WO2023176531A1

WO2023176531A1 - Lymphangiogenesis-inducing device

Info

Publication number: WO2023176531A1
Application number: PCT/JP2023/008208
Authority: WO
Inventors: 川▲崎▼麻奈美; 石田昌弘; 大沢航介
Original assignee: テルモ株式会社
Priority date: 2022-03-18
Filing date: 2023-03-06
Publication date: 2023-09-21

Abstract

This lymphangiogenesis-inducing device (10) comprises: a puncture member (12) that can be inserted into biological tissue (90); a rod-shaped body (14) inserted through the lumen (122) of the puncture member (12); and a closing part (16) that is joined to the distal end of the rod-shaped body (14) and has a cross-section larger than that of the rod-shaped body (14) to thereby close the lumen (122), the closing part (16) being capable of projecting from a distal-end part (12a) of the puncture member (12) in association with displacement of the rod-shaped body (14). The closing part (16) has a cut formation part (22) for forming a cut at a target site of the biological tissue (90).

Description

Lymphangiogenesis induction device

The present invention relates to a lymphangiogenesis inducing device used in a procedure for inducing lymphangiogenesis.

Lymph vessels are one of the routes for collecting interstitial fluid in living bodies. When lymphatic vessels are blocked, interstitial fluid may accumulate, leading to lymphedema, which is associated with functional decline such as swelling and numbness in limbs such as arms and legs. Lymphedema is said to often develop due to lymph node dissection or radiation therapy performed as part of cancer treatment such as breast cancer treatment.

Lymphedema is a disease that is difficult to completely cure once it develops. Once it becomes chronic, it is difficult to improve easily, and if left untreated, it can become even more severe. As a treatment for such lymphedema, a method of embedding filamentous substances into the subcutaneous tissue has been proposed. For example, Specially opened 2020-127607 Public Bill, International Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Public Bulletin, Special Open 2021-104161 Public Bulletin, and “Brorson H. LipOSUCTION GIVES COMPLETE REDUCTE REDUCTION OF CHRONIC LARGE ARGE ARGE ARMP LYMP Hedema After Breast Cancer. ACTA Oncologica, 2000; 39 (3):407-20.”

291(3): H1402-H1410.” and “Tammela & Alitalo, Lymphangiogenesis: Molecular mechanism.” s and future promise. Cell. 2010 Feb 19; 140(4): 460-76.” reports on the mechanism of lymphatic vessel formation that occurs during the healing process of common wounds. Joseph MR et al, mentioned above, reported that macrophages accumulate as a result of the immune response to a wound, and that the accumulated macrophages produce VEGF-C (vascular endothelial growth factor C), which induces the generation of lymphatic vessels. . Additionally, Tammela & Alitalo mentioned above report that new lymphatic vessels originate from existing lymphatic vessels and appear to bud from the existing lymphatic vessels.

In procedures for inducing lymphangiogenesis, a more effective lymphangiogenesis inducing device is desired.

The present invention aims to solve the above problems.

One aspect of the following disclosure provides a puncturing member having a distal end portion that can be inserted into living tissue, and a lumen extending in the axial direction from the distal end portion toward a proximal end; a rod-shaped body having a small outer diameter, inserted through the inner cavity while forming a gap between the rod-shaped body and displaceable in the front-rear direction along the inner cavity of the puncturing member; a closing part that is joined to the tip, has a larger cross section than the rod-like body, closes the inner cavity, and can protrude from the tip of the puncture member as the rod-like body is displaced; The occlusion section is in a lymphangiogenesis inducing device that includes a wound forming section that inflicts a wound on the target site of the biological tissue.

The lymphangiogenesis inducing device of the above aspect allows the rod-shaped body and the occluding portion to reliably protrude from the puncturing member because the occluding portion prevents tissue fragments from entering the inner cavity of the puncturing member. Therefore, the lymphangiogenesis-inducing device can reliably form a wound that induces lymphangiogenesis at the target site.

