operation portion 120 is provided on the side surface (left side) of the grip portion 84, for example, the grip portion 84. It is possible to switch between the operation of the first operation unit 116 and the operation of the second operation unit 120 simply by shifting the position of the thumb without changing the gripping method. As a result, the handleability of the device 30 by the user can be improved.
  • the operating force transmission mechanism is composed of the operating line 78, and by rotating the winding section 110 in the second operating section 120, the operating line 78 is wound and the sheet mounting section 38 is deformed. It is possible. Thereby, the deformation of the seat mounting portion 38 can be easily realized.
  • the first operation unit 116 has the slide operation unit 100, and by moving the slide operation unit 100 to the tip end side and the base end side, the sheet mounting portion 38 protrudes from the inside of the outer cylinder 34. It is possible to switch between the unfolded state and the state in which the seat mounting portion 38 is housed in the outer cylinder 34. Therefore, it is possible to quickly switch between the expanded state and the accommodation state of the sheet mounting portion 38 with a simple structure, and the movement amount of the seat mounting portion 38 is used as the movement amount of the slide operation unit 100. , It becomes easy to grasp accurately and sensuously.
  • FIGS. 21 and 22 show the device 130 as the fifth embodiment of the present disclosure in a deployed state in which the sheet mounting portion 38 protrudes from the outer cylinder 34.
  • the device 130 of the present embodiment differs from the device 30 described in the fourth embodiment only in the position of the second operation unit 134 provided in the grip portion 132, and the structure and basic of the other parts are different.
  • the method of use is the same as that of the device 30 described in the fourth embodiment. Therefore, in the following description, the differences from the device 30 described in the fourth embodiment will be described, and the members and parts substantially the same as those in the fourth embodiment will be described in the fourth embodiment in the drawing. Detailed description will be omitted by adding the same reference numerals as those of the embodiments.
  • the grip portion 132 of the present embodiment is provided with a first operation portion 116 (slide operation portion 100) for moving the inner member 36 in the axial direction with respect to the outer cylinder 34 at the upper part.
  • the grip portion 132 is provided with the second operation portion 134 on the tip side of the first operation portion 116.
  • the dial portion 114 constituting the second operation portion 120 is provided on the side surface (left side) of the grip portion 84, and the central axis of the dial portion 114 extends in the left-right direction.
  • the dial portion 136 has a substantially cylindrical shape, and the central axis of the dial portion 136 extends in the length direction of the outer cylinder 34. A part of the dial portion 136 on the circumference is exposed from the grip portion 132, and for example, a thumb is placed on the outer peripheral surface of the dial portion 136 so that the dial portion 136 can be rotated around the central axis.
  • a take-up portion 138 for winding the operation line 78 is integrally formed on the base end side of the dial portion 136, and the operation line 78 is fixed to the outer peripheral surface of the take-up portion 138. ..
  • the dial portion 136 can be rotated around the central axis to wind up the operation line 78, thereby exerting an operating force on the seat mounting portion 38 via the operation line 78 to deform the seat mounting portion 38. You can do it.
  • the sheet-like substance 32 is placed on the sheet mounting portion 38 via the nylon mesh 77 as necessary, and then the first operation unit 116 is configured.
  • the slide operation unit 100 is slid and displaced toward the base end side.
  • the inner member 36 and the seat mounting portion 38 are slid and displaced toward the base end side together with the slide operating portion 100, and the seat mounting portion 38 is housed in the tip portion of the outer cylinder 34.
  • the subsequent operation method is the same as the method described in the fourth embodiment.
  • the base end portion of the inner member 36 is inserted into the inner holes of the dial portion 136 and the take-up portion 138, and the dial portion 136 and the winding portion are wound when the inner member 36 is slid to the base end side.
  • the taking part 138 does not interfere.
  • the operating force input from outside the living body is placed on the seat mounting portion 38 in the deployed state via the operating force transmission mechanism (operation line 78).
  • the sheet-like substance 32 attached to the treatment site can be deformed so as to peel off the sheet mounting portion 38, so that the same effect as that of the device 30 described in the fourth embodiment can be obtained. Can be demonstrated.
