JP2021094270A - Bone marrow collection device - Google Patents

Abstract

To provide a bone marrow collection device which is low-invasive and hardly damages cells capable of efficiently collecting a large amount of bone marrow liquid or cancellous bone strips with one time insertion without crushing mesenchymal stem cells.SOLUTION: A bone marrow collection device 100 includes a screw tube 10, a rotary drive device 30, and a suction device 50. The screw tube 10 whose inside is hollow is flexible, and includes a spiral convexoconcave part 12 in a hollow wall at a distal part. The rotary drive device 30 rotationally drives a proximal part 14 of the screw tube 10 around its axis. The suction device 50 sucks liquid containing a solid matter from the distal end 10a through the hollow inside 10c of the screw tube 10.SELECTED DRAWING: Figure 1

Description

The present invention relates to a bone marrow collection device that collects bone marrow tissue from bones of a human body or an animal.

Human or animal bone has a structure having cortical bone consisting of hard bones constituting the outer surface and cancellous bone having a large number of small holes and reticulated trabeculae arranged three-dimensionally inside the cortical bone. It has become. In large bones, a bone marrow cavity lacking cancellous bone is formed in the center of the bone.
"Bone marrow" refers to the tissue inside the bone that fills the cancellous bone pits and medullary cavities. The cells contained in the bone marrow are roughly divided into two types. Blood cell lineage cells and the stromal cells that support them. Blood cell lineage cells are, for example, erythroblasts and hematopoietic stem cells, and stromal cells are adipocytes, fibroblasts, endothelial cells, mesenchymal stem cells and the like.

Of these, hematopoietic stem cells are stem cells that can differentiate into all cells of the blood cell lineage such as erythrocytes, leukocytes (lymphocytes, neutrophils, eosinophils, basal cells), platelets, and blood cell lineage cells, and are bone marrow cavities. It is abundant in the bone marrow inside. Stem cells are cells that have self-proliferative ability and pluripotency. Bone marrow transplantation performed when treating patients with hematological cancers such as leukemia, malignant lymphoma, and multiple myeloma is mainly aimed at collecting and transplanting these hematopoietic stem cells. There are about 13,000 patients with cancer of the blood system annually.

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

On the other hand, mesenchymal stem cells include mesenchymal cells such as osteoblasts, bone cells, chondrocytes, and fat cells, endometrial cells such as muscle cells and gastric epithelial cells, epithelial cells, and nerve cells. It is a somatic stem cell capable of differentiating into ectodermal cells. Mesenchymal stem cells are expected to be applied to regenerative medicine such as reconstruction of bones, blood vessels, and myocardium by utilizing this differentiation potential. For example, clinical application has begun in regenerative medicine for osteoarthritis. Mesenchymal stem cells are obtained from a variety of tissues, but the tissue currently used as a cell source for clinical application is bone marrow.
Mesenchymal stem cells are abundant in the bone marrow that fills the cancellous bone pits.

Conventionally, the Asspiration Method (suction method) has been used for collecting bone marrow for bone marrow transplantation. The aspiration method is a method of aspirating bone marrow fluid from the donor's ilium using a bone marrow collection needle.
However, with the suction method using a bone marrow collection needle, only about 10 ml of bone marrow fluid can be collected with one puncture, so it is necessary to collect 500 to 1200 ml of bone marrow fluid about 50 to 300 times, cortical bone. It is necessary to puncture the bone. Therefore, the physical burden on the donor such as invasion by multiple punctures and long-term general anesthesia was heavy. It was also a heavy burden for the operator to have to perforate the hard cortical bone 50 to 300 times.

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

In the "bone marrow collection device" of Patent Document 1, a flexible and flexible drill that is driven by a power unit and has a suction function is installed in a manipulator, and a suction needle is injected into the ilium of a donor to suck bone marrow fluid. Collect. This allows a large amount of bone marrow fluid to be collected from a wide area while the flexible drill passively bends and punctures the bone marrow cavity along the cortical bone in a single puncture.

The “bone marrow collecting device” of Patent Document 2 is provided with a rigid cannula and collects bone marrow cells, blood, and bone fragments. The rigid cannula has an inner surface that defines a proximal end, a distal end, an opening, and an internal passage extending from the opening toward the proximal end. A cutting tip is provided on the rigid cannula at the distal end so that it can be moved axially and radially. A suction force is applied to the passage, and the destroyed bone marrow cells, blood, and bone fragments are drawn into the internal passage and collected. The device also has a rotating shaft coaxially located in the internal passage. The rotating shaft has a cutting bit at its tip that cuts and crushes bone tissue.

