JPH07163573A - 外科用器具 - Google Patents
外科用器具Info
- Publication number
- JPH07163573A JPH07163573A JP6258993A JP25899394A JPH07163573A JP H07163573 A JPH07163573 A JP H07163573A JP 6258993 A JP6258993 A JP 6258993A JP 25899394 A JP25899394 A JP 25899394A JP H07163573 A JPH07163573 A JP H07163573A
- Authority
- JP
- Japan
- Prior art keywords
- jaw
- distal end
- cord
- proximal end
- instrument
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- 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
-
- 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
-
- 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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
- A61B2017/294—Connection of actuating rod to jaw, e.g. releasable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Ophthalmology & Optometry (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
Abstract
(57)【要約】
【目的】 優れた操縦部材を有する外科用器具を提供す
る。 【構成】 組織に対して操作する遠位端１５１，遠位端
を操縦する近位端１５２，遠位端と近位端をつなぐ構造
体１５６，及び構造体の中にある操縦部材（コード等）
からなる外科用器具１５０。操縦部材は、コバルト滅菌
可能、非毒性、液晶、ポリエステル−ポリアクリレート
重合体から形成され、高い引張強度と低い伸び率を有す
る。
る。 【構成】 組織に対して操作する遠位端１５１，遠位端
を操縦する近位端１５２，遠位端と近位端をつなぐ構造
体１５６，及び構造体の中にある操縦部材（コード等）
からなる外科用器具１５０。操縦部材は、コバルト滅菌
可能、非毒性、液晶、ポリエステル−ポリアクリレート
重合体から形成され、高い引張強度と低い伸び率を有す
る。
Description
【０００１】
【産業上の利用分野】この発明は、組織に対して操作す
る遠位端とその操縦をする操縦部材と近位端を有する外
科用器具に関するものである。
る遠位端とその操縦をする操縦部材と近位端を有する外
科用器具に関するものである。
【０００２】
【従来の技術】過去数年にわたって外科で使用される器
具は複雑さを増している。鉗子，開創器，把握器等の器
具が長い間使用されているが、クリップ適用器，ステー
プラー等の新しい器具も使用されつつある。外科用器具
の開発につれ、それらは複雑になっていく。そのような
複雑な器具の例として、線状ステープラー，円状ステー
プラー，結紮器具，結紮器，分割器がある。内視鏡手術
の進歩に伴い、それらの器具のサイズは小さくなってい
く。
具は複雑さを増している。鉗子，開創器，把握器等の器
具が長い間使用されているが、クリップ適用器，ステー
プラー等の新しい器具も使用されつつある。外科用器具
の開発につれ、それらは複雑になっていく。そのような
複雑な器具の例として、線状ステープラー，円状ステー
プラー，結紮器具，結紮器，分割器がある。内視鏡手術
の進歩に伴い、それらの器具のサイズは小さくなってい
く。
【０００３】結紮，ステープル，切る，又は他の組織処
置等の幾つかの手術機能を行うための、多くの器具が開
発されている。現在では、これらの多くの器具が容易に
使用できるように改善されつつある。一例として、手術
部以内で様々な位置で使用できるような回転可能な操作
端を形成する。他の例として、器具の遠位端即ち操作端
を関節式にする。即ち、操作端に回転運動を加え人の組
織の様々な形に容易に適合できるようにする。従来、こ
れらの複雑な器具のほとんどは種々のタイプの機械的連
動装置を介して駆動又は操縦されている。この連動装置
は許容できるものであるが、特に内視鏡装置で使用する