  • FIGS. 23 and 24 show the device 140 as the sixth embodiment of the present disclosure in a deployed state in which the sheet mounting portion 38 protrudes from the outer cylinder 34.
  • the structures of the first operation unit 144 and the second operation unit 146 provided in the grip portion 142 are different from those of the devices 30 and 130 described in the fourth and fifth embodiments.
  • the structure and basic usage of other parts are the same as those of the devices 30 and 130 described in the fourth and fifth embodiments. Therefore, in the following description, the differences from the device 30 described in the fourth embodiment will be described, and the members and parts substantially the same as those in the fourth embodiment will be described in the fourth embodiment in the drawing. Detailed description will be omitted by adding the same reference numerals as those of the embodiments.
  • a gear (pinion portion 152, which will be described later) provided in the first operation unit 144 as an input unit in which a driving force in the length direction is applied to the upper side of the base end side portion of the inner member 148 as the inner member.
  • a rack portion 150 constituting the rack and pinion is provided. That is, on the upper side of the base end side portion of the inner member 148, flat tooth-like irregularities are continuously provided in the length direction of the outer cylinder 34, and the rack portion 150 is provided from the base end of the inner member 148. It is provided over a certain length.
  • the first operation unit 144 is provided with a pinion unit 152, which is a gear corresponding to the rack unit 150, in the accommodation space 94, and is provided coaxially with the pinion unit 152 and can rotate together with the pinion unit 152. It is equipped with an operation unit 154.
  • the pinion portion 152 has a plurality of teeth that can be meshed with the rack portion 150 on the outer peripheral surface, and the central axis extends in the left-right direction.
  • the rotation operation portion 154 has a substantially disk shape larger than that of the pinion portion 152, and a part of the circumference protrudes upward from the grip portion 142, and the rest of the circumference is in the accommodation space 94. It is contained.
  • the pinion portion 152 and the rotation operation portion 154 are integrally rotated around the first rotation shaft portion 156 extending in the left-right direction. Therefore, by rotating the rotation operation unit 154 from the outside, the rotation operation unit 154 and the pinion unit 152 rotate integrally with the first rotation shaft portion 156 fixed to the housing 86 as the rotation center axis. It has become. Then, as the pinion portion 152 rotates, the gears of the pinion portion 152 mesh with the dentition of the rack portion 150, and the inner member 148 having the rack portion 150 is movable in the axial direction with respect to the outer cylinder 34.
  • the first operation unit 144 of the present embodiment converts the rotation operation force exerted on the rotation operation unit 154 into a linear driving force by a gear mechanism composed of a rack and pinion, and indirectly informs the rack unit 150 which is an input unit. It is designed to exert.
  • the rotation operation unit 154 has an uneven portion 158 on the outer peripheral surface of which a plurality of irregularities are continuously provided, and the bottom of the grip portion 142 is engaged with the bottom of the grip portion 142 so as to project upward in the accommodation space 94.
  • a protrusion 160 is provided. Then, as the rotation operation around the central axis of the rotation operation unit 154 is performed, the engaging protrusion 160 gets over the convex portion and moves to the concave portion with respect to the uneven portion 158 provided on the outer peripheral surface of the rotation operation unit 154. By repeating the entry, the rotation operation unit 154 can be rotated step by step with a sense of moderation (click feeling).
  • the second operation unit 146 includes a winding unit 162 capable of winding the operation line 78 by fixing and rotating the operation line 78 inside the accommodation space 94.
  • the take-up portion 162 has a substantially tubular shape, and an operation line 78 is fixed to the outer peripheral surface of the take-up portion 162.
  • the second operation unit 146 is provided coaxially with the winding unit 162 and includes a dial unit 164 that can rotate together with the winding unit 162.
  • the dial portion 164 has a substantially disk shape larger than that of the take-up portion 162, and a part of the peripheral portion protrudes upward from the grip portion 142, and the remaining portion on the peripheral portion is accommodated in the accommodation space 94. ing.
