ES2348481T3 - Mecanismo de bloqueo de pomo giratorio para máquina grapadora quirúrgica. - Google Patents

Mecanismo de bloqueo de pomo giratorio para máquina grapadora quirúrgica. Download PDF

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Publication number
ES2348481T3
ES2348481T3 ES07017289T ES07017289T ES2348481T3 ES 2348481 T3 ES2348481 T3 ES 2348481T3 ES 07017289 T ES07017289 T ES 07017289T ES 07017289 T ES07017289 T ES 07017289T ES 2348481 T3 ES2348481 T3 ES 2348481T3
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surgical stapling
stapling machine
locking mechanism
knob
machine according
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Paul A. Scirica
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Covidien LP
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Tyco Healthcare Group LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2923—Toothed members, e.g. rack and pinion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • A61B2017/293—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft with means preventing relative rotation between the shaft and the actuating rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means

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

Abstract

Una máquina grapadora quirúrgica (10) que comprende: un bastidor (12); una pieza de actuación (28); una porción de cuerpo alargado (14) soportado para su rotación alrededor del bastidor; un pomo (32) para rotación de la porción de cuerpo; y un mecanismo de bloqueo (50) para impedir la rotación de la porción de cuerpo alargado, que es automáticamente embragado con el accionamiento de la pieza de accionamiento, y caracterizada porque: el mecanismo de bloqueo comprende una pieza de bloqueo (52) que está montada pivotante (50a) en el bastidor para presionar contra el pomo para provocar la resistencia a la rotación del pomo.