The “body tissue recovery device” of Patent Document 3 has a stirring member (whisk) extending from the distal end of the cannula. The device has a suction system that supplies and sucks fluid from the distal end of the cannula. In addition, the cannula is configured to rotate or vibrate.

The “minimally invasive tissue recovery device” of Patent Document 4 includes a handpiece and a tissue recovery mechanism connected to the handpiece. The tissue recovery mechanism includes an open distal tip and a cannula with an outer diameter of less than 5 mm and a rotating member with a spiral thread in the distal portion. The distal portion of the rotating member is located beyond the open distal tip of the cannula and sandwiches the tissue between the spiral threads. The device is designed to draw soft tissue into the cannula as the rotating member rotates, without the need for an auxiliary suction source.

The device of Non-Patent Document 1 is provided with speed and suction control, a removable rotating flexible shaft, and an ergonomic power handle, and when powered, it sucks abundant stem cells into the medullary cavity. Rotate and move. This device is minimally invasive, painless, and can collect the required amount of bone marrow fluid with a single insertion.

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

"MarlowMiner: REGENMED TECHNOLOGY", [online], [Search on October 23, 1st year of Reiwa], Internet <URL: https: // www. regenmed systems. com / technology>

Bone marrow collection has two different purposes. The first purpose is the treatment of leukemia, in which case hematopoietic stem cells are collected as bone marrow fluid. The second purpose is to regenerate bone, viscera, blood vessels, and other organs, in which case mesenchymal stem cells are collected.
As mentioned above, hematopoietic stem cells are mainly contained in the bone marrow fluid in the medullary cavity, and mesenchymal stem cells are mainly contained in the bone marrow that fills the small pores of the cancellous bone.

When the purpose is to collect mesenchymal stem cells, the above-mentioned prior art has the following problems.
(1) Bone marrow fluid is a jelly-like liquid, whereas cancellous bone is a cancellous bone in which thin and hard trabecula are three-dimensionally stretched in a mesh pattern. Therefore, in order for the operator to advance the puncture needle into the bone by the suction method using the bone marrow collection needle, the puncture needle must be advanced while twisting the hard puncture needle and pushing it with a strong force to destroy the trabecula. It can also penetrate excessively and damage other tissues.
(2) When a flexible tube, for example, a flexible shaft, is used as a cannula, when the tip reaches the cancellous bone (cannula-like solid) from the bone marrow cavity, the tube bends even if the end is pushed with a strong force and is distal. The part cannot be inserted into the cannula.
(3) When a drill, a cutting tip, a stirring member, a rotating member, etc. are provided in the distal part in order to insert the tip of the cannula into the cancellous bone, the mesenchymal stem cells (cells having a size of about 30 μm) On the other hand, since shearing force acts, there is a high possibility that cells will be crushed.
(4) Mesenchymal stem cells are more abundant in the cancellous foramen than in the medullary cavity. The cancellous bone pits are small and are surrounded by hard trabeculae. On the other hand, in order to use mesenchymal stem cells for bone marrow transplantation and regenerative medicine, it is necessary to collect them carefully so as not to crush the cells due to the burden of excessive suction force or shear force. Therefore, in order to collect mesenchymal stem cells without destroying them, it was necessary to crush the trabecula of the cancellous bone and collect the bone marrow in the small foramen together with the cancellous bone fragments.

The present invention has been devised to solve the above-mentioned problems. That is, an object of the present invention is minimally invasive cells that can collect a large amount of bone marrow fluid or cancellous bone fragments with a single insertion and can efficiently collect mesenchymal stem cells without disrupting them. The purpose is to provide a bone marrow collection device with less damage.

According to the present invention, it is a bone marrow collection device that collects bone marrow fluid and cancellous bone fragments from a human body or an animal.
A flexible screw tube that is hollow inside and has a spiral concavo-convex part on the hollow wall at the distal part.
A rotary drive device that rotationally drives the proximal portion of the screw tube around its axis,
A suction device for sucking a liquid containing a solid substance from the distal end thereof through the hollow inside of the screw tube is provided.
The screw tube is provided with a bone marrow collection device having a swivel blade provided at the distal end for circularly cutting the cancellous bone and a suction opening provided inside or near the swivel blade for passing the solid matter. To.

Further, according to another embodiment of the present invention, it is a bone marrow collection device that collects bone marrow fluid and cancellous bone fragments from a human body or an animal.
A flexible screw tube that is hollow inside and has a spiral concavo-convex part on the hollow wall at the distal part.
A rotary drive device that rotationally drives the proximal portion of the screw tube around its axis,
A suction device for sucking a liquid containing a solid substance from the distal end thereof through the hollow inside of the screw tube is provided.
The screw tube includes a spindle portion provided in the distal portion and having a spindle shape and the distal end being drawn, and a liquid sampling hole provided in the side surface of the screw tube and communicating the hollow inner surface and the outer surface. , A bone marrow collection device is provided.

