JPH0318354A - ３ステープル駆動部材 - Google Patents

３ステープル駆動部材

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Publication number
JPH0318354A
JPH0318354A JP2136900A JP13690090A JPH0318354A JP H0318354 A JPH0318354 A JP H0318354A JP 2136900 A JP2136900 A JP 2136900A JP 13690090 A JP13690090 A JP 13690090A JP H0318354 A JPH0318354 A JP H0318354A
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JP
Japan
Prior art keywords
staple
cam
staple drive
drive member
plates
Prior art date
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Granted
Application number
JP2136900A
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JP2659265B2 (ja
Inventor
David T Green
ティー グリーン ディヴィッド
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United States Surgical Corp
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United States Surgical Corp
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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
    • 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
    • A61B17/068—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
    • A61B2017/07214—Stapler heads
    • 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
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Valve Device For Special Equipments (AREA)
  • Portable Nailing Machines And Staplers (AREA)

Abstract

(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。

Description

【発明の詳細な説明】 （産業上の利用分野） 本発明は、外科用ステープル駆動装置に関し、さらに詳
しくは、外科用ステープルを体内組織に駆動するための
、外科用ステープラ内にある駆動部材に関する。
（従来技術） 外科用ステープル駆動装置は、留め具すなわちステープ
ルを体内組織に駆動することによって体内組織を迅速か
つ効率的に閉じるため、外科処置で広く使用されている
。ある種のステープラ、例えば中空の組織を互いに機械
的に縫合するためのステーブラでは、主直線駆動カム部
材が、ステプラが駆動される方向に対して横方向に動く
。代表的には、このようなステープラはいくつかのステ