場合等、連動装置に伴うサイズと空間の問題があった。
サイズと空間の多くの制限はケーブルやプーリ等の機械
的な手段によって克服できる。このようなケーブルは少
ない空間しか必要とせず、曲がった路でも所望の力を伝
えることができる。また、ケーブルは一般に単一体であ
るため誤差の問題も少ない。これら全ての留め具は外科
用器具、特に内視鏡器具の設計で生じる問題を減少させ
る。
置等の幾つかの手術機能を行うための、多くの器具が開
発されている。現在では、これらの多くの器具が容易に
使用できるように改善されつつある。一例として、手術
部以内で様々な位置で使用できるような回転可能な操作
端を形成する。他の例として、器具の遠位端即ち操作端
を関節式にする。即ち、操作端に回転運動を加え人の組
織の様々な形に容易に適合できるようにする。従来、こ
れらの複雑な器具のほとんどは種々のタイプの機械的連
動装置を介して駆動又は操縦されている。この連動装置
は許容できるものであるが、特に内視鏡装置で使用する
場合等、連動装置に伴うサイズと空間の問題があった。
サイズと空間の多くの制限はケーブルやプーリ等の機械
的な手段によって克服できる。このようなケーブルは少
ない空間しか必要とせず、曲がった路でも所望の力を伝
えることができる。また、ケーブルは一般に単一体であ
るため誤差の問題も少ない。これら全ての留め具は外科
用器具、特に内視鏡器具の設計で生じる問題を減少させ
る。
【０００４】ケーブルを外科用器具の操縦部材として使
用するのは幾つかの利点があるが、多くのケーブルには
まだ重大な問題がある。鋼ケーブルは操縦部材として使
用する時は優れた強度を有するが、かなり半径の小さい
湾曲部を回らなくてはならない曲がった路で使用する
と、「ゆがみ」を生じ器具の信頼性を損なう。
用するのは幾つかの利点があるが、多くのケーブルには
まだ重大な問題がある。鋼ケーブルは操縦部材として使
用する時は優れた強度を有するが、かなり半径の小さい
湾曲部を回らなくてはならない曲がった路で使用する
と、「ゆがみ」を生じ器具の信頼性を損なう。
【０００５】
【発明が解決しようとする課題】以上述べたように、従
来の外科用器具は操縦部材がゆがみやすい等の問題点が
あった。
来の外科用器具は操縦部材がゆがみやすい等の問題点が
あった。
【０００６】この発明は上記のような問題点を解消する
ためになされたもので、本発明の目的は、コバルト滅菌
できる外科用器具の操縦部材を提供することである。
ためになされたもので、本発明の目的は、コバルト滅菌
できる外科用器具の操縦部材を提供することである。
【０００７】本発明の他の目的は、優れた強度を有し、
かつかなり制限された空間での曲がり路を通れる操縦部
材を提供することである。
かつかなり制限された空間での曲がり路を通れる操縦部
材を提供することである。
【０００８】本発明のさらに他の目的は、操縦部材を使
用するときかなり大きな力を加えることのできる高い引
張強度を有する外科用器具に使用する操縦部材を提供す
ることである。
用するときかなり大きな力を加えることのできる高い引
張強度を有する外科用器具に使用する操縦部材を提供す
ることである。
【０００９】
【課題を解決するための手段及び作用】新規な改善され
た外科用器具を開示する。この器具は、外科処置での操
作を実施するために使用される遠位端を有する。操作の
例として、クリップの適用，ステープルの適用，組織の
切開，組織の把握又はこれらの操作の様々な組合せがあ
る。この器具は近位端を有し、近位端には遠位端即ち操
作端を操縦し制御する作動手段がある。遠位端と近位端
は軸，ハウジング等の適当な構造体によってつながって
いる。本発明の好ましい器具では、内視鏡手術で使用で
きるように、それらは比較的小さい直径の長形の軸でつ
ながっている。
た外科用器具を開示する。この器具は、外科処置での操
作を実施するために使用される遠位端を有する。操作の
例として、クリップの適用，ステープルの適用，組織の
切開，組織の把握又はこれらの操作の様々な組合せがあ
る。この器具は近位端を有し、近位端には遠位端即ち操
作端を操縦し制御する作動手段がある。遠位端と近位端
は軸，ハウジング等の適当な構造体によってつながって
いる。本発明の好ましい器具では、内視鏡手術で使用で
きるように、それらは比較的小さい直径の長形の軸でつ
ながっている。
【００１０】本発明の器具は軸を通って近位端から遠位
端に延びる部材を有する。この部材により遠位端を操縦
できる。この操縦部材の少なくとも一部はコバルト滅菌
可能，非毒性，液晶，ポリエステルーポリアクリレート
重合体である。液晶重合体は高い引張特性と低い伸び率
を有する。好ましくは、操縦部材の形状は、マルチ繊維
（multifilament fiber）からなる、「コード」，「ケ