  • the take-up portion 162 and the dial portion 164 are integrally rotatable around a second rotation shaft portion 166 extending in the left-right direction. Therefore, by rotating the dial portion 164 from the outside, the dial portion 164 and the take-up portion 162 are integrally rotated with the second rotation shaft portion 166 fixed to the housing 86 as the rotation center axis. It has become. Then, the operation line 78 is wound up with the rotation of the winding unit 162, and the sheet-like substance 32 attached to the treatment site can be deformed so that the sheet mounting portion 38 is peeled off.
  • the dial portion 164 has an outer peripheral surface 168 provided with a plurality of rough surfaces (or irregularities or the like), and the bottom portion of the grip portion 142 protrudes into the accommodation space 94 to form a dial portion 164.
  • a contact protrusion 170 that abuts on the outer peripheral surface 168 is provided.
  • the rotation operation feeling of the dial portion 164 may be appropriately adjusted and set based on the contact action, the sliding contact action, the engagement action, etc. of the contact protrusion 170 with the dial portion 164 (outer peripheral surface 168). Is possible.
  • a smooth rotation operation of the dial portion 164 can be realized by applying a substantially constant rotational resistance, and particularly in a rotation direction in which a tensile force is applied.
  • a predetermined moderation click feeling is given to facilitate fine adjustment when the sheet mounting portion 38 is peeled off, and further, the rotational position of the dial portion 164 can be held so that the tensile force on the seat mounting portion 38 can be maintained. It is also possible to make it holdable.
  • the operating force input from outside the living body to the seat mounting portion 38 in the deployed state is transmitted via the operating force transmission mechanism (operation line 78).
  • the device 30 according to the fourth embodiment can be deformed so as to peel off the sheet mounting portion 38 from the sheet-like substance 32 attached to the treatment site by exerting the effect on the sheet mounting portion 38. Can exert the same effect as.
  • FIGS. 25 and 26 show the device 180 as the seventh embodiment of the present disclosure in a deployed state in which the sheet mounting portion 38 protrudes from the outer cylinder 34.
  • the device 180 of the present embodiment is the first operation unit 184 and the second operation unit 184 provided in the grip unit 182 in the same manner as in the sixth embodiment with respect to the devices 30 and 130 described in the fourth and fifth embodiments.
  • the structure of the part 186 is different, the structure of the other parts and the basic usage are the same as those of the devices 30 and 130 described in the fourth and fifth embodiments.
  • the housing 190 constituting the grip portion 182 is connected to the base end side of the outer cylinder 34 into which the inner member 188 as the inner member and the projecting member 48 are inserted. That is, the outer cylinder 34 is inserted and fixed to the insertion hole 96 at the tip of the housing 190, and the base end of the inner member 188 in the inner hole of the housing 190 is larger than the base end of the outer cylinder 34. It protrudes to the base end side. Further, the input portion 192 is fixedly attached to the base end of the inner member 188, and the operation line 78 connected to the seat mounting portion 38 on the tip end side extends to the base end side through the insertion pipe 70. , It penetrates the input unit 192 and reaches the base end side of the input unit 192.
  • a slide operation member 194 including the first operation unit 184 and a rotation operation member 196 including the second operation unit 186 are inserted from the base end side at each tip portion.
  • the slide operation member 194 has a substantially cylindrical shape as a whole, and is a first small-diameter cylindrical portion 198 having a thin cylindrical shape having a size at which the tip end side portion can be inserted into the inner hole from the base end side of the housing 190. ..
  • the base end portion of the slide operation member 194 has a substantially rectangular tubular shape having a larger diameter than the first small diameter tubular portion 198, and protrudes toward the base end side of the housing 190.
  • the base end portion of the slide operation member 194 is a first operation unit 184 that can be picked up by the user and slid toward the base end side in the axial direction.
  • the slide operation member 194 is assembled to the housing 190 so as to be relatively non-rotatable around the central axis and relatively movable in the central axis direction.
  • a connecting portion 200 is provided at the tip of the first small-diameter tubular portion 198, and is fixed to the input portion 192 at the base end of the inner member 188 and connected so as not to rotate relative to each other.
  • a female screw 202 is formed on a base end portion (for example, the inner peripheral surface of a portion having a large diameter cylinder portion) on the inner peripheral surface of the slide operation member 194.