ープル駆動部材すなわち押し出し要素を使用しており、
該部材は、ステープル保持カートリッジの溝付スロット
に位置し、端から端まで数列になって配置されている。
普通の作動状態では、前記横方向に動くカムは、駆動部
材のカム面に接触し、それによって、ステープル駆動部
材を溝付スロットの下方に押し出す。駆動部材は、駆動
カムからステープルへ直線運動を伝達する。それによっ
て、ステープル列が、閉しるべき体内組織の中へ駆動さ
れる。
このような駆動部材の例は、グリーン等（Ｇｒｅｅｎｅ
ｔａｌ．）の米国特許第３４９０６７５号に説明されて
いる。該特許に開示されている駆動部材は、押し出し板
と、案内レールと、駆動カムと接触するためのＶ形部と
を有している。
更に変更されたものが、グリーンの米国特許第３４９９
５９１号に説明されており、該特許は、２ステープル駆
動部材を開示している。これは、１回のカム行程で、１
列のステープル列の代わりに２列のステープル列を駆動
可能であるという利点があるが、その理由は、２列のス
テープル列は大きな保持強度を有するからである。該特
許に開示されている２ステープル駆動部材は、押し出し
カムと接触するための■形頂面を有し、別々の平面にあ
る２つの駆動部分から成る一体部品構造である。各ステ
ープル対は長平方向に千鳥配置され（すなわち、各ステ
ープルは、他のステープルの斜め後方に、互いにシグザ
グ状に位置決めされている）、押し出し棒通路を埋めて
いる。
グリーンの第３４９９５９１号特許の２つの駆動部材が
、２つのステープルを押し出して組織をつなぐとき、発
生ずる力が横方向及び前後方向の両方でつりあおうとし
、それによって、駆動部材にかかるオフセット荷重を減
少させ、組織をつなごうとする傾向を減少させる。駆動
部材を動かしてステープルを押し出すために用いるグリ
ーンの第３４９９５９　１号特許の押し出し棒の先端は
、Ｂ形にステープルを形成する間に作用させなければな
らない最大力が、ある時間では１つのステブル対にのみ
発生ずるように駆動部材に対して配置されている。これ
は、押し出し棒の先端を長平方向に千鳥配置することに
よって達成される。
ストレコフトフ（Ｓｔｒｅｋｏｐｙｔｏｖｌの米国特許
第３２５２６４３号は、実際は横に並べた２つの装置で
あるＣクランブ装置を説明している。脱着自在なマガジ
ンが、第３の列と離れた２つのステブル列を有している
。この装置は、まず２つのステープル列を駆動し、次い
で、組織を操作し、再び、第３のステープル列を駆動す
る。
従来技術から明らかなように、複数の外科用ステープル
を駆動するための駆動部材を設計する際、いくつかの問
題が生しる。特に、ステープルを押し出すときに駆動部
材にかかる力を効率的につり合わせることができない場
合は、ステープル駆動部材が溝付スロット壁に引っ掛か
って動かなくなるという傾向を生ずるかもしれない。更
に、複数のステープルを駆動するための駆動部材は、駆
動カムの長平方向の動きに抵抗する傾向があり、従って
、外科医は、ステーブラを作動させるのに、より大きな
力をかけることが必要になる。
駆動部材は、作動中に比較的滑らかな押し出し力をかけ
ることが可能であることが望ましい。
（発明の構成） より大きな保持強度と改良された止血性とを得るため，
３列の平行なステープルを千鳥に重ねて配置することが
望ましいことがわかった。しかしながら，本発明の荊に
は、３列のステープルを１回の駆動作用で同時に並べる
ことができる駆動部材は存在しなかった。
従って、本発明の１つの目的は、外科用ステブル装置部
材を提供することである。
本発明の別の目的は、３つのステープルを駆動可能な外
科用ステープル駆動部材を提供することである。
更に本発明の他の目的は、３つのステープルを平行かつ
千鳥配置に駆動可能な外科用ステープル駆動部材を提供
１−ることである。
本発明の更に別の同的は、引っ掛かりが少なく容易に作