ーブル」又は他の柔軟なストランド（strand）様部材で
ある。コードはマルチ繊維の単一のストランドでも、複
数のストランドでもよい。本発明の性能の点からコード
やケーブルに有用な繊維の例として、ブリッジウォータ
ーニュージャージー（Bridgewater,NewJersey）のヘキ
ストーセラネス（Hoechst-Celanese）で製造する商標
「ベクトラン（Vectran）」，「ベクトラ（Vectr
a）」，「スペクトラ（Spectra）」等の物質から形成さ
れた繊維がある。さらに、ネムール，ウィルミントン，
デラウェア（Nemours,Wilmington,Delaware）のイーテ
ィーデュポン（E.T.Dupont）で製造する商標「ケブラー
（Kevlar）」も有用であると考えられる。本発明の範囲
には、高い引張強度（少なくとも１０ポンドを越える）
と低い伸び率（１０％より少ない）を有する、滅菌可
能，非毒性の全ての重合体コードが含まれる。このよう
なポリエステルーポリアクリレートの例として、一般
に、液晶熱可塑共重合体，熱可塑単独重合体，共重合体
がある。また、このような重合体は、米国特許第 4,18
3,895、 4,450,737、 4,799,985号に説明されている。
端に延びる部材を有する。この部材により遠位端を操縦
できる。この操縦部材の少なくとも一部はコバルト滅菌
可能，非毒性，液晶，ポリエステルーポリアクリレート
重合体である。液晶重合体は高い引張特性と低い伸び率
を有する。好ましくは、操縦部材の形状は、マルチ繊維
（multifilament fiber）からなる、「コード」，「ケ
ーブル」又は他の柔軟なストランド（strand）様部材で
ある。コードはマルチ繊維の単一のストランドでも、複
数のストランドでもよい。本発明の性能の点からコード
やケーブルに有用な繊維の例として、ブリッジウォータ
ーニュージャージー（Bridgewater,NewJersey）のヘキ
ストーセラネス（Hoechst-Celanese）で製造する商標
「ベクトラン（Vectran）」，「ベクトラ（Vectr
a）」，「スペクトラ（Spectra）」等の物質から形成さ
れた繊維がある。さらに、ネムール，ウィルミントン，
デラウェア（Nemours,Wilmington,Delaware）のイーテ
ィーデュポン（E.T.Dupont）で製造する商標「ケブラー
（Kevlar）」も有用であると考えられる。本発明の範囲
には、高い引張強度（少なくとも１０ポンドを越える）
と低い伸び率（１０％より少ない）を有する、滅菌可
能，非毒性の全ての重合体コードが含まれる。このよう
なポリエステルーポリアクリレートの例として、一般
に、液晶熱可塑共重合体，熱可塑単独重合体，共重合体
がある。また、このような重合体は、米国特許第 4,18
3,895、 4,450,737、 4,799,985号に説明されている。
【００１１】本発明の具体的な実施態様は、次の通りで
ある。 （１）前記操縦部材はコバルト滅菌可能，非毒性，液
晶，ポリエステルーポリアクリレート重合体からなるコ
ードである請求項１記載の外科用器具。 （２）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（１）記載の外科用器具。 （３）角度を有する動きを可能とする前記操縦部材はコ
バルト滅菌可能，非毒性，液晶，ポリエステルーポリア
クリレート重合体からなるコードである請求項２記載の
外科用器具。 （４）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（３）記載の外科用器具。 （５）前記操縦部材はコバルト滅菌可能，非毒性，液
晶，ポリエステルーポリアクリレート重合体からなるコ
ードである請求項３記載の外科用器具。 （６）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（５）記載の外科用器具。 （７）前記角度を有する動きを可能とする前記操縦部材
はコバルト滅菌可能，非毒性，液晶，ポリエステルーポ
リアクリレート重合体からなるコードである請求項４記
載の外科用器具。 （８）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（７）記載の外科用器具。 （９）前記重合体コードは熱可塑重合体である請求項４
記載の外科用器具。 （１０）前記熱可塑体はポリエステルの単独重合体又は
ポリエステルの共重合体である上記実施態様（９）記載
の外科用器具。 （１１）前記熱可塑体はポリエステルの共重合体である
上記実施態様（９）記載の外科用器具。 （１２）前記共重合体は液晶芳香族ポリエステルの共重