  • the rotation operation member 196 has a substantially cylindrical shape as a whole, and the tip end side portion is a second small diameter tubular portion 204 having a size that can be inserted into the inner hole of the slide operation member 194, and the base end.
  • the portion has a larger diameter than the second small-diameter cylindrical portion 204 and has a non-circular shape such as a polygonal outer peripheral surface, and protrudes toward the base end side of the slide operation member 194.
  • a male screw 206 screwed with the female screw 202 of the slide operation member 194 is formed over a predetermined length, and the user can use the rotation operation member 196 at the base end portion.
  • the rotation operation member 196 By pinching a large-diameter cylinder and rotating the rotation operation member 196 with respect to the slide operation member 194, the rotation operation member 196 is centered with respect to the slide operation member 194 by the screw mechanism of the male screw 206 and the female screw 202. It is designed to be moved relative to each other in the axial direction.
  • a substantially annular or disk-shaped connecting portion 208 is attached to the tip of the second small diameter cylinder portion 204 so as to be rotatable with respect to the second small diameter cylinder portion 204 and inseparably in the axial direction. Then, the operation line 78 extending toward the base end side from the input unit 192 is connected to the second small diameter cylinder portion 204 via the connecting portion 208 in the first small diameter cylinder portion 198 of the slide operation member 194. ..
  • the sheet-like substance 32 is placed on the sheet mounting portion 38 via the nylon mesh 77, if necessary, and then as shown in FIGS. 27 and 28.
  • the first operation unit 184 is picked up and the slide operation member 194 is slid to the base end side with respect to the housing 190. Since the slide operation member 194 is connected to the inner member 188 via the connecting portion 200, the inner member 188 and the seat mounting portion 38 are slid and displaced toward the base end side together with the slide operation member 194, and the seat is mounted.
  • the portion 38 is housed in the tip portion of the outer cylinder 34.
  • the first operation portion 184 is picked up and the slide operation member 194 is slid to the tip side, and FIGS.
  • the seat mounting portion 38 is projected from the outer cylinder 34 to be in the unfolded state.
  • the second operation unit 186 is picked and the rotation operation is performed, and the rotation operation member 196 is screwed to the base end side with respect to the slide operation member 194.
  • the rotation operation member 196 is moved to the base end side with respect to the slide operation member 194 to peel off the sheet mounting portion 38 from the sheet-like substance 32, and then the slide operation member 194 is separated together with the rotation operation member 196.
  • the inner member 188 and the seat mounting portion 38 move to the base end side together with the slide operating member 194, and the seat mounting portion 38 is moved into the outer cylinder 34 again.
  • the sheet mounting portion 38 was peeled off from the sheet-like substance, the sheet mounting portion 38 was projected without being housed in the outer cylinder 34. In this state, the entire device including the outer cylinder 34 may be pulled out from the endoscope port.
  • the tensile force exerted on the seat mounting portion 38 via the operation line 78 is substantially. It is designed to be kept constant. That is, in the present embodiment, when the inner member 188 moves with respect to the outer cylinder 34 in the length direction, the operating force holding that holds the operating force exerted on the seat mounting portion 38 by the operating force transmission mechanism (operation line 78).
  • the mechanism 209 is configured by connecting the operation line 78 to the rotation operation member 196 that moves together with the inner member 188 via the slide operation member 194.
  • the operation line 78 is not connected to the outer cylinder 34 and the housing 190 side, but is connected to the rotation operation member 196 which is a member on the inner member 188 side which is an inner member.
  • the operating force holding mechanism is also configured by connecting the operating line 15 to the operating portion 14 on the inner member 12 side in the first to third embodiments described above.
  • the operation line 78 is prevented from loosening, so that the operation line 78 is caught or entangled. It is possible to prevent problems. Further, for example, as the inner member 188 moves with respect to the outer cylinder 34 in the length direction, the tensile force exerted on the seat mounting portion 38 via the operation line 78 is inadvertently released, and the seat is mounted. It can also be prevented that the deformation of the placement portion 38 is unintentionally released.
  • the operating force input from outside the living body to the seat mounting portion 38 in the deployed state is transmitted via the operating force transmission mechanism (operation line 78).