FIG. 1 is a longitudinal cross-sectional view of the lymphangiogenesis-inducing device according to the first embodiment. FIG. 2A is a cross-sectional view showing the relationship between the diameters of the occlusion part and the puncture member of the lymphangiogenesis-inducing device of FIG. 1, and FIG. 2B is an enlarged sectional view of the rod-shaped body and the occlusion part. FIG. 3A is an explanatory diagram of the step of puncturing the lymphangiogenesis-inducing device of FIG. 1 into living tissue, and FIG. 3B is an explanatory diagram of the step of moving the lymphangiogenesis-inducing device of FIG. 1 to a target site. FIG. 4A is an explanatory diagram of the step of protruding the rod-shaped body and the occlusion part from the puncture member in FIG. It is an explanatory view of the step of providing. FIG. 5A is a cross-sectional view of the vicinity of the distal end of the lymphangiogenesis-inducing device according to the second embodiment, and FIG. 5B is a perspective view of the rod-shaped body and the occluding portion of FIG. 5A. FIG. 6A is a cross-sectional view of the vicinity of the tip of the lymphangiogenesis-inducing device according to the third embodiment, and FIG. 6B is a perspective view of the vicinity of the tip of the lymphangiogenesis-guiding device of FIG. 6A. FIG. 7A is a perspective view of the closure part according to the fourth embodiment, and FIG. 7B is a perspective view of the closure part according to the fifth embodiment. FIG. 8 is a cross-sectional view of the lymphangiogenesis-inducing device according to the sixth embodiment.

(First embodiment)
Lymphedema is said to be caused by lymphatic vessel dysfunction. When a blockage site occurs in a lymphatic vessel, the blockage site forms a thick and enlarged wall of the vessel. Such a vessel wall narrows or obstructs the flow path of the collecting lymphatic vessel, inhibits drainage of interstitial fluid of the lymphatic vessel, and causes swelling of the extremities.

The lymphangiogenesis-inducing device 10 according to the present embodiment is used to treat lymphatic tissue having the above-mentioned dysfunction. This lymphangiogenesis inducing device 10 promotes the generation of new lymphatic vessels by creating a linear wound at a site that serves as a detour around the blocked site.

As shown in FIG. 1, the lymphangiogenesis inducing device 10 includes a puncture member 12, a rod-shaped body 14, a blocking portion 16, a puncture member hub 18, and a rod-shaped body hub 20. The puncture member 12 has an elongated cylindrical shape. A puncturing member hub 18 is connected to the proximal end 12b of the puncturing member 12. The puncturing member hub 18 has a shape that is easy to grasp, and is used to operate the puncturing member 12. An operator such as a doctor can operate the puncturing member 12 by holding the puncturing member hub 18.

The puncturing member 12 further includes a needle tip 121 and a lumen 122. The needle tip 121 is formed at the tip 12a of the puncturing member 12. The needle tip 121 has a blade surface 123 cut out diagonally with respect to the extending direction of the puncturing member 12 . A sharp tip 124 that can puncture the living tissue 90 is formed at the tip of the blade surface 123 .

A lumen 122 is formed inside the puncture member 12. The lumen 122 extends along the central axis of the puncture member 12, and passes through the puncture member 12 from the distal end 12a to the proximal end 12b in the axial direction. The tip of the inner cavity 122 opens into a blade surface 123 . A proximal end of lumen 122 opens into the interior of puncture member hub 18 . Puncturing member hub 18 has a hollow portion 181 therein that communicates with lumen 122 . As shown in FIG. 2A, the puncture member 12 and the lumen 122 have a circular cross section. The cross-sectional shapes of the puncture member 12 and the lumen 122 are not limited to circular shapes, but may be rectangular or polygonal.

The piercing member 12 can be made of a metal material such as stainless steel, aluminum or an aluminum alloy, titanium, or a titanium alloy (for example, a nickel-titanium alloy). The material of the puncture member 12 may be hard resin, ceramics, or the like. The outer diameter D1 of the puncture member 12 is, for example, about 0.5 to 4.0 mm, and the inner diameter φ of the inner cavity 122 is, for example, about 0.25 to 3.5 mm.