Description

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ANTECEDENTES
Campo Técnico
La presente descripción se refiere a una máquina grapadora quirúrgica que tiene
��
una cabeza grapadora giratoria para aplicar grapas a un tejido. Más concretamente, la
descripción se refiere a una máquina grapadora quirúrgica que tiene un mecanismo de
bloqueo para impedir la rotación de la cabeza grapadora.
Antecedentes de la Técnica Relacionada
���
Dispositivos quirúrgicos para sujetar o grapar tejido entre estructuras
mandibulares opuestas de un ensamblaje de herramienta y posteriormente abrochar el
tejido grapado son conocidos en la técnica. La solicitud de patente de Estados Unidos
nº 2004/0232201 describe una máquina grapadora quirúrgica de esta clase.
Están funcionando procedimientos quirúrgicos laparoscópicos y/o endoscópicos
���
a través de pequeñas incisiones o a través de estrechas cánulas insertadas a través
de pequeñas heridas de entrada en un paciente. En procedimientos convencionales o
abiertos, los cirujanos acceden directamente al sitio donde operar. Con el fin de
reducir el trauma al paciente, acortar períodos de recuperación del paciente y reducir
sustancialmente el coste global, se prefieren procedimientos laparoscópicos antes que
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procedimientos abiertos. Con el fin de atender las necesidades específicas de los
procedimientos quirúrgicos endoscópicos y/o laparoscópicos, han sido desarrolladas
máquinas grapadoras quirúrgicas endoscópicas que suministran al cirujano una mayor
manejabilidad de la cabeza grapadora del dispositivo quirúrgico.
La cabeza grapadora del dispositivo quirúrgico para utilizar en procedimientos
���
endoscópicos y/o laparoscópicos está montada en el extremo distal de un eje
alargado, que permite insertar la cabeza grapadora a través de una pequeña incisión o
cánula estrecha. El extremo proximal del eje alargado es giratorio y está soportado por
la empuñadura de la grapadora. La capacidad de girar del eje alargado permite al
cirujano orientar selectivamente la cabeza grapadora para sujetar o enganchar mejor
���
el tejido. Típicamente, estas máquinas grapadoras incluyen un pomo posicionado en el
extremo proximal del eje alargado para proveer un medio de sujeción con capacidad
de giro para orientar la cabeza grapadora. Tyco Healthcare Group, LP ha fabricado y
comercializado instrumentos para grapar endoscópicos que incluyen un pomo
giratorio, tales como el MULTIFIRE ENDO GIA *30, MULTIFIRE ENDO GIA *60 y
ENDO GIA *Universal, durante varios años. Estos instrumentos han suministrado
beneficios clínicos significativos al campo de la cirugía endoscópica.
Una máquina grapadora quirúrgica que incluye un mecanismo de bloqueo para
impedir la rotación de la cabeza grapadora, una vez que el cirujano ha orientado la
�� cabeza grapadora en la posición deseada, está descrita en EP-A-702937, de donde emana el preámbulo de la reivindicación independiente 1.
COMPENDIO
La invención está definida en la reivindicación 1 más adelante. Las
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reivindicaciones dependientes están dirigidas a características óptimas y realizaciones preferentes. Se proporciona una máquina grapadora quirúrgica que tiene un mecanismo de bloqueo de pomo giratorio. La máquina grapadora quirúrgica incluye un bastidor, una pieza de accionamiento, una porción de cuerpo alargado soportado con capacidad de giro en el bastidor, y un mecanismo de bloqueo para impedir el giro de la
���
porción de cuerpo alargado, mecanismo de bloqueo que es embragado automáticamente ante la actuación de la pieza de accionamiento. El mecanismo de bloqueo de la máquina grapadora quirúrgica incluye una pieza montada pivotante y configurada para presionar contra el pomo para provocar por rozamiento resistencia al giro del pomo.
���
La máquina grapadora quirúrgica puede incluir un ensamblaje de herramienta articulada. Puede estar incluida una pieza de articulación para articular el ensamblaje de herramienta. La pieza de articulación está situada en el pomo que se utiliza para girar la porción de cuerpo alargado.
La máquina grapadora quirúrgica incluye además un elemento de agarre. El
���
elemento de agarre incluye una empuñadura operable conectada a la pieza de actuación. El engatillado de la empuñadura embraga el mecanismo de bloqueo. En cambio, la liberación de la empuñadura desembraga el mecanismo de bloqueo. El mecanismo de bloqueo de la grapadora quirúrgica se desembraga automáticamente al liberar la pieza de actuación.
���
En otra realización, una máquina grapadora quirúrgica incluye un elemento de agarre que incluye una pieza de actuación, una pieza de cuerpo alargado giratorio soportado en el elemento de agarre, y medios de bloqueo para impedir la rotación de la pieza de cuerpo alargado ante el accionamiento de la citada pieza de actuación. La máquina grapadora quirúrgica incluye un pomo para la rotación de la porción de
cuerpo alargado y un ensamblaje de herramienta articulado en el extremo distal de la
porción de cuerpo alargado.
En otra realización, el elemento de agarre incluye además una empuñadura
operable conectada a la pieza de actuación. El movimiento del gatillo embraga el
��
mecanismo de bloqueo. El mecanismo de bloqueo incluye una pieza montada
pivotante configurada para embragar el pomo. La pieza montada pivotante puede ser
de cualquier forma, incluyendo una chapa plana, un cilindro o un cuadrado, y puede
incluir también una arandela o una superficie rugosa para embragar por fricción el
pomo.
���
BREVE DESCRIPCION DE LOS DIBUJOS
Los objetos y ventajas precedentes de la presente invención pueden ser
entendidos más fácilmente por un especialista en la técnica teniendo como referencia
la descripción detallada que sigue de las realizaciones preferentes de la misma,