  • the device 30 according to the fourth embodiment can be deformed so as to peel off the sheet mounting portion 38 from the sheet-like substance 32 attached to the treatment site by exerting the effect on the sheet mounting portion 38. Can exert the same effect as.
  • the device 2 shown in FIG. 10 was manufactured.
  • the device 2 includes an outer cylinder 11 (length: 20 cm, outer diameter: 18 mm, thickness: 1 mm, material: stainless steel) and a sheet mounting portion 13 (5 x 3 cm, thickness: 1 mm, rounded square type).
  • hollow cylindrical inner member 12 (length: 35 cm, outer diameter 10 mm, thickness: 1 mm, material: stainless steel), a discharge port 21 at one end, and a syringe 22 at the other end. It has a tube 20 and a tube 20.
  • the outer cylinder 11 has a hollow cylindrical shape.
  • the inner member 12 has a hollow cylindrical shape, and a seat mounting portion 13 is attached to the tip end portion thereof, and an operation portion 14 is attached to the base end portion.
  • the operating portion 14 is a male screw, and a female screw is formed on the inner surface of the inner member 12 on the proximal end side so as to be engaged with the male screw.
  • One hole 19 was formed on the side surface of the inner member 12, and the tube 20 was inserted into the inner member 12 through this hole.
  • the tube 20 is arranged so that the discharge port 21 attached to one end (tip side) thereof is on the seat mounting surface side of the seat mounting portion 13 and protrudes from the tip of the inner member 12.
  • One end of the operation line 15 was attached to the through hole formed on the tip end side of the seat mounting portion 13.
  • the other end of the operation line 15 is passed through a through hole provided on the base end side of the seat mounting portion 13 from the surface of the seat mounting portion 13 opposite to the seat mounting surface 13a, and is inside the inner member 12. It was connected to the operation unit 14 via a swivel (not shown). With the seat mounting portion 13 protruding from the outer cylinder 11, if the operation portion 14 (male screw) in contact with the inner member 12 is rotated so as to advance in the direction opposite to the tip, the operation line 15 is pulled.
  • the operation line 15 and the operation unit 14 are configured so that the sheet mounting portion 13 is elastically deformed and curved with the seat mounting surface 13a facing outward.
  • telomerase reverse transcriptase (TERT) gene was introduced
  • a cell sheet (MSC sheet) imitating a heart tissue sheet was prepared.
  • FBS fetal bovine serum
  • 5.5 mmol / L 2-mercaptoethanol 0.5 ml penicillin.
  • the cells were cultured at 37 ° C. in a humid atmosphere of air. Culture medium was changed every 2 days to maintain TERT-hMSC.
  • the TRT-hMSC was removed from the dish and dissociated into single cells by incubation with 0.25% trypsin / ethylenediaminetetraacetic acid (EDTA) solution for 3 minutes.
  • EDTA ethylenediaminetetraacetic acid
  • a cell sheet was prepared according to a conventional method. Made. 5-6 million cells (TERT-hMSC) were seeded in an FBS-coated 10 cm dish (UpCell®, CellSeed, Inc.) with ⁇ MEM + 10% FBS and humidified with 5% CO 2 /95% air. Incubated at 37 ° C. in the atmosphere. On day 4, the MSC sheet was recovered from UpCell® at room temperature.
  • a heart model was prepared using UV-equipped inkjet 3D printer technology. Then, the MSC sheet was transferred from the culture dish to the sheet mounting surface 13a of the sheet mounting portion 13 of the device using an appropriately cut nylon mesh (hole 35 ⁇ m). At this time, the nylon mesh and the MSC sheet were set in the sheet mounting portion 13 in this order so that the nylon mesh was in contact with the sheet mounting surface 13a, so that the MSC sheet did not come into direct contact with the sheet mounting surface 13a.
  • the seat mounting portion 13 on which the MSC sheet and the nylon mesh are set is brought into contact with the surface of the heart model, and then the operating portion 14 is rotated in one direction to pull the operation line 15 and bend the seat mounting portion 13.
  • the MSC sheet and nylon mesh were affixed to the heart model in place on the heart model. Then, the nylon mesh was peeled off while the MSC sheet was held by the heart model. As a result, the MSC sheet could be attached to the heart model.