動可能な外科用ステープル駆動部材を提供することであ
る。
これら及び他の目的は、横移動カムによって駆動され、
前記カムの１回の行程で３つの外科用ステープルを駆動
可能であり、遠位端部と、少なくとも１つのカム面を備
えた近位端部と、カムの動く方向に縦方向に整列した、
３つのほぼ矩形の押し出し板とを有する本体部分から成
る、外科用ステープル駆動装置用一体構造単一部品ステ
ープル駆動部材を提供することによって実現される。
（実施例） 外科用ステープルを押し出すためにステープル１：］ １　０ 駆動部材を使用する外科用ステープル駆動装置は、グリ
ーン等の米国特許第３４９０６７５号及びグリーンの米
国特許第３４９９５９１号に説明されており、双方とも
ここで参照し組み入れられている。
概略的に言えば、本発明に関するｆｆｆｉ　類の外科用
ステープル駆動装置は、代表的には、体力組織を受け入
れて固定するように形成され寸法決めされた２つの細長
あごを有している。代表的には、方のあごは、平行な列
に配置された複数の駆動部材と、ステープルとを保持す
るカートリッジを支持し、カムを有する押し出し棒の側
面に位置し、他方のあごは、ステープルを形成するため
のアンビルを有している。押し出し棒は、該棒のカムが
溝内で駆動部材に動きを伝達し、それによって、ステー
プルを、体内組織を通してアンビルに駆動するように、
カートリッシを保持するあごに沿って長平方向に動く。
米国特許第３４９９５９　１号に示すように、ステープ
ル駆動部材の２つの平行列が設けられてもよく、各ステ
ープル駆動部材は、２つのステープルに作用する。前述
の特許ては、ステープル駆動部材の各列は、ステープル
の２つの平行列の下方にある。２つの平行なステプル駆
動部材列を設けることにより、平行な２組のステープル
列ができ、合計で４つのステープル列、すなわち、各組
について２つのステープル列ができる。前述の特許に又
示されているように、２組の平行なステープル列の間の
組織を切断するため、ナイフが設けられてもよい。この
後者の構成は、中空組織を導通させて結合するのに特に
有利である。ｎｉｊに説明したように、このような装置
で生しるであろう２つの問題は、駆動部材にかかる望ま
しくないトルクと、複数ステープル駆動手段の高い抵抗
である。本発明は、一方の問題と他方の問題と併せて考
える、すなわち、ステープルの抵抗の分布が望ましくな
いトルクと釣り合うように、駆動部材を設けることによ
り、これらの問題を回避している。
第１Ａ図、第ＩＢ図、第２Ａ図及び第２Ｂ図について説
明する。これらの図は、本発明のステブル駆動部材を斜
視図及び端面図で示しており、３ステープル駆動部材ｌ
ＯＯは、横方向に動く押１１ １２ し出し棒のカムと接触するため、駆動部材の近位端部に
傾斜カム面１０４を有している本体部分１０２から成る
。二つのカム面が示されているが、一つのカム面でも十
分てある。
本体部分１０２は、３つの別々の交差しない平面を形成
するように整列した、ほぼ矩形の３つの押し出し板１０
６Ａ、１０６Ｂ及び１０６Ｃを有している。
押し出し板１０６Ａ、１０６Ｂ及び１０６Ｃは、カムの
動く方向及び外科用ステープル駆動装置の長平方向軸線
に沿って縦方向に整列している。押し出し板１０６Ａ、
１０６Ｂ及び１　０６Ｃのいずれち、駆動部材１００の
近位端部から遠位端部１１１Ｂまで完全に延びてはいな
い。むしろ、押し出し板は、２つの外方押し出し板１０
６Ａ及び１０６Ｃが相互に横方向に並び各々がステープ
ル駆動部材１００の２つの側面の各ノノになり、かつ各
々が、３ステープル駆動部材１００の近位端部１１１Ａ
に隣接する端部を有し、中央押し出し板１．　０　６　
Ｂが前記制方抑し出し板１０６Ａ及びｌ　０６Ｃと横方
向にずれて配置されるように、互いに千鳥配置されてい
る。中央押し出し板１０６は３ステープル駆動部材の遠
位端部１１１Ｂに隣接した端部を有する。