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tomada conjuntamente con los dibujos que se acompañan, en los que:
La FIG. 1 es una vista lateral de una máquina grapadora quirúrgica que tiene
un mecanismo de bloqueo de pomo giratorio de acuerdo con la presente
invención;
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la FIG. 2 es una vista superior de la máquina grapadora quirúrgica de la FIG.1;
la FIG. 3 es una vista parcial lateral del corte transversal de la máquina
grapadora quirúrgica de las FIGS. 1-2;
la FIG. 4 es una vista lateral en perspectiva del mecanismo de bloqueo de la
máquina grapadora quirúrgica mostrada en FIGS.1-3, en una posición
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desembragada y desbloqueada;
la FIG. 5 es una vista lateral en perspectiva del mecanismo de bloqueo de la
FIG. 4, en una posición embragada y bloqueada;
la FIG. 6 es una vista lateral de una realización alternativa de una máquina
grapadora quirúrgica que tiene mecanismo de bloqueo giratorio de acuerdo con
���
la presente invención.
la FIG: 7 es una vista lateral de la máquina grapadora quirúrgica de la FIG. 6
orientada en una segunda configuración; y
la FIG. 8 es una vista parcial lateral de un corte transversal de la máquina
grapadora de las FIGS. 6-7.
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DESCRIPCION DETALLADA DE REALIZACIONES PREFERENTES
Se describen ahora en detalle realizaciones preferentes de la presente
descripción de la máquina grapadora quirúrgica con referencia a los dibujos en los que
las referencias numéricas iguales designan elementos idénticos o correspondientes en
�� cada una de las diferentes vistas. En la descripción que sigue, el término “proximal”, como es tradicional, se referirá al extremo de la máquina grapadora que está más cercano del operador, mientras que el término “distal” se referirá al extremo de la máquina que está más lejano del operador.
Las FIGS. 1-5 ilustran una realización preferente de la presente descripción de
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máquina grapadora quirúrgica mostrada genéricamente como 10. Se aprecia que estas máquinas grapadoras quirúrgicas son bien conocidas en la técnica y pueden incluir cualquier número de características varias que dependen de la aplicación. Como tal, la máquina grapadora quirúrgica 10 sólo será descrita en detalle en relación al mecanismo de bloqueo de la presente descripción.
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Con referencia ahora a las FIGS 1 y 2, la máquina grapadora quirúrgica 10 incluye un elemento de agarre 12 y un cuerpo alargado 14. El elemento de agarre 12 incluye una pieza de empuñadura fija 26, una empuñadura móvil o gatillo 28 y una porción de tubo 30. El elemento de agarre 12 incluye además el bastidor 38 y está hecho preferiblemente de plástico moldeado en dos medias secciones de bastidor 38a
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y 38b. Alternativamente, pueden utilizarse otros materiales para hacer el bastidor, incluyendo metales, por ejemplo acero inoxidable. El bastidor 38 comprende la empuñadura fija 26 y la porción de tubo 30 del elemento de agarre 12. La empuñadura móvil 28 está soportada con capacidad giratoria entre las medias secciones 38a y 38b del bastidor. Una pieza giratoria o pomo 32 está montada con capacidad giratoria
���
en el extremo delantero de la porción de tubo 30 y asegurada en el extremo proximal 14a de la pieza de cuerpo alargado 14. La pieza giratoria 32 está configurada para facilitar el giro de la pieza de cuerpo alargado 14 respecto al elemento de agarre 12. La pieza giratoria 32 está hecha preferentemente de una pieza de plástico moldeado en dos medias secciones 32a y 32b. La pieza giratoria 32 puede además estar
���
ranurada o estriada para facilitar el agarre. Un ensamblaje de herramienta 20 está soportado en el extremo distal 14b del cuerpo alargado 14. El ensamblaje de herramienta 20 incluye un ensamblaje de cartucho 22 y un ensamblaje de yunque 24.
Con referencia ahora a la FIG 3, el elemento de agarre 12 incluye además un mecanismo de actuación 40 operativamente conectado a la empuñadura móvil 28. El
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mecanismo de actuación 40 incluye un linguete con muelle cargado 44 configurado
para engranar y avanzar una cremallera dentada 60 cuando se opera la empuñadura móvil 28. La cremallera dentada 60 está conectada operativamente al extremo proximal 58a de la varilla de disparo 58. La varilla de disparo 58 tiene la longitud del cuerpo alargado 14. El extremo distal de la varilla de disparo 58 está configurado para
�� conectarse operativamente con el ensamblaje de herramienta 20 (FIG 2). En realizaciones alternativas, la varilla de disparo 58 y el cuerpo alargado 14 pueden incluir más de una sección, y pueden incluir además una o más juntas articuladas.
El elemento de agarre 12 incluye además un mecanismo de bloqueo 50. El mecanismo de bloqueo 50 incluye una pieza de bloqueo 52 y una pieza de embrague
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53 soportada en el extremo distal 52a de la pieza de bloqueo 52. La pieza de embrague 53 puede comprender una arandela, u otra pieza elástica o de fricción de cualquier forma capaz de embragar la pieza giratoria 32. El extremo proximal 52b de la pieza de bloqueo 52 está montado pivotante al bastidor 38 alrededor del punto 50a con la porción de tubo 30 del elemento de agarre 12. El extremo distal 52a de la pieza
���
de bloqueo 52 va desde la porción de tubo 30 hasta la pieza giratoria 32. La pieza giratoria 32 está configurada para recibir el extremo distal 52a de la pieza de bloqueo 52, incluyendo la arandela 53. La pieza de bloqueo 52 está configurada para enganchar en el extremo distal 60a de la cremallera dentada 60 durante la operación de la empuñadura móvil 28. Un extremo proximal 52b de la pieza de bloqueo 52