According to the present invention, since the inside of the screw tube is hollow and the hollow wall at the distal portion has a spiral concavo-convex portion, the rotational force of the rotational driving device is converted into a linear driving force to advance or advance in the cancellous bone. Retreat is possible.

In addition, although the screw tube is flexible, the spiral uneven portion at the distal portion is held by the cancellous bone, so even if the tip reaches the cancellous bone (cancellous solid), the screw tube Can flexibly follow and move forward in the cancellous bone.
Therefore, according to the present invention, a large amount of bone marrow fluid and cancellous bone fragments can be collected with a single insertion.

Further, since a swivel blade for cutting the cancellous bone in an annular shape is provided at the distal portion of the screw tube, when the distal end reaches the cancellous bone (cancellous solid), the cancellous bone is annularly cut by the swivel blade. Can be cut into.

Further, the swivel blade provided at the distal portion of the screw tube cuts the cancellous bone in an annular shape by combining the rotation and advance of the screw tube. Therefore, since the shearing force does not act on the mesenchymal stem cells (cells having a size of about 30 μm), it is possible to prevent the mesenchymal stem cells from being crushed (cell damage).

Further, since the screw tube has a suction opening for passing solid matter inside or near the swivel blade, the suction device can suck the liquid containing the solid matter from its hand, that is, from the proximal end through the hollow inside of the screw tube. it can. As a result, mesenchymal stem cells of cancellous bone can be efficiently collected without being crushed.

Alternatively, a spindle-shaped spindle portion whose distal end is drawn is provided at the distal end of the screw tube, and a liquid sampling hole for communicating the hollow inner surface and the outer surface is provided on the side surface of the screw tube. .. By screwing the spindle into the cancellous bone, the small holes in the cancellous bone are destroyed, so there were broken trabeculae and inside the small holes in the tunnel in the cancellous bone formed by the spindle. There is a mixture of bone marrow. Here, by further advancing the screw tube, the convex portion of the spiral concavo-convex portion presses the mixture of the broken trabecula and the bone marrow against the inner wall of the tunnel, and the exuded bone marrow fluid is sucked from the liquid collection hole.
As a result, the bone marrow collection device can selectively aspirate the bone marrow fluid that was in the small hole of the cancellous bone, excluding the cancellous bone fragments that cannot pass through the fluid collection hole.

It is an overall block diagram of the bone marrow collection apparatus by this invention. It is an overall block diagram of the 1st Embodiment of a handle device. It is an overall block diagram of a screw tube. It is a 1st Embodiment figure of the distal part of a screw tube. It is a 2nd Embodiment figure of the distal part of a screw tube. It is a 3rd Embodiment figure of the distal part of a screw tube. It is a 4th Embodiment figure of the distal part of a screw tube. It is an overall block diagram of the 2nd Embodiment of a handle device. It is explanatory drawing which shows the use method of the bone marrow collection apparatus by this invention.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. In addition, the same reference numerals are given to common parts in each figure, and duplicate description is omitted.

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

The screw tube 10 is flexible and has a hollow inside from the tip (distal end 10a) to the hand end (proximal end 10b, see FIG. 2). Has. The distal portion means a site at the tip (distal end 10a).
The diameter of the screw tube 10 is preferably 2 to 20 mm, and the total length is preferably 50 to 200 mm. The material may be a metal or alloy used for medical or surgical purposes. For example, it may be made of stainless steel, titanium, or a titanium alloy.
The flexibility of the screw tube 10 is preferably such that it bends comfortably in the ilium along the inner surface of the cortical bone within an elastic range. In other words, this flexibility is preferably such a hardness that the cancellous bone can be cut but the cortical bone cannot be perforated from within the ilium. This flexibility can be set by the wall thickness of the screw tube 10 (for example, 0.2 to 0.6 mm), the depth of the spiral concavo-convex portion 12, and the pitch P.
Details of the screw tube 10 will be described later.

The handle device 20 is a device that the operator grasps and operates the bone marrow collection device 100.
A proximal portion 14 (the end portion on the right side in the figure) of the screw tube 10 is fixed to the handle device 20.