As shown in FIG. 1, the rod-shaped body 14 is inserted into the inner cavity 122 of the puncture member 12. The rod-shaped body 14 is an elongated cylindrical member that is approximately the same as or longer than the entire length of the puncture member 12 . The rod-shaped body 14 may have a solid cylindrical shape, a prismatic tube shape, or a prismatic shape. The proximal end portion 14b of the rod-shaped body 14 protrudes more proximally than the puncturing member 12. A rod-shaped body hub 20 is connected to the base end portion 14b of the rod-shaped body 14. The rod-shaped body hub 20 has a larger outer diameter than the rod-shaped body 14. The operator can grasp the rod-shaped body hub 20 and perform an operation to move the rod-shaped body 14 forward (displaced toward the distal end) or backward (displaced toward the proximal end) in the axial direction. As shown in FIG. 2A, the rod-shaped body 14 has an outer diameter D2 smaller than the inner diameter φ of the inner cavity 122. A gap 15 is formed between the rod-shaped body 14 and the inner cavity 122 . The gap 15 is larger in the radial direction than the gap 13 described later. The gap 15 reduces the contact area between the rod-like body 14 and the inner cavity 122, so that the rod-like body 14 can move forward or backward inside the inner cavity 122 with small sliding resistance.

As shown in FIG. 1, the rod-shaped body 14 has a closing portion 16 at its tip 14a. The occlusion part 16 constitutes the wound forming part 22 of the lymphangiogenesis inducing device 10 of this embodiment. The closing portion 16 of this embodiment has a disk shape. The closing portion 16 is oriented substantially perpendicular to the direction in which the rod-shaped body 14 extends. The closing portion 16 is joined to the tip portion 14a of the rod-shaped body 14 by various methods such as welding, brazing, adhesion, and caulking. Therefore, the closing portion 16 is displaced integrally with the rod-shaped body 14.

As shown in FIG. 2A, the outer diameter D3 of the closing portion 16 is slightly smaller than the inner diameter φ of the inner cavity 122 of the puncture member 12. The difference between the outer diameter D3 of the closed portion 16 and the inner diameter φ of the inner cavity 122 is, for example, 0.005 to 0.2 mm. In this way, most of the lumen 122 is occluded by the occluder 16. A narrow gap 13 is formed between the inner cavity 122 and the closed portion 16. This gap 13 is a gap between the closing portion 16 and the inner cavity 122, and is distinguished from the gap 15 between the rod-shaped body 14 and the inner cavity 122. The gap 13 prevents the passage of tissue fragments, thereby preventing the tissue fragments from clogging the lumen 122 on the proximal side of the closing portion 16.

As shown in FIG. 2B, the closing portion 16 extends in the axial direction with a length L1. The dimension in the length L1 direction of the closing part 16 can be set as appropriate within a range where the forward movement of the closing part 16 is not hindered even if a piece of tissue enters the gap 13. An example of the length L1 of the closing portion 16 can be three times or less the length of the blade surface 123 of the puncturing member 12 in the axial direction. More preferably, it can be made smaller than the inner diameter φ of the inner cavity 122. When the length L1 of the closing portion 16 is smaller than the inner diameter φ of the inner cavity 122, malfunction of the closing portion 16 is prevented even if a piece of tissue enters the gap 13. Another example of the length L1 may be 0.2 to 3.49 mm. Note that if the length L1 of the closing portion 16 is made too small, the rigidity of the closing portion 16 will decrease and deformation will easily occur.

The closing part 16 of this embodiment has an edge 24 as a wound forming part 22. The edge 24 is located at the outer periphery of the closure portion 16. Specifically, the closing portion 16 has edges 24 at the distal and proximal corners of the outer periphery, respectively. The edge 24 is formed over the entire circumferential area of the closing portion 16 . The edge 24 has a small radius of curvature of 0.5 mm or less, preferably 0.001 mm or more and 0.5 mm or less. When such an edge 24 moves forward or backward within the living tissue 90, it can form a wound in the living tissue 90.

The lymphangiogenesis inducing device 10 of this embodiment is configured as described above. The procedure using the lymphangiogenesis inducing device 10 has the following steps.

Prior to puncturing with the lymphangiogenesis inducing device 10, the operator confirms the occluded site of the lymphatic vessel in advance. The site of lymphatic occlusion can be confirmed by methods such as ICG lymphatic angiography, lymphoscintigraphy, MRI, CT, and ultrasound imaging. Next, the operator confirms the new route of lymph vessels. For example, the operator identifies a blocked site of a lymphatic vessel and determines a route that connects to an unoccluded lymphatic vessel adjacent to the blocked site. Further, for example, the operator determines a route that bypasses the blocked site of the lymphatic vessel.