押し出し板１０６Ａ、］．　０　６　Ｂ及び１０６Ｃは
各々、近位端部及び遠位端部の双方に案内レール１０８
を有している。又、各押し出し板１０６Ａ．１０６Ｂ及
び１０６Ｃは、押し出し板の縁部に沿って縦方向に延び
、横棒、すなわち外科用ステープルの背部と接触するス
テープル収容切欠き１１０を有している。案内レール１
．　０　８は切欠き１１０から押し出し板の頂部まで延
びている。
本体部分１０２の遠位端部にある斜面１１４により、カ
ムは、駆動部１０２の表面を前後両方向に滑らかに乗り
越えることができる。
阻止面１１２は、ステープル保持カートリッシ５０２の
基部５０４の内面（第５図参照）に衝合することにより
、作動中にステープル駆動部材１００が飛び出ずのを防
止する。
第３図を参声すると、カム３０２が、矢印Ｌで示す方向
にスデープル駆動装置内で長平方向に移Ｙ　３ １　４ 動する。カム３０２はステープル駆動部材１００の近位
端部１］１Ａに近づき、点１０４Ａで傾斜カム面１０４
と接触する。図からわかるように、カムブレード３０２
の縁部と移動方向Ｌとの間の角度Ｂは、カム面１０４と
移動方向Ｌとの間の角度Ａよりも小さい。この角度の相
違により、もし角度Ｂが角度Ａよりち大きかったら生ず
るであろう部材の引っ掛かりを回避することができる。
カム面の角度Ａは、水平から約２０度傾いているのが最
適であり、近位端部での斜面１１４は水平から約１５゜
だけ傾いている。
図からわかるように、カム３０２がカム面１０４と接触
したとき、ステープル保持カートリッジ（第５図参照）
の溝付スロットに配置されたステープル駆動部材１００
に下向きの動きが生ずる。しかし又、矢印Ｔによって概
略的に示すように、ステープル駆動部材には望ましくな
いトルクが発生ずる。このトルクは溝付スロット内でス
テープル駆動部材１００を回転させ、その結果、該部材
が引っ掛かることがある。しかし、ステプル駆動部材１
００については、この望ましくないトルクは、ステープ
ル駆動部材の近位端部１．　１　１　Ａにおけるより大
きな抵抗と釣り合う。これは、近位端部には、押し出し
板１０６Ａ及びＬＯ６Ｃによって各々駆動され、双方と
も抵抗を発生ずる２つのステープルがあり、遠位端部１
１１Ｂには、押し出し板１０６Ｂによって駆動される１
つのステープルのみがあるためである。ステープル駆動
部材１００は又、２つのステープルが近位端部で側方押
し出し板１０６Ａ及びｌ０６ｃによって駆動される限り
、該２つのステープルのみを作動させてもよい。ちしも
、駆動部材１００がただ１つのステープルしか有してお
らず、中央押し出し板１０６Ｂによって駆動されるとし
たら、ステープル駆動部材１００は、もっと引っ掛かり
やすくなるであろう。
第４Ａ図及び第４Ｂ図は、それぞれ、単一及び２ブレー
ドカム３　０，２　Ａ及び３０２Ｂと関連させた、本発
明のステープル駆動部材ｌＯＯを示している。ステープ
ル駆動部材１００を駆動してステープル４０２を押し出
すため、どちらの形式のカムが、外科用ステーブラに使
用されてもよい。
ｌ　５ １　６ しかし、２ブレードカム３０２Ｂが好ましい。カムは、
一般的には、ステンレス鋼のような高強度の比較的硬い
材料で作られ、従来技術で周知の機構によって作動され
る。
第５図は、外科用ステープル装置のステープル保持カー
トリッジ５０２を示している。このようなカートリッジ
はステープル４０２を保持しかつ駆動するための手段を
提供する。カートリッジ５０２は、ステープル駆動手段
１００用の溝付スロットを形成するように配置された基
部５０４と、側板５０３とを有する本体から成る。２ブ
レードカム３０２Ｂが長平方向に移動して、駆動部材１
００を次々とカートリッジの下方に押し出す。（１つの
ステープル駆動部材のみが示されている。しかし、通常
の作動では、溝付スロットの全てがステープル駆動部材
１００とステーブラ４０２とによって占有されている。