The suction device 50 has a suction pump 52, a sampling pot 54, and a hollow flexible plastic tube 56.
The suction pump 52 sucks the inside of the collection pot 54 under a negative pressure (negative pressure).
The flexible plastic tube 56 connects the suction tube 22 (see FIG. 2) provided in the handle device 20 and the inside of the collection pot 54, and sucks the hollow inside 10c of the screw tube 10 into a negative pressure (negative pressure). To do. The flexible plastic tube 56 is preferably made of flexible plastic.
With this configuration, the suction device 50 can suck the liquid containing the solid matter from the tip (distal end 10a) through the hollow inside 10c of the screw tube 10 and collect the liquid in the collection pot 54.

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

In FIG. 2, the proximal portion 14 (terminal portion) of the screw tube 10 is a hollow circular tube having no spiral concavo-convex portion 12, and is centered on the axis thereof by a plurality of bearings 25a and 25b in the main body of the handle device 20. It is rotatably supported.
Further, a gear 32 is fixed to the proximal portion 14 of the screw tube 10 concentrically with the axial center of the screw tube 10.

The rotary drive device 30 includes a gear 32, a motor 34 with a speed reducer for rotationally driving the gear 32, and a battery 36 for supplying electric power to the motor 34 with a speed reducer.
With this configuration, the motor 34 with a speed reducer can transmit the rotational force to the screw tube 10 via the gear 32.

The motor 34 with a speed reducer preferably has a torque limiter 35 capable of setting a maximum value of rotational torque acting on the screw tube 10.
By setting the maximum value of the rotational torque by the torque limiter 35, it is possible to prevent the swivel blade 16 from cutting a hard tissue such as cortical bone.

The rotation drive device 30 further includes a right rotation switch 37a for rotating the screw tube 10 clockwise, a left rotation switch 37b for rotating left, a right rotation indicator 38a for displaying right rotation, and a left rotation indicator for indicating left rotation. It has 38b.
The shape of the grip portion of the main body 28 of the handle device 20 is set so that the right rotation switch 37a or the left rotation switch 37b can be easily operated by a finger while the operator holds the handle device 20 with one hand.

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

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

The rotary joint 24 tightly connects the tip 22a of the suction pipe 22 and the end 10b of the screw tube 10.
The tip 22a of the suction tube 22 is fixed so as not to rotate, and the end 10b of the screw tube 10 is rotationally driven to rotate clockwise or counterclockwise about its axis.
Therefore, the rotary joint 24 has a seal portion that is liquid-tightly fixed to one of the suction tube 22 and the screw tube 10 (for example, the suction tube 22) and that is liquid-tightly sealed between the other (for example, the screw tube 10). Have.

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

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

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

In FIG. 3C, the cross-sectional shape of the screw tube 10 is a Dharma shape in which the symmetrical position with respect to the axial center of the thin hollow circular tube is recessed toward the axial center. That is, the cross-sectional shape of the screw tube 10 is closed by a pair of convex portions 13a that are convex outward and a pair of concave portions 13b that are convex inward.
In this example, the spiral concave-convex portion 12 is the position of the concave portion 13b, and is formed in a right-handed screw shape on the outer surface on the tip end side of the screw tube 10 at a constant pitch P.

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

In this example, the screw tube 10 is in the form of a double-threaded screw having two spiral concave-convex portions 12 at positions symmetrical with respect to the axis, but the present invention is not limited to this example, and the present invention is not limited to this example. It may be in the form of a screw.

Further, the cross-sectional shape of the spiral concavo-convex portion 12 is an arcuate concave groove in this example, but the present invention is not limited to this, and may be a rectangular groove, a triangular groove, or another shape.
Similarly, the cross-sectional shapes of the convex portion 13a and the concave portion 13b are also arcuate in this example, but the present invention is not limited to this, and may be a rectangle, a triangle, or another shape.

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

The swivel blade 16 is provided at the distal portion of the screw tube 10 and swivels around the axis of the screw tube 10 to cut the cancellous bone in an annular shape.
The swivel blade 16 is located forward in the rotational direction of the distal portion of the screw tube 10 when the screw tube 10 rotates in the normal direction. Further, as shown in FIG. 4C, the swivel blade 16 is provided with a cutting blade 16a so that the chips cut when the screw tube 10 rotates in the normal direction are directed toward the center. As a result, the chips are directed to the suction opening 18 and are sucked into the suction opening 18. For example, a part of the chips generated by the swivel blade 16 shown on the upper side in FIG. 4B is collected inside the swivel blade 16 and is sucked as it is from the suction opening 18. The remaining chips exceed the swivel blade 16 and slide on the outer surface of the screw tube 10 due to the rotation of the screw tube 10 and are sucked from the suction opening 18 on the lower side of this figure.
In FIG. 4B, the swivel blade 16 is a part of a convex portion 13a and a concave portion 13b located forward in the rotational direction of the cross-sectional shape of the screw tube 10 when the screw tube 10 is rotated forward (advanced). ..
The width of the narrowest portion 11 of the swivel blade 16 is preferably 1 mm or more, preferably 2 to 3 mm.
The swivel blade 16 is a hardened metal, for example TiN, and preferably has a hardness suitable for cutting cancellous bone. For example, in the screw tube 10, only the distal portion having the swivel blade 16 may be subjected to nitriding treatment to be cured.