Next, as shown in FIG. 3A, a step of puncturing the lymphangiogenesis inducing device 10 is performed. The lymphangiogenesis inducing device 10 punctures the target site from the needle tip 121 of the puncture member 12. To prevent tissue debris from entering the lumen 122 of the puncture member 12, the occlusion 16 is positioned near the distal end of the lumen 122 of the puncture member 12.

Next, as shown in FIG. 3B, a step of advancing the lymphangiogenesis inducing device 10 to a predetermined site of the living tissue 90 is performed. Through this step, the needle tip 121 of the puncture member 12 is placed at a predetermined site where wounding is to be started. While advancing the puncture member 12, a portion of the living tissue 90 enters the lumen 122. Occlusion 16 prevents tissue debris from entering lumen 122 . In other words, the tissue piece is prevented from entering into the proximal side of the closing part 16 . This can prevent the occurrence of a problem in which the gap 15 between the rod-shaped body 14 and the inner cavity 122 is clogged with tissue pieces and the rod-shaped body 14 cannot move forward.

Next, as shown in FIG. 4A, a step of creating a wound using the occluding portion 16 is performed. In this step, the rod-shaped body 14 and the closure part 16 are advanced toward the distal end with respect to the puncture member 12. The above operation is performed by pushing the rod-shaped hub 20 toward the tip. This step may be an operation of retracting the puncture member 12 to the proximal end. Alternatively, in this step, an operation of pulling the puncture member 12 toward the proximal end and an operation of pushing the puncture member 12 toward the distal end may be performed alternately. As a result, the closed portion 16 is exposed inside the living tissue 90 as shown in the figure.

Next, as shown in FIG. 4B, inside the living tissue 90, a step of retracting the occluding portion 16 toward the proximal end or advancing the occluding portion 16 toward the distal end is performed. If necessary, the closing portion 16 may be moved forward and backward multiple times. This step causes the edge 24 of the closure part 16 to rub against the living tissue 90. As a result, many minute wounds are formed in the living tissue 90 by the edges 24 of the closed portion 16. Fine wounds are formed along the path along which the occlusion section 16 moves. In order to form a wound more reliably, an operation of advancing the rod-shaped body 14 or an operation of rotating the rod-shaped body 14 and the closure part 16 may be performed as necessary. This step includes an operation of retracting the puncture member 12 proximally. This step is completed when the puncture member 12 and the closure part 16 are completely withdrawn from the living tissue 90.

Through the above steps, wounding at one location is completed. By repeating the above steps for other routes, wounds are formed for all desired routes, and the procedure using the lymphangiogenesis inducing device 10 of this embodiment is completed.

According to the above procedure, during the healing process of a linear wound, immune cells accumulate in the wound due to an immune response to the wound. The accumulated immune cells enhance the expression of lymphatic growth factors. Therefore, the lymphangiogenesis-inducing device 10 of this embodiment can induce lymphangiogenesis.

(Second embodiment)
As shown in FIG. 5A, the lymphangiogenesis inducing device 10A of this embodiment has a rod-shaped body 14A and an occlusion part 16 connected to form an L-shape when viewed from the side. In addition, in the lymphangiogenesis inducing device 10A of this embodiment, the same components as the lymphangiogenesis inducing device 10 of FIG. Furthermore, in the lymphangiogenesis inducing device 10A of FIG. 5A, the puncture member hub 18 and the rod-shaped body hub 20 are the same as those in FIG. 1, so illustration and description thereof will be omitted.

As shown in FIG. 5B, the rod-shaped body 14A has an arcuate cross-sectional shape. The rod-shaped body 14A has a thin plate shape that is curved along the inner cavity 122 of the puncture member 12. The closing portion 16 is integrally connected to the rod-shaped body 14A. The closing portion 16 is connected to the rod-shaped body 14A via a bent portion 161.

The lymphangiogenesis inducing device 10A of this embodiment is configured as described above. The lymphangiogenesis inducing device 10A has the same effects as the lymphangiogenesis inducing device 10 of the first embodiment. Furthermore, in this embodiment, the rod-shaped body 14A and the closing portion 16 can be formed by pressing a single metal plate, simplifying the structure and manufacturing process.