  • MSC sheet endoscopic transplantation using a heart model A thoracic cavity model (pericardium, lungs, bones, muscles, skin) is created using vacuum casting, a cardiac model is placed therein, and the left ventricular (LV) anterior wall region and LV of the cardiac model are used. An attempt was made to endoscopically implant the MSC sheet into the side wall region. As a result, the MSC sheet could be transplanted to the cardiac model in both the LV front wall region and the LV side wall region without causing tearing, distortion, dislocation, or the like of the MSC sheet.
  • LV left ventricular
  • the mode of connecting the operation line to the seat mounting portion is not limited to that exemplified in the above embodiment.
  • the deformation mode of the sheet mounting portion due to the external force action is not limited to the deformation mode in which the tip portion is pulled toward the back surface side to warp, as in the above embodiment, and the sheet mounting portion is mounted on the sheet mounting surface. Any modification may be used as long as the sheet-like substance that has been formed and attached to the living body is separated from the sheet-placed portion.
  • the mode of connecting the operation line to the seat mounting portion is also appropriately set according to the deformation mode and the like generated in the seat mounting portion, and is not limited to the above-described embodiment.
  • FIG. 31A An example of a specific modification mode is shown in FIG. 31A.
  • two operation lines 212a and 212b are connected to the seat mounting portion 210.
  • the members and parts substantially the same as those in the embodiment are designated by the same reference numerals as those in the fourth embodiment, and detailed description thereof will be omitted. That is, in FIG. 31A, the insertion pipe 70 extends to the top of the seat back surface 82 of the sheet mounting portion 210, and the folded portion on the tip end side of the operation line 212a, which is one endless annular shape, extends to the right from the insertion pipe 70.
  • the seat is extended and connected to the right end portion in the width direction of the seat mounting portion 210, and the folded portion on the tip end side of the operation line 212b, which is another endless annular shape, extends to the left from the insertion pipe 70 and is seated. It is connected to the left end portion of the mounting portion 210 in the width direction.
  • both the operation lines 212a and 212b are fixed to the winding portion or the like of the embodiment at the folded-back portion on the proximal end side, and are wound and pulled on the proximal end side of the device.
  • the right end portion and the left end portion of the sheet mounting portion 210 are respectively subjected to a tensile force toward the back surface side, and the sheet mounting portion 210 is deformed as shown in FIG. 31B.
  • the lower surface in the drawing is a sheet mounting surface 74 on which a sheet-like substance (physiologically active substance) is placed, and is a surface to be superimposed on the treatment site when the sheet-like substance is attached. Therefore, in this embodiment, after the sheet-like substance is attached, the sheet-mounting portion 210 is deformed so that both end portions in the left-right width direction of the sheet-mounting portion 210 are peeled off from the sheet-like substance 32. By deforming it, the sheet mounting portion 210 can be peeled off from the sheet-like substance 32.
  • the axis (the line maintained linearly even during bending deformation) of the sheet mounting portion 210 during bending or bending deformation is substantially parallel to the central axis of the outer cylinder 34. It is said that. Therefore, the seat mounting portion 210 is re-stored in the outer cylinder 34 after being deformed, as compared with the other embodiment described above in which the axis line at the time of deformation of the seat mounting portion 210 is substantially orthogonal to the central axis of the outer cylinder 34. In this case, the sheet mounting portion 210 can be easily stored in the outer cylinder 34 in the deformed state.
  • the seat mounting portion 210 can be re-stored in the outer cylinder 34 without requiring such an operation.
  • the sheet mounting portion 210 is mounted on the sheet.
  • the shape stability of the placement portion 210 is improved, and the support stability of the sheet-like substance is also improved.
  • FIG. 31B when the sheet-like substance is peeled off, the peeling is started from both side edge portions in the width direction, so that the peeling from the sheet-like substance can be performed more reliably. The time required for peeling can be shortened.
  • the projecting piece protruding from the inner peripheral surface of the outer cylinder to form a part of the seat support surface is not essential, even when the projecting piece is provided, the projecting mode of the projecting piece is the fourth to the fourth.