The suction opening 18 is provided inside or near the swivel blade 16 and has a size for passing a solid object.
The suction opening 18 is located in front of the swivel blade 16 in the rotation direction when the screw tube 10 rotates in the normal direction.
In FIGS. 4A and 4B, the suction opening 18 is an opening located in front of the swivel blade 16 in the rotation direction when the screw tube 10 rotates in the normal direction (when moving forward).

The screw tube 10 is provided on the side surface thereof and has a plurality of liquid sampling holes 19 that communicate the hollow inner surface 10c with the outer surface. The liquid sampling hole 19 is provided in the convex portion 13a. The liquid collection hole 19 of the present embodiment is preferably sized to allow the cancellous bone fragments to pass through, but the cancellous bone fragments may not pass through. As a result, the convex portion 13a having the plurality of liquid collection holes 19 is pressed against the inner surface of the tunnel in the cancellous bone formed by the screw tube 10 while being rubbed against the inner surface of the tunnel. The chips can be efficiently sucked from the liquid sampling hole 19.
The liquid sampling hole 19 is preferably drilled. The shape of the liquid sampling hole 19 may be circular, elliptical, or slit-shaped. Further, the liquid sampling holes 19 are preferably arranged in a spiral shape (for example, on the two-point chain line in this figure) intersecting the spiral direction of the spiral concave-convex portion 12. As a result, a large number of liquid sampling holes 19 can be provided while maintaining the strength of the screw tube 10.
The liquid sampling hole 19 may be arranged from the distal end 10a of the screw tube 10 to a position 5 cm to half of the total length of the screw tube 10. The liquid sampling hole 19 may be formed larger toward the tip of the screw tube 10.

The screw tube 10 described above converts the rotational force of the rotational driving device 30 into a linear driving force by the pitch P of the spiral concave-convex portion 12 and advances in the cancellous bone. Due to the configuration of the swivel blade 16, the speed at which the screw tube 10 advances in the cancellous bone and the speed at which the swivel blade 16 scrapes the cancellous bone are the same, so that cells in the bone marrow can be collected without being crushed. Further, at the distal end 10a of the screw tube 10, a suction opening 18 having a size for passing cancellous bone fragments is opened in front of the swivel blade 16 in the rotation direction at the time of normal rotation. The cancellous bone fragments and bone marrow fluid can be sucked from the suction opening 18 into the hollow inside 10c of the screw tube 10 by negative pressure suction.
Therefore, since the bone marrow collection by the screw tube 10 of the present embodiment has less cell damage, it is possible to collect bone marrow tissue dominated by cells in good condition, which can be used for bone marrow transplantation and regenerative medicine. Further, since the screw tube 10 of the present embodiment can collect cancellous bone fragments and the bone marrow tissue around them together, not only for the purpose of collecting hematopoietic stem cells but also at the time of bone marrow collection for the purpose of collecting mesenchymal stem cells. Can also be used.

FIG. 5 is a second embodiment view of the distal portion of the screw tube 10. In this figure, (A) is a side view of the distal portion, and (B) is a view taken along the line BB of (A). The hollow inside 10c of the screw tube 10 is shown in a lattice pattern.
In this example, the swivel blade 16 is a spiral cutting blade provided in a range of one pitch (for example, a range of half the pitch P) from the tip (distal end 10a) of the screw tube 10, and is a spiral cutting blade of the screw tube 10. The cancellous bone is cut into an annular shape by turning around the axis.
In FIG. 5B, the swivel blade 16 is a part of a convex portion 13a and a concave portion 13b located on the rotation downstream side of the cross-sectional shape of the screw tube 10 when the screw tube 10 is rotated forward (when moving forward).

The suction opening 18 is provided inside or near the swivel blade 16 and has a size for passing a solid object. In FIGS. 5A and 5B, the suction opening 18 is located between the swivel blades 16 and is within one pitch range (for example, half the pitch P range) from the tip (distal end 10a) of the screw tube 10. It is an opening provided.
The other distal configurations are the same as in the first embodiment.

Also in the second embodiment of the distal portion described above, the cancellous bone fragments and bone marrow fluid cut by the revolving blade 16 when the rotational force of the rotational driving device 30 is converted into a linear driving force to advance in the cancellous bone. Can be sucked from the suction opening 18 into the hollow inside 10c of the screw tube 10 by negative pressure suction.
The effect of the distal end 10a of the other second embodiment of the screw tube 10 is similar to that of the first embodiment.