(Third embodiment)
The lymphangiogenesis inducing device 10B of this embodiment has a closing portion 16A that is inclined with respect to the central axis of the puncture member 12, as shown in FIG. 6A. In addition, in the lymphangiogenesis induction device 10B of this embodiment, the same code|symbol is attached|subjected to the structure similar to the lymphangiogenesis induction device 10 of FIG. 1, and the detailed description is abbreviate|omitted. Furthermore, in the lymphangiogenesis inducing device 10B of FIG. 6A, the puncture member hub 18 and the rod-shaped body hub 20 are the same as those in FIG. 1, so illustration and description thereof will be omitted.

As shown in FIG. 6B, the obstructing portion 16A has an inclination angle with respect to the axial direction that is equal to the inclination angle of the blade surface 123 of the puncturing member 12 with respect to the axial direction. In the initial state, the closing portion 16A is arranged at the same position as the needle tip 121, and the closing portion 16A forms the same plane as the blade surface 123. The closing portion 16A has an edge 24A at a corner of the outer periphery. The closing portion 16A inflicts a wound on the living tissue 90 by the edge 24A.

The lymphangiogenesis inducing device 10B of this embodiment has the same effects as the lymphangiogenesis inducing device 10 of FIG. 1. Furthermore, the lymphangiogenesis-inducing device 10B of this embodiment can further reduce the amount of tissue debris that invades the lumen 122. Thereby, the lymphangiogenesis inducing device 10B can more effectively prevent malfunctions due to clogging of the lumen 122 with tissue debris. Further, since the closing portion 16A is inclined with respect to the rod-shaped body 14, when the closing portion 16A is advanced through the rod-shaped body 14, it is less likely to receive resistance inside the living tissue 90, and the forward operation can be performed easily.

(Fourth embodiment)
As shown in FIG. 7A, the closing portion 16B of this embodiment has a side cutter. The closing portion 16B has a plurality of sawtooths 26 on the tip and outer periphery. This closing portion 16B can be used in place of the closing portion 16 in FIG. 1. As shown in FIG. 7A, the closing portion 16B has a plurality of sawtooths 26a extending radially in the radial direction toward the distal end, and sawtooth teeth 26b extending toward the outer periphery. The saw teeth 26b protrude toward the outer periphery. The sharp ridgeline portions of these sawtooths 26a and 26b constitute the edge 24B of this embodiment. Moreover, the sawtooth 26b has an inclined surface that generates a directional force that moves forward or backward when the closing portion 16B is rotated.

The closing portion 16B of this embodiment can inflict fine wounds on the living tissue 90 not only by forward and backward movement but also by rotational movement. Moreover, the closing part 16B moves forward by the rotational movement, and can inflict a wound on the living tissue 90 as the closing part 16B moves forward.

(Fifth embodiment)
As shown in FIG. 7B, the closing portion 16C of this embodiment has a conical surface 162 on the outer periphery. This closing portion 16C can replace the closing portion 16 in FIG. 1. The closing portion 16C has a conical surface 162 whose outer diameter gradually decreases toward the tip. The closed portion 16C has the largest outer diameter at the proximal end. The closing portion 16C blocks the lumen 122 (see FIG. 1) at the proximal end, thereby preventing tissue fragments from entering the lumen 122.

Note that the closing portion 16C of this embodiment may have a completely conical shape without having a flat surface at the tip. Further, the closing portion 16C may have a conical surface having the largest outer diameter on the distal end side and gradually decreasing the outer diameter toward the proximal end side.

(Sixth embodiment)
As shown in FIG. 8, the lymphangiogenesis inducing device 10C of the present embodiment includes a puncture member 12, a rod-shaped body 14A, a blocking portion 16, a puncture member hub 18, a rod-shaped body hub 20, a wire 28, It has a wire hub 30. In addition, in the lymphangiogenesis induction device 10C of this embodiment, the puncture member 12, the puncture member hub 18, and the rod-shaped body hub 20 are the same as the puncture member 12, the puncture member hub 18, and the rod-shaped body hub 20 in FIG. It is similar to Moreover, in the lymphangiogenesis induction device 10C, the rod-shaped body 14A and the occlusion part 16 are the same as the rod-shaped body 14A and the occlusion part 16 shown in FIGS. 5A and 5B.