合体である上記実施態様（１１）記載の外科用器具。
ある。 （１）前記操縦部材はコバルト滅菌可能，非毒性，液
晶，ポリエステルーポリアクリレート重合体からなるコ
ードである請求項１記載の外科用器具。 （２）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（１）記載の外科用器具。 （３）角度を有する動きを可能とする前記操縦部材はコ
バルト滅菌可能，非毒性，液晶，ポリエステルーポリア
クリレート重合体からなるコードである請求項２記載の
外科用器具。 （４）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（３）記載の外科用器具。 （５）前記操縦部材はコバルト滅菌可能，非毒性，液
晶，ポリエステルーポリアクリレート重合体からなるコ
ードである請求項３記載の外科用器具。 （６）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（５）記載の外科用器具。 （７）前記角度を有する動きを可能とする前記操縦部材
はコバルト滅菌可能，非毒性，液晶，ポリエステルーポ
リアクリレート重合体からなるコードである請求項４記
載の外科用器具。 （８）前記コードはマルチ繊維の単一のストランドであ
る上記実施態様（７）記載の外科用器具。 （９）前記重合体コードは熱可塑重合体である請求項４
記載の外科用器具。 （１０）前記熱可塑体はポリエステルの単独重合体又は
ポリエステルの共重合体である上記実施態様（９）記載
の外科用器具。 （１１）前記熱可塑体はポリエステルの共重合体である
上記実施態様（９）記載の外科用器具。 （１２）前記共重合体は液晶芳香族ポリエステルの共重
合体である上記実施態様（１１）記載の外科用器具。
【００１２】
【実施例】図中で同一部位には同一番号を使用してい
る。図１〜６は本発明による外科用器具の一実施態様の
概略を示している。これらに示される実施例では、コバ
ルト滅菌可能、非毒性、液晶、ポリエステル−ポリアク
リレート重合体の操縦部材はマルチ繊維のコードであ
り、器具の遠位即ち操作端にある一対の顎の動きを制御
するために使用される。ポリエステル−ポリアクリレー
ト繊維は、必要な大きな力を伝えて操作端を操縦するた
めに、高い引張特性（即ち、強度と係数）を有する。こ
の高い引張特性は、また、器具の操作中の操縦部材の伸
長，変形，破壊の恐れを少なくする。さらに、操縦部材
は低い伸び率を有し、それの破壊強度の５０％までクリ
ープは測定できない。器具の顎は、ステープルを組織に
適用する，結紮クリップを血管に適用する，組織を掴む
等外科処置での機能を実施できるように、構成できる。
る。図１〜６は本発明による外科用器具の一実施態様の
概略を示している。これらに示される実施例では、コバ
ルト滅菌可能、非毒性、液晶、ポリエステル−ポリアク
リレート重合体の操縦部材はマルチ繊維のコードであ
り、器具の遠位即ち操作端にある一対の顎の動きを制御
するために使用される。ポリエステル−ポリアクリレー
ト繊維は、必要な大きな力を伝えて操作端を操縦するた
めに、高い引張特性（即ち、強度と係数）を有する。こ
の高い引張特性は、また、器具の操作中の操縦部材の伸
長，変形，破壊の恐れを少なくする。さらに、操縦部材
は低い伸び率を有し、それの破壊強度の５０％までクリ
ープは測定できない。器具の顎は、ステープルを組織に
適用する，結紮クリップを血管に適用する，組織を掴む
等外科処置での機能を実施できるように、構成できる。
【００１３】図１は、開口外科又は内視鏡器具の近位部
に取り付けられる、顎組立体を示している。近位部は一
般に支持ハウジング３４である（図２）。器具のこの部
分は外科医によって掴まえられる。内視鏡器具では、ハ
ウジングの近位部は患者の外にあり、器具の残りの部分
はトロカールカニューレ（図示せず）を通って体くうに
挿入される。
に取り付けられる、顎組立体を示している。近位部は一
般に支持ハウジング３４である（図２）。器具のこの部
分は外科医によって掴まえられる。内視鏡器具では、ハ
ウジングの近位部は患者の外にあり、器具の残りの部分
はトロカールカニューレ（図示せず）を通って体くうに
挿入される。
【００１４】顎組立体は回転可能に器具に取り付けるこ
とができ、器具のこの端には取付組立体４０がある（図
１）。取付組立体４０は、底張出部４２，上張出部４
４，支持部材４６からなる。底張出部４２には孔４８
が、上張出部４４には孔５０が、支持部材４６には孔５
２がある。孔４８，５０，５２が並びヒンジ，ピン，回
転ピン５４が入るように、構成部品は組立てられる（図
１と４）。底張出部４２と上張出部４４の近位部は適当
な手段（図示せず）でハウジング３４に取り付けられ