FIG. 6 is a third embodiment view of the distal portion of the screw tube 10. In this figure, (A) is a side view of the distal portion, and (B) is a view taken along the line BB of (A). The hollow inside 10c of the screw tube 10 is shown in a lattice pattern.
As in this example, the screw tube 10 prevents clogging in the screw tube 10 by deepening the screw drawing toward the tip and making the inscribed circle 17 between the swivel blades 16 smaller than the narrowest portion 11. May be good.
Other distal configurations and effects are similar to those of the first embodiment.

FIG. 7 is a fourth embodiment view of the distal portion of the screw tube 10. In this figure, (A) is a side view of the distal portion, and (B) is a view taken along the line BB of (A).
In this example as well, the screw tube 10 has a plurality of liquid sampling holes 19 provided on the side surface thereof and communicating the hollow inner surface 10c and the outer surface, as in the first embodiment. The liquid collection hole 19 of the present embodiment has a size that does not allow the cancellous bone fragments to pass through.
With this configuration, more efficient bone marrow fluid can be collected, and the cancellous bone fragments collected at the distal end 10a can be easily fluidly transported to the proximal portion 14 by the flow of suction.

Further, in this example, the screw tube 10 has a spindle portion 15 provided at the distal portion and having a spindle shape, and the distal end 10a is drawn. Alternatively, it is preferable that there is an opening at the distal end 10a of the screw tube 10 and the opening is large enough to prevent the cancellous bone fragments from entering. The spindle portion 15 may have a truncated conical shape with a thin tip side.
The spindle portion 15 is preferably formed by narrowing the distal portion of the screw tube 10 into a spindle shape.
In this case, the swivel blade 16 is not provided, but may be on the distal end 10a or the outer surface of the spindle portion 15.
With this configuration, it is possible to collect more pure bone marrow fluid from the fluid collection hole 19 by preventing the cancellous bone fragments from entering from the distal end 10a. That is, since the distal end 10a has a spindle shape or a truncated cone shape and has no blade, when the screw tube 10 is advanced, the surrounding trabecula is crushed on the side surface of the spindle portion 15 to destroy the small hole structure of the cancellous bone. Will be done. When the screw tube 10 is rotated and advanced as it is, the mixture of the broken trabecula and the bone marrow in the small hole is pressed against the wall surface of the tunnel provided by the spindle portion 15 by the side surface or the convex portion 13a of the spindle portion 15 and pressed. To do. The distal end 10a of the screw tube 10 is closed by drawing, or the opening of the distal end 10a is sized to prevent cancellous bone debris from entering. The liquid collection hole 19 provided in the convex portion 13a is also sized so that the cancellous bone fragments cannot pass through. Therefore, the mixture of the broken trabecula and the bone marrow in the small hole is pressed against the inner wall of the tunnel to squeeze out the exuded bone marrow fluid, and the bone marrow fluid containing mesenchymal stem cells can be selectively aspirated. .. Therefore, the screw tube 10 of the present embodiment can be used at the time of bone marrow collection mainly for the purpose of collecting hematopoietic stem cells.

Further, the pitch P of the spiral uneven portion 12 described above is not limited to a constant value, and may be gradually increased or decreased from the distal portion to the proximal portion 14.
With this configuration, by changing the pitch P of the screw tube 10 (gradual increase or decrease), the bone marrow fluid can be squeezed more efficiently from the medullary cavity by the phase change of the contact surface.

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

FIG. 8 is an overall configuration diagram of the second embodiment of the handle device 20.
In this example, the rotary drive device 30 has a head portion 40, a drive shaft 42, and a motor 34 with a speed reducer.
The head portion 40 is configured such that the proximal portion 14 of the screw tube 10 can be attached and detached, is liquidtight, and can be fixed.
The tip 42a of the drive shaft 42 is liquid-tightly fixed to the head portion 40 and extends concentrically with the screw tube 10 in the right direction in the drawing. Further, the drive shaft 42 is a hollow tube, and is rotatably supported around the axis thereof by a plurality of bearings 25a and 25b in the main body of the handle device 20. Further, the end 42b of the drive shaft 42 is rotatably and liquidtightly connected to the sampling chamber 44 by a sealing device (for example, an O-ring) (not shown).
Further, in this example, the suction tube 22 communicates with the sampling chamber 44 and is fixed to the main body 28 of the handle device 20.