） 第６図は、カートリッジ５０２の基部５０４の底面図を
示している。細長開口部５０５は、ステープル用出口を
提供する。基部の開口部を取り囲む構造は、ステープル
駆動部材１００が飛び出すのを防止する手段を提供する
。３ステープル駆動部材１００がカム３０２Ｂによって
下方に駆動されたときには、阻止面１１２が基部５０４
の内面と接触するようになり、それによって、ステープ
ル駆動部材ｌＯＯがカートリッジから外れるのを防止し
ている。
３ステープル駆動部材１００は、（Ｄｅｌｒｉｎ．登録
商標）アセクールのような高強度の高分子樹脂から単一
部品として射出成形されてもよい。ステープル駆動部材
１００は、駆動するステープルの機能に適した寸法であ
るのがよい。このような駆動部材は、代表的には長さが
約２５ｍｍ（Ｏ　ｌインチ）乃至約５　１　ｍｍ　（０
．　２インチ）、高さが約１９ｍｍ　（０．０７５イン
チ）、幅が約２５ｍｍ　（０．１インチ）乃至約３８ｍ
ｍ（０　１５インチ）である。
限定でなく例示として、第７図に、本発明によるステー
プル駆動部材を適用することができる外科用ステープル
装置５１０を示ず。
外科用ステーブラ５１０は、内視鏡部５１２と、ハンド
ル部５１４とを有している。内視鏡部１　７ ｌ　８ は、ハンドル部５１４によって作用されるステプル駆動
作動を制御しつつ、約１０ミリの狭い内径の開口部ある
いはチューブを通して体内にＩＩＩ人されるようになっ
ている。下あご部５１６が内視鏡部５１２に対して固定
され、ステープルと本発明によるステープル駆動部材（
図示せず）とを収容しているカートリッジ５１８を保持
している。
カートリッジ５１８は又、ナイフを備えていてちよい。
上あご部５２０が、下あご部５１６に向かう矢印５２２
の方向に閉しることができるように、内視鏡部５１２に
対し、例えばヒンジによって移動自在に取り付けられて
いる。作動の際には、レバー５２４を矢印５２６の方向
に閉じて、矢印５３０の長平方向に適当な機械的手段に
よりカラー５２８を前進させ、あご部５１８及び５２０
を閉してその間に人体組織を固定する。次いで、駆動棒
５３６を内視鏡部５１２を通して長手方向に前進させる
ため、ハンドル５３２を矢印５３４の方向の長手方向に
前進させる。本発明によって構成された複数の３ステー
プル駆動手段を駆動し、それによって、カートリッジか
らステプルを飛び出させるため、単数又は複数の押し出
しカムが駆動棒５３６に接続され、カートリッジ５１８
に対して長平方向に同時に前進する。飛び出したステー
プルは体内組織を貫通し上あご部５２０のアンビルに当
たって形成されて閉しられる。
前述の説明は多くの特定を含むけれども、これらの特定
は、発明の限定と解釈するべきではなく、発明の好まし
い実施例による例示と解釈するべきである。当業者は、
特許請求の範囲で定められる発明の範囲及び精神の中で
、多くの変更を考えるであろう。
【図面の簡単な説明】
第ＩＡ図及び第ＩＢ図は、本発明のステープル駆動部材
の斜視図である。 第２Ａ図及び第２Ｂ図は、それぞれ、本発明のステープ
ル駆動部材の後面図及び前面図である。 第３図は、ステープル駆動部材をカムとともに示した側
面図である。 第４Ａ図及び第４Ｂ図は、それぞれ、ステーブ｛　９ ２　０ ル駆動部材の単一カム及びダブルカムの作動を示した図
である。 第５図は、ステープル駆動部材を収容する外科用ステー
ブラカートリッジの斜視図である。 第６図は、外科用ステーブラカートリッジの底面図であ
る。 第７図は、本発明のステープル駆動部材を含む外科用ス
テープル駆動装置の切取り斜視図である。 １００　　・ １０４　　・ １０６　・ １　０８　・ １　１０　・ ３０２　・ ４０２　・ ５０２　・ ５１０　　・ 駆動部材、 カム面、 押し出し板、 案内レール、 切欠き、 カム、 ステープル、 カートリッジ、 外科用ステープ−ル駆動装置。 ２ ｌ