The wire 28 is made of, for example, a metal wire. For example, the wire 28 has one end 28a connected to the closure part 16. The wire 28 may be connected to the tip side of the rod-shaped body 14A. That is, one end 28a of the wire 28 is connected to a portion of the rod-shaped body 14A or the closure portion 16 that can protrude from the puncture member 12. A portion of the wire 28 on the other end 28b side is accommodated in the gap 15 between the inner cavity 122 of the puncture member 12 and the rod-shaped body 14A. The other end 28b of the wire 28 is joined to a wire hub 30. The wire hub 30 is attached to the rod-shaped body hub 20. The wire hub 30 is movable relative to the puncture member hub 18 and the rod-shaped body hub 20 in the axial direction.

As shown in the figure, when the wire hub 30 is advanced with the closing portion 16 protruding toward the distal end from the distal end 12a of the puncture member 12, the portion of the wire 28 exposed from the puncture member 12 is loosened, and the wire 28 is rotated in the axial direction. spread outward. When the wire hub 30 is pulled toward the proximal end, the wire 28 is pulled toward the proximal end and becomes taut, thereby arranging the rod-like bodies 14A in parallel in the vicinity of the rod-like bodies 14A.

The lymphangiogenesis inducing device 10C of this embodiment can repeatedly relax and tension the wire 28 by operating the wire hub 30 inside the living tissue 90. The subcutaneous tissue (mainly adipose tissue) in which interstitial fluid accumulates is flexible. When the wire 28 is relaxed, the biological tissue 90 enters the gap 13 between the wire 28 and the rod-shaped body 14A. Thereafter, when the wire hub 30 retreats, the wire 28 is tensed, and the flexible living tissue 90 (mainly fat tissue) that has entered between the wire 28 and the rod-shaped body 14A is cut, thereby creating a wound. Such a wound induces new lymphatic vessel formation during the healing process.

As described above, the lymphangiogenesis inducing device 10C of this embodiment is capable of inflicting a wound by relaxing and tensioning the wire 28 in addition to inflicting a wound by advancing and retracting the rod-shaped body 14A and the occlusion part 16. . The wound can be applied by the wire 28 over a wider range than the movement range of the closure part 16. Therefore, the lymphangiogenesis inducing device 10C can more effectively promote the generation of lymphatic vessels.

The above

lymphangiogenesis inducing devices

10, 10A, 10B, and 10C are summarized as follows.

Lymphangiogenesis induction devices

10, 10A, 10B, 10C include a puncture member 12 having a distal end 12a that can be inserted into living tissue 90, and a lumen 122 extending in the axial direction from the distal end toward the proximal end. , having an outer diameter smaller than the inner cavity of the puncturing member, passing through the internal cavity while forming a gap 15 between the puncturing member and extending in the front-rear direction along the internal cavity of the puncturing member. A displaceable rod-shaped body 14 is joined to the tip of the rod-shaped body and has a larger cross section than the rod-shaped body to close the inner cavity, and as the rod-shaped body is displaced, the tip of the puncturing

member occlusion parts

16, 16A, 16B, and 16C that can protrude from the body tissue, and the occlusion part has a wound forming part 22 that inflicts a wound on the target part of the living tissue.

In the above-mentioned lymphangiogenesis inducing device, the rod-shaped body and the occluding portion can reliably protrude from the puncturing member because the occluding portion prevents tissue fragments from entering the inner lumen of the puncturing member. Therefore, the lymphangiogenesis-inducing device can reliably form a wound that induces lymphangiogenesis at the target site.

In the above lymphangiogenesis inducing device, the wound forming part may have

sharp edges

24, 24A, and 24B formed on the outer periphery of the occlusion part. This lymphangiogenesis inducing device can create a wound that induces new lymphatic vessel generation at a predetermined site by moving the occluded part within the living tissue.

In the above lymphangiogenesis inducing device, the wound forming part may have an uneven shape formed on the surface of the occluding part. This lymphangiogenesis inducing device can form minute wounds by rubbing the uneven shape against living tissue.

In the above lymphangiogenesis inducing device, the wound forming section may have a side cutter formed in the occlusion section. This lymphangiogenesis-inducing device can efficiently form a wound in living tissue with a large number of saw teeth.