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

Also in the second embodiment of the handle device 20 described above, the rotational force can be transmitted to the screw tube 10 via the gear 32 by the motor 34 with a speed reducer. This rotational motion is converted into a linear motion of the screw tube 10 forward and backward by the screw structure of the spiral concave-convex portion 12.

FIG. 9 is an explanatory diagram showing a method of using the bone marrow collecting device 100 according to the present invention.
In this figure, 1 is the ilium of the human body or animal. When collecting bone marrow, a hole is first drilled in the cortical bone on the surface of the bone.

Next, the distal portion of the screw tube 10 is inserted into the sea surface bone through this hole, and the proximal portion 14 of the screw tube 10 is rotated clockwise about its axis by the right rotation switch 37a. By this rotation, the pitch P of the spiral concavo-convex portion 12 converts the rotational force of the rotational driving device 30 into a linear driving force, and advances while cutting the screw tube 10 into the cancellous bone without applying an unreasonable force. Can be made to.
Further, the left rotation switch 37b rotates the proximal portion 14 of the screw tube 10 counterclockwise about the axis thereof, so that the pitch P of the spiral concave-convex portion 12 does not apply an unreasonable force to the screw tube 10. Can be retracted from within the cancellous bone.

It is preferable that the suction device 50 is always operated during the use of the bone marrow collection device 100.
The swivel blade 16 cuts the cancellous bone in an annular shape by combining the rotation and advancing of the screw tube 10.
Further, the suction device 50 simultaneously collects the cancellous bone fragments cut by the swivel blade 16 and the bone marrow fluid from the suction opening 18 by negative pressure suction.

According to the above-described embodiment of the present invention, since the inside of the screw tube 10 is hollow and the spiral uneven portion 12 is provided on the hollow wall at the distal portion, the rotational force of the rotational drive device 30 is converted into a linear drive force. It is possible to move forward or backward in the cancellous bone.

Further, although the screw tube 10 is flexible, the screw tube 10 is flexible even if the tip 10a reaches the cancellous bone because the spiral uneven portion 12 at the distal portion is held by the cancellous bone. Can follow and move forward in the cancellous bone.

Further, since the swivel blade 16 for cutting the cancellous bone in an annular shape is provided at the distal end 10a of the screw tube 10, the swivel blade 16 is provided when the distal end 10a reaches the cancellous bone (cancellous solid). Allows the cancellous bone to be cut in an annular shape.

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

Further, the swivel blade 16 provided at the distal portion of the screw tube 10 cuts the cancellous bone in an annular shape by combining the rotation and advancing of the screw tube 10. Therefore, since the shearing force does not act on the mesenchymal stem cells (cells having a size of about 30 μm), it is possible to prevent the mesenchymal stem cells from being crushed (cell damage).

Further, since the screw tube 10 has a suction opening 18 for passing solid matter inside or near the swivel blade 16, the suction device 50 sucks the liquid containing the solid matter from the end 10b through the hollow inside 10c of the screw tube 10. be able to. As a result, mesenchymal stem cells of cancellous bone fragments can be efficiently collected without being crushed.
This makes it possible to collect low-damaged stem cells.

Alternatively, a spindle-shaped spindle portion 15 whose distal end is drawn is provided at the distal end 10a of the screw tube 10, and a liquid sampling hole communicating the hollow inner surface 10c and the outer surface is provided on the side surface of the screw tube 10. 19 is provided. By screwing the spindle portion 15 into the cancellous bone, the small holes of the cancellous bone are destroyed. Therefore, in the tunnel in the cancellous bone formed by the spindle portion 15, there is a broken trabecula and a small hole in the cancellous bone. There is a mixture of bone marrow that was present. Here, by further advancing the screw tube 10, the convex portion 13a of the spiral concavo-convex portion 12 presses the mixture of the broken trabecula and the bone marrow against the inner wall of the tunnel, and the exuded bone marrow fluid is discharged from the fluid collection hole 19. Suction.
As a result, the bone marrow collection device 100 can selectively suck the bone marrow fluid in the small hole of the cancellous bone in a state where the cancellous bone fragment that cannot pass through the fluid collection hole 19 is removed.

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

Further, the bone marrow collection device 100 may be used for bone perforation (microfracture method) used for cartilage regeneration. In this case, the cartilage is perforated with the screw tube 10, and then the hollow hole 27 of the screw tube 10 is filled with a mixture of a drug that promotes cartilage regeneration and the collected cancellous bone fragments, instead of the suction device 50. A pressure pump connected to the handle device 20 may feed a mixture of a drug that promotes cartilage regeneration and collected cancellous bone fragments into the perforation.
As a result, the screw tube 10 enables the bone marrow fluid to be continuously supplied to the regeneration target portion of the cartilage defect.