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incluye una superficie de leva para enganchar con el extremo distal 60a de la cremallera dentada 60.
Con referencia ahora a las FIGS. 4 y 5, el mecanismo de bloqueo 50 se mantiene en una posición de desbloqueo (FIG. 4) anterior a la actuación de la máquina grapadora 10. Cuando el mecanismo de bloqueo 50 está en una posición de
���
desbloqueo la pieza giratoria 32 puede girar libremente. De esta manera, el ensamblaje de herramienta 20 situada en el extremo distal 14a del cuerpo alargado 14 puede ser orientado de tal manera que el ensamblaje de cartucho 22 y el ensamblaje de yunque 24 están en mejor orientación para sujetar el tejido a ser grapado.
Con la operación de la empuñadura móvil 28, el mecanismo de actuación 40
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avanza la cremallera dentada 60. El avance de la cremallera dentada 60 provoca que el extremo distal 60a de la cremallera dentada 60 embrague la superficie de leva en el extremo proximal 52b de la pieza de bloqueo 52 (FIG. 5). El embrague con la cremallera dentada 60 provoca que la pieza de bloqueo 52 pivote alrededor del punto 50a. De esta manera, la arandela 53 soportada en el extremo distal 52a de la pieza de
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bloqueo 52 es presionada hacia la superficie interior de la pieza giratoria 32,
enganchando por fricción la pieza giratoria 32. En la posición de bloqueo o embragado, el mecanismo de bloqueo 50 proporciona resistencia al giro de la pieza giratoria 32.
La pieza de actuación 40 puede estar configurada de tal manera que un disparo
�� de la empuñadura móvil 28 provoque la retracción de la cremallera dentada 60. Por ejemplo, la cremallera dentada 60 puede estar predispuesta en una dirección proximal. En una realización alternativa, la cremallera dentada 60 puede estar ligada a pomos de retracción (no mostrados), para la retracción manual de la cremallera dentada 60. La retracción de la cremallera dentada 60 provoca que el extremo distal 60a de la
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cremallera dentada 60 se desembrague de la pieza de bloqueo 52. El desembrague de la pieza de bloqueo 52 de la cremallera dentada 60 permite al extremo distal 52a, incluyendo la arandela 53, de la pieza de bloqueo 52 pivotar hacia fuera de la pieza giratoria 32. Una pieza que obligue, como un muelle, puede ser usada para facilitar el desembrague. De esta manera, la pieza giratoria 32 puede una vez más girar
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libremente.
Durante un procedimiento quirúrgico, la máquina grapadora 10 puede ser usada por un cirujano para manipular con capacidad de giro tejido sujetado entre el ensamblaje de cartucho 22 y el ensamblaje de yunque 24. Mediante engatillado parcial de la empuñadura móvil 28, un cirujano puede embragar el mecanismo de bloqueo 50
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mientras sujeta el tejido entre el ensamblaje de cartucho 22 y el ensamblaje de yunque 24 sin descargar las grapas. Como se describió anteriormente, el embrague del mecanismo de bloqueo 50 suministra resistencia al giro de la pieza giratoria 32. Bloqueando la pieza giratoria 32, la totalidad de la máquina grapadora 10 queda bloqueada en una posición fija y ningún giro del elemento de agarre 12 por el cirujano
���
es directamente trasladado al ensamblaje de herramienta 20. De esta manera, el cirujano puede usar la máquina grapadora 10 como pinzas quirúrgicas para manipular el tejido sujeto entre el ensamblaje de cartucho 22 y el ensamblaje de yunque 24. Al liberar la empuñadura móvil 28 el tejido sujeto entre el ensamblaje de cartucho 22 y el ensamblaje de yunque 24 es liberado y el mecanismo de bloqueo 50 es
���
desembragado. La manipulación del tejido utilizando la máquina grapadora 10 como pinzas quirúrgicas puede repetirse tantas veces como sea necesario.
Con referencia ahora a las FIGS. 6-8, en una realización alternativa de la presente descripción de una máquina grapadora quirúrgica 10’ incluye además un ensamblaje de herramienta articulado 20’. El ensamblaje de herramienta 20’ es
���
giratorio, como se describió anteriormente, utilizando una pieza giratoria 32’.
La articulación del ensamblaje de herramienta 20’ se controla usando una pieza de articulación 33’ dispuesta con capacidad de operación en la pieza giratoria 32’. Durante un proceso quirúrgico, anteriormente a sujetar el tejido a manipular y/o grapar, el ensamblaje de herramienta 20’ de la máquina grapadora 10’ puede girarse
�� usando la pieza giratoria 32’ y/o articularse con la pieza de articulación 33’ para orientar mejor el ensamblaje de herramienta 20’ para enganchar el tejido. Una vez debidamente orientado el ensamblaje de herramienta 20’, el engatillado de la empuñadura móvil 28’ provoca el embrague del mecanismo de bloqueo 50’ con la pieza giratoria 32’ como se describió anteriormente. El mecanismo de bloqueo 50’
���
(FIG. 8) puede embragarse sin tener en cuenta el giro o la articulación del ensamblaje de herramienta 20’. Como se describió anteriormente, el mecanismo de bloqueo 32’ provoca resistencia a, o impide el giro del ensamblaje de herramienta 20’ mientras la empuñadura móvil 28’ está engatillada. Con el retorno de la empuñadura móvil 28’ a una posición liberada o desengatillada, el mecanismo de bloqueo 50’ se desbloquea o
���
desembraga, y el ensamblaje de herramienta 20’ es una vez más libremente giratorio.
Se aprecia que el mecanismo de bloqueo de la presente descripción puede además ser incorporado a cualquier número de dispositivos que tengan un eje giratorio, incluyendo fórceps endoscópicos, agarradores, cauterizadores, cizallas, abrazaderas, etc.