Claims (16)

    【特許請求の範囲】
  1. （１）横移動カムによって駆動され、前記カムの１回の
    行程で３つの外科用ステープルを駆動可能であり、遠位
    端部と、少なくとも１つのカム面を備えた近位端部近位
    端部と、カムの動く方向に縦方向に整列した、３つのほ
    ぼ矩形の押し出し板とを有する本体部分から成る、外科
    用ステープル駆動装置用ステープル駆動部材。
  2. （２）前記３つのほぼ矩形の押し出し板が、３つの別々
    の交差しない平面を形成することを特徴とする請求項（
    １）に記載のステープル駆動部材。
  3. （３）前記３つのほぼ矩形の押し出し板が、ｉ）前記ス
    テープル駆動部材の近位端部に隣接した端部を各々有し
    、前記本体部分の両側に配置された、互いに横方向に整
    列した２つの側方押し出し板と、 ｉｉ）前記ステープル駆動部材の遠位端部に隣接した端
    部を有する中央押し出し板と から成ることを特徴とする請求項（２）に記載のステー
    プル駆動部材。
  4. （４）前記本体部分の前記遠位端部が斜面を有している
    ことを特徴とする請求項（１）に記載のステープル駆動
    部材。
  5. （５）前記ステープル駆動部材が高分子樹脂で構成され
    ていることを特徴とする請求項（１）に記載のステープ
    ル駆動部材。
  6. （６）前記高分子樹脂がアセタールであることを特徴と
    する請求項（５）に記載のステープル駆動部材。
  7. （７）前記各押し出し板が案内レールを備えていること
    を特徴とする請求項（１）に記載のステープル駆動部材
    。
  8. （８）前記各押し出し板が更にステープルの背部を入れ
    る切欠きを有していることを特徴とする請求項（１）に
    記載のステープル駆動部材。
  9. （９）前記案内レールが前記各押し出し板の近位端部と
    遠位端部に配置されていることを特徴とする請求項（７
    ）に記載のステープル駆動部材。
  10. （１０）ａ）遠位端部と、少なくとも１つのカム面を有
    する近位端部と、カムの動く方向に縦方向に整列した、
    ３つのほぼ矩形の押し出し板とを有する本体部分から成
    る、複数のステープル駆動部材と、 ｂ）作動手段と、カム手段と、前記ステープル駆動手段
    を受け入れるようになっている複数のスロットを有する
    カートリッジと、アンビル部材とを有する外科用ステー
    プル駆動装置と を組み合わせた装置。
  11. （１１）作動手段と、 カム手段と、 遠位端部と、少なくとも１つのカム面を有する近位端部
    と、前記カム手段の動く方向に整列した３つの押し出し
    板とを有し、前記作動手段によって前記カム手段に動き
    が伝えられたときに、前記カム面が前記カム手段に係合
    する、本体部分から各々成る複数のステープル駆動部材
    を含むカートリッジと から成る外科用ステープル駆動装置。
  12. （１２）前記３つの押し出し板はほぼ矩形であり、３つ
    の別々の交差しない平面を縦方向に形成することを特徴
    とする請求項（１１）に記載の外科用ステープル駆動装
    置。
  13. （１３）前記３つのほぼ矩形をした押し出し板が、ｉ）
    前記ステープル駆動部材の近位端部に隣接した端部を各
    々有し、前記本体部分の両側に配置された、互いに横方
    向に整列した２つの側方押し出し板と、 ｉｉ）前記ステープル駆動部材の遠位端部に隣接した端
    部を有する中央押し出し板と から成ることを特徴とする請求項（１２）に記載の外科
    用ステープル駆動装置。
  14. （１４）前記各押し出し板が更にステープルの横棒を入
    れる切欠きを有していることを特徴とする請求項（１３
    ）に記載の外科用ステープル駆動装置。
  15. （１５）開いた位置と、前記カートリッジに整合しかつ
    向かい合う閉じた位置とをとるアンビルを更に備え、前
    記駆動部材が、前記カートリッジから前記アンビルにス
    テープルを駆動する請求項（１４）に記載の外科用ステ
    ープル駆動装置。
  16. （１６）前記駆動手段に応答して、前記カム手段の動く
    方向に移動可能なナイフ部材を更に備えていることを特
    徴とする請求項（１５）に記載の外科用ステープル駆動
    装置。
JP2136900A 1989-05-26 1990-05-25 ３ステープル駆動部材 Expired - Lifetime JP2659265B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US358547 1989-05-26
US07/358,547 US4978049A (en) 1989-05-26 1989-05-26 Three staple drive member

Publications (2)

Publication Number Publication Date
JPH0318354A true JPH0318354A (ja) 1991-01-25
JP2659265B2 JP2659265B2 (ja) 1997-09-30

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EP (1) EP0399699B1 (ja)
JP (1) JP2659265B2 (ja)
AT (1) ATE130744T1 (ja)
AU (1) AU617280B2 (ja)
CA (1) CA2013053C (ja)
DE (1) DE69023811T2 (ja)
ES (1) ES2079440T3 (ja)

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CA2013053C (en) 1995-08-15
EP0399699B1 (en) 1995-11-29
DE69023811D1 (de) 1996-01-11
JP2659265B2 (ja) 1997-09-30
EP0399699A1 (en) 1990-11-28
ATE130744T1 (de) 1995-12-15
CA2013053A1 (en) 1990-11-26
DE69023811T2 (de) 1996-05-23
AU5571690A (en) 1990-11-29
ES2079440T3 (es) 1996-01-16
US4978049A (en) 1990-12-18
AU617280B2 (en) 1991-11-21

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