  • the embodiment is not limited to the embodiment described in 7, and may project from the lower side to the upper side, for example, as shown in FIG. 17 of Patent Document 1. In such a case, for example, in a plan view, a seat mounting portion symmetrical with respect to the central axis of the outer cylinder may be adopted.
  • the device according to the present disclosure is not limited to the shape as exemplified in the above embodiment, and may be a gun type as in the device 220 shown in FIG. 32, for example. That is, the user grips the grip portion 222 of the gun type device 220, and for example, by pulling the trigger 224 with the index finger, the inner member 226 connected to the trigger 224 moves to the base end side and the outer cylinder 34
  • the sheet mounting portion 38 protruding from the outer cylinder may be housed in the outer cylinder 34, and the seat mounting portion 38 may be stored in the outer cylinder 34 by moving the trigger 224 to the tip side and returning it to the initial position. It may be designed to protrude from 34.
  • a second operation portion 228 for winding the operation line 78 so as to separate the developed sheet mounting portion 38 from the sheet-like substance 32 may be provided in the vicinity of the grip portion 222.
  • the second operation unit 228 may be configured to include a winding unit 230 and a dial unit 232 to which the operation line 78 is connected on the proximal end side of the device 220, as in the fourth embodiment.
  • the seat mounting portion 38 may be projected from the outer cylinder 34 by pulling the trigger 224, and such a configuration is realized by connecting the trigger 224 and the outer cylinder 34, for example. As a result, the outer cylinder 34 can be moved to the base end side with respect to the seat mounting portion 38 and the inner member 226 by pulling the trigger 224.

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  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
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PCT/JP2021/038091 2020-10-15 2021-10-14 シート状物質を生体内に貼付するためのデバイス WO2022080459A1 (ja)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023120224A1 (ja) * 2021-12-22 2023-06-29 テルモ株式会社 シート状送達物を適用するための医療機器および方法

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10511589A (ja) * 1995-01-06 1998-11-10 ユーン，インバエ 内視鏡下で閉塞部位に空間を作るための拡張可能な多機能器具およびその方法
US20070208422A1 (en) * 2006-01-26 2007-09-06 Wake Forest University Health Sciences Medical tools for facilitating deep lamellar endothelial keratoplasty and related methods
JP2008173333A (ja) * 2007-01-19 2008-07-31 Hoya Corp 治療用物質の運搬投与器具
JP2009000511A (ja) * 2007-05-22 2009-01-08 Hoya Corp 治療用物質の運搬投与器具
WO2012005322A1 (ja) * 2010-07-09 2012-01-12 オリンパスメディカルシステムズ株式会社 内視鏡保持装置および内視鏡システム
JP2014045892A (ja) * 2012-08-30 2014-03-17 Olympus Corp シート貼付装置
WO2017043600A1 (ja) * 2015-09-09 2017-03-16 学校法人東京女子医科大学 治療物質運搬デバイス、及び治療物質運搬キット

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10511589A (ja) * 1995-01-06 1998-11-10 ユーン，インバエ 内視鏡下で閉塞部位に空間を作るための拡張可能な多機能器具およびその方法
US20070208422A1 (en) * 2006-01-26 2007-09-06 Wake Forest University Health Sciences Medical tools for facilitating deep lamellar endothelial keratoplasty and related methods
JP2008173333A (ja) * 2007-01-19 2008-07-31 Hoya Corp 治療用物質の運搬投与器具
JP2009000511A (ja) * 2007-05-22 2009-01-08 Hoya Corp 治療用物質の運搬投与器具
WO2012005322A1 (ja) * 2010-07-09 2012-01-12 オリンパスメディカルシステムズ株式会社 内視鏡保持装置および内視鏡システム
JP2014045892A (ja) * 2012-08-30 2014-03-17 Olympus Corp シート貼付装置
WO2017043600A1 (ja) * 2015-09-09 2017-03-16 学校法人東京女子医科大学 治療物質運搬デバイス、及び治療物質運搬キット

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023120224A1 (ja) * 2021-12-22 2023-06-29 テルモ株式会社 シート状送達物を適用するための医療機器および方法

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