Claims (9)

  1. REIVINDICACIONES
    1. Una máquina grapadora quirúrgica (10) que comprende:
    �� un bastidor (12); una pieza de actuación (28); una porción de cuerpo alargado (14) soportado para su rotación alrededor del bastidor; un pomo (32) para rotación de la porción de cuerpo; y
    ��� un mecanismo de bloqueo (50) para impedir la rotación de la porción de cuerpo alargado, que es automáticamente embragado con el accionamiento de la pieza de accionamiento, y
    caracterizada porque:
    ���
    el mecanismo de bloqueo comprende una pieza de bloqueo (52) que está montada pivotante (50a) en el bastidor para presionar contra el pomo para provocar la resistencia a la rotación del pomo.
  2. 2. Una máquina grapadora quirúrgica de acuerdo con la reivindicación 1, que
    ���
    incluye además un ensamblaje de herramienta articulada (20’).
  3. 3.
    Una máquina grapadora quirúrgica de acuerdo con la reivindicación 2, que incluye además una pieza de articulación (33’) para articular el ensamblaje de herramienta.
  4. 4.
    Una máquina grapadora quirúrgica de acuerdo con la reivindicación 3, en la que la pieza de articulación está dispuesta en el pomo.
  5. 5. Una máquina grapadora quirúrgica de acuerdo con una cualquiera de las
    ���
    reivindicaciones precedentes, en la que el mecanismo de bloqueo es automáticamente desembragado al liberar la pieza de actuación.
  6. 6.
    Una máquina grapadora quirúrgica de acuerdo con una cualquiera de las reivindicaciones precedentes, que incluye además un elemento de agarre (12).
  7. 7.
    Una máquina grapadora quirúrgica de acuerdo con la reivindicación 6, en la que el elemento de agarre incluye una empuñadura operativa conectada a la pieza de actuación.
    �� 8. Una máquina grapadora quirúrgica de acuerdo con la reivindicación 7, en la que la operación de la empuñadura embraga el mecanismo de bloqueo.
  8. 9.
    Una máquina grapadora quirúrgica de acuerdo con la reivindicación 8, en la que la liberación de la empuñadura desembraga el mecanismo de bloqueo.
  9. 10.
    Una máquina grapadora quirúrgica de acuerdo con una cualquiera de las reivindicaciones precedentes, en la que la pieza de bloqueo montada pivotante incluye una arandela (53) para agarrar mediante fricción el pomo.
ES07017289T 2006-09-11 2007-09-04 Mecanismo de bloqueo de pomo giratorio para máquina grapadora quirúrgica. Active ES2348481T3 (es)

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CA2600237A1 (en) 2008-03-11
EP1897502A1 (en) 2008-03-12
US20130214029A1 (en) 2013-08-22
US20090236395A1 (en) 2009-09-24
CA2600237C (en) 2015-01-13
JP2008068073A (ja) 2008-03-27
EP1897502B1 (en) 2010-08-04
JP5237597B2 (ja) 2013-07-17
US9295467B2 (en) 2016-03-29
AU2007216621A1 (en) 2008-04-03
DE602007008178D1 (de) 2010-09-16
US20080061108A1 (en) 2008-03-13
US8794496B2 (en) 2014-08-05
US8424737B2 (en) 2013-04-23
JP2013135905A (ja) 2013-07-11
AU2007216621B2 (en) 2013-04-11

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