Further, the bone marrow collection device 100 may be used for drilling an elastic substance such as rubber or a soft and brittle substance (gel-like). Since the cutting edge 16a has a shape for discharging chips toward the inside of the screw tube 10 (suction opening 18), for example, it is possible to prevent rubber or gel-like chips from getting entangled with the screw tube 10. You can. Therefore, by using this screw tube 10, it is possible to drill a clean cutting surface.

P pitch, 1 ilium, 10 screw tubes,
10a tip (distal end), 10b end (proximal end), 10c hollow inside,
11 narrowest part, 12 spiral uneven part,
13 spiral part, 13a convex part, 13b concave part,
14 Proximal part (end part), 15 Spindle part, 16 Swing blade, 16a cutting blade,
17 inscribed circle, 18 suction opening, 19 liquid sampling hole,
20 handle device, 22 suction tube, 22a tip, 22b end,
24 rotary joints, 25a, 25b bearings, 27 hollow holes, 28 main bodies,
30 rotary drive, 32 gears, 34 motor with reducer,
35 torque limiter, 36 battery, 37a right rotation switch,
37b left rotation switch, 38a right rotation indicator, 38b left rotation indicator,
40 head part, 42 drive shaft, 42a tip, 42b end,
44 sampling chamber, 50 suction device, 52 suction pump,
54 collection pot, 56 flexible plastic tube,
100 Bone marrow collection device

Claims (10)

A bone marrow collection device that collects bone marrow fluid and cancellous bone fragments from the human body or animals.
A flexible screw tube that is hollow inside and has a spiral concavo-convex part on the hollow wall at the distal part.
A rotary drive device that rotationally drives the proximal portion of the screw tube around its axis,
A suction device for sucking a liquid containing a solid substance from the distal end thereof through the hollow inside of the screw tube is provided.
The screw tube is a bone marrow collection device having a swivel blade provided at the distal end for cutting cancellous bone in an annular shape, and a suction opening provided inside or near the swivel blade for passing the solid matter. A bone marrow collection device that collects bone marrow fluid and cancellous bone fragments from the human body or animals.
A flexible screw tube that is hollow inside and has a spiral concavo-convex part on the hollow wall at the distal part.
A rotary drive device that rotationally drives the proximal portion of the screw tube around its axis,
A suction device for sucking a liquid containing a solid substance from the distal end thereof through the hollow inside of the screw tube is provided.
The screw tube includes a spindle portion provided in the distal portion and having a spindle shape and the distal end being drawn, and a liquid sampling hole provided in the side surface of the screw tube and communicating the hollow inner surface and the outer surface. , A bone marrow collection device. The screw tube can move forward or backward in the cancellous bone by converting the rotational force of the rotational driving device into a linear driving force by the pitch of the spiral uneven portion.
The swivel blade can cut the cancellous bone in an annular shape by combining the rotation and advance of the screw tube.
The bone marrow collection device according to claim 1, wherein the suction device simultaneously collects the cancellous bone fragments cut by the swivel blade and the bone marrow fluid from the suction opening by negative pressure suction. At the time of normal rotation of the screw tube,
The swivel blade is located anterior to the distal portion of the screw tube in the direction of rotation.
The bone marrow collecting device according to claim 1, wherein the suction opening is located in front of the swivel blade in the rotation direction. The bone marrow collecting device according to claim 1 or 2, which is provided on a convex portion of the spiral concavo-convex portion of the side surface of the screw tube and has a liquid collecting hole for communicating the hollow inner surface and the outer surface. The bone marrow collecting device according to claim 1, wherein the swivel blade has a cutting blade that discharges chips toward a suction opening. The handle device is provided so that the proximal portion of the screw tube can be fixed.
The bone marrow according to claim 1 or 2, wherein the handle device includes a rotation driving device, a suction tube for sucking and collecting the cancellous bone fragment and the bone marrow fluid via the screw tube. Sampling device. The rotary drive device includes a head portion that detachably and liquid-tightly fixes the proximal portion of the screw tube, and a hollow drive shaft whose tip is liquid-tightly fixed to the head portion and extends concentrically with the screw tube. The bone marrow collection device according to claim 7, further comprising a motor with a speed reducer for rotationally driving the drive shaft. The bone marrow collecting device according to claim 1 or 2, wherein the pitch of the spiral uneven portion is constant or gradually increases or decreases from the distal portion to the proximal portion. The depth of the concave portion with respect to the convex portion of the spiral concave-convex portion is according to claim 1 or 2, wherein the distal portion is deeply drawn and gradually shallowly drawn from the distal portion toward the proximal portion. Bone marrow collection device.

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