In the above lymphangiogenesis inducing device, the occlusion portion may have a disk shape. This lymphangiogenesis-inducing device can simplify the structure and manufacturing process, making it easy to manufacture.

In the above-described lymphangiogenesis inducing device, the wound forming section may include a wire 28 that has one end 28a attached to the occlusion section and that is inserted through the inside of the lumen. This lymphangiogenesis-inducing device can form a wound in a wider range by relaxing and tensioning the wire 28.

In the above lymphangiogenesis inducing device, the rod-shaped body may be movable in the axial direction while being rotated around the axis. This lymphangiogenesis-inducing device can efficiently inflict a large number of wounds by moving in the axial direction with rotational motion.

The above-mentioned lymphangiogenesis inducing device includes a puncture member hub 18 that supports the proximal end of the puncture member, and a rod-shaped body hub 20 that supports the base end of the rod-shaped body, and the rod-shaped body hub supports the puncture member. By moving the rod-shaped body relative to the member hub, the rod-shaped body may be able to be protruded from and retracted from the distal end portion of the puncturing member. This lymphangiogenesis inducing device allows the rod-shaped body and the obstruction portion to protrude through the rod-shaped body hub, and has excellent operability.

The above-mentioned lymphangiogenesis inducing device includes a puncture member hub that supports the proximal end of the puncture member, a rod-shaped body hub that supports the base end of the rod-shaped body, and a wire hub 30 joined to the other end 28b of the wire. , the rod-shaped body hub is moved relative to the puncturing member hub so that the rod-shaped body can be protruded and retracted from the tip of the puncturing member, and the wire hub is moved relative to the puncturing member hub. The wire may be relaxed or tensioned by moving it relative to the wire. This lymphangiogenesis inducing device can manipulate the relaxation and tension of the wire through the wire hub, and has excellent operability.

Note that the present invention is not limited to the embodiments described above, and can take various configurations without departing from the gist of the present invention.

Claims

a puncture member having a distal end that can be inserted into living tissue, and a lumen that extends in the axial direction from the distal end toward the proximal end;
It has an outer diameter smaller than the inner cavity of the puncturing member, is inserted through the internal cavity while forming a gap with the internal cavity, and is movable in the front-rear direction along the internal cavity of the puncturing member. A rod-shaped body,
a closing part that is joined to the tip of the rod-shaped body, has a larger cross section than the rod-shaped body, closes the inner cavity, and can protrude from the tip of the puncture member as the rod-shaped body is displaced; , comprising;
The closing part has a wound forming part that applies a wound to the target site of the living tissue.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to claim 1, wherein the wound forming part has a sharp edge formed on the outer periphery of the occluded part.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to claim 1 or 2, wherein the wound forming part has an uneven shape formed on the surface of the occluding part.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to any one of claims 1 to 3, wherein the wound forming part has a side cutter formed in the occluding part.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to any one of claims 1 to 4, wherein the occlusion part has a disk shape.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to any one of claims 1 to 5, wherein the wound forming section has a wire that is attached at one end to the occlusion section and that is inserted through the interior of the lumen.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to any one of claims 1 to 6, wherein the rod-shaped body is movable in the axial direction while being rotated around the axis.
Lymphangiogenesis induction device.
The lymphangiogenesis inducing device according to any one of claims 1 to 7, comprising: a puncture member hub that supports the proximal end of the puncture member; and a rod-shaped body hub that supports the proximal end of the rod-shaped body. have,
The rod-shaped body hub is moved relative to the puncturing member hub so that the rod-shaped body can be protruded from and retracted from the distal end portion of the puncturing member.
Lymphangiogenesis induction device.
7. The lymphangiogenesis inducing device according to claim 6, wherein a puncture member hub that supports the proximal end of the puncture member, a rod-shaped body hub that supports the proximal end of the rod-shaped body, and a puncture member hub that is joined to the other end of the wire. a wire hub;
The rod-shaped body hub is moved relative to the puncturing member hub to allow the rod-shaped body to protrude and retract from the tip of the puncturing member,
The wire hub relaxes or tensions the wire by moving it relative to the rod-shaped body hub.
Lymphangiogenesis induction device.