る。
とができ、器具のこの端には取付組立体４０がある（図
１）。取付組立体４０は、底張出部４２，上張出部４
４，支持部材４６からなる。底張出部４２には孔４８
が、上張出部４４には孔５０が、支持部材４６には孔５
２がある。孔４８，５０，５２が並びヒンジ，ピン，回
転ピン５４が入るように、構成部品は組立てられる（図
１と４）。底張出部４２と上張出部４４の近位部は適当
な手段（図示せず）でハウジング３４に取り付けられ
る。
【００１５】支持部材４６は、顎組立体を取り付ける片
持ち部材５６を有する。顎組立体は第一の顎、即ち下の
顎６１を有する。第一の顎６１には、第一の側壁６４，
第二の側壁６６，底壁又は床６８（図４）によって形成
される溝の形をした近位部がある。図４に示されるよう
に支持部材４６の突出部材５６が第一の顎６１の近位部
の中に入り、適当な手段（例、ねじやま留め具，圧入，
接着剤，溶接，鑞付け）（図示せず）によってその中に
留められる。顎組立体を部材５６や器具の他の所望の部
分に取り付ける特別の手段は、本発明のどの部分も構成
しない。
持ち部材５６を有する。顎組立体は第一の顎、即ち下の
顎６１を有する。第一の顎６１には、第一の側壁６４，
第二の側壁６６，底壁又は床６８（図４）によって形成
される溝の形をした近位部がある。図４に示されるよう
に支持部材４６の突出部材５６が第一の顎６１の近位部
の中に入り、適当な手段（例、ねじやま留め具，圧入，
接着剤，溶接，鑞付け）（図示せず）によってその中に
留められる。顎組立体を部材５６や器具の他の所望の部
分に取り付ける特別の手段は、本発明のどの部分も構成
しない。
【００１６】第一の顎の側壁６４には開口部６９があ
り、第一の顎の側壁６６には開口部７０がある。長円形
レバーアーム７４がピン７２に配置し、第一の顎６１の
開口部６９，７０に取り付けられる。
り、第一の顎の側壁６６には開口部７０がある。長円形
レバーアーム７４がピン７２に配置し、第一の顎６１の
開口部６９，７０に取り付けられる。
【００１７】顎組立体は上の、即ち第二の顎７６を有
し、第二の顎７６には一対の突起又は耳７８が形成され
る近位端部がある。各突起７８に孔８０がある。第二の
顎７６の近位部は第一の顎の側壁６４，６６の間に入
る。各側壁６４，６６には垂直に向いた長形のスロット
８４がある。軸８６がスロット８４と第二の顎の孔８０
を通って取り付けられ、第二の顎７６を第一の顎６１に
取り付けて保持する。
し、第二の顎７６には一対の突起又は耳７８が形成され
る近位端部がある。各突起７８に孔８０がある。第二の
顎７６の近位部は第一の顎の側壁６４，６６の間に入
る。各側壁６４，６６には垂直に向いた長形のスロット
８４がある。軸８６がスロット８４と第二の顎の孔８０
を通って取り付けられ、第二の顎７６を第一の顎６１に
取り付けて保持する。
【００１８】各スロット８４の長さは軸８６の直径より
大きい。従って、軸８６はスロット８４の中で縦方向に
自由に移動できる。これは、第二の顎７６の近位部が第
一の顎６１に近付いたり離れたりする動きに都合がよ
い。さらに、軸８６は、第二の顎７６がその周りを回転
できる回転軸として特徴づけることができる。この回転
軸は当然固定されず、軸８６がスロット８４に添って動
くので第一の顎６１に対して動くことができる。
大きい。従って、軸８６はスロット８４の中で縦方向に
自由に移動できる。これは、第二の顎７６の近位部が第
一の顎６１に近付いたり離れたりする動きに都合がよ
い。さらに、軸８６は、第二の顎７６がその周りを回転
できる回転軸として特徴づけることができる。この回転
軸は当然固定されず、軸８６がスロット８４に添って動
くので第一の顎６１に対して動くことができる。
【００１９】図示する実施例では、スプリング９０が図
１と４に示す顎組立体の中に取り付けられる。スプリン
グ９０はほぼＵ形であり、揺籃部９２を形成するＵ形に
曲がった脚を有する。揺籃部９２は軸８６に係合し、軸
にバイアス力をかけることにより、第二の顎７６の近位
部は第一の顎６１から離れて上方に上がる。
１と４に示す顎組立体の中に取り付けられる。スプリン
グ９０はほぼＵ形であり、揺籃部９２を形成するＵ形に
曲がった脚を有する。揺籃部９２は軸８６に係合し、軸
にバイアス力をかけることにより、第二の顎７６の近位
部は第一の顎６１から離れて上方に上がる。
【００２０】図１〜６に示される実施例では、操縦部材
はコード９６である。コードは、マルチ繊維の形の、コ
バルト滅菌可能、非毒性、液晶、ポリエステル−ポリア
クリレート重合体の単一のストランドである。所望によ
り、コードはマルチ繊維重合体の複数のストランドでも
よい。このような複数のストランドは、所望により編ん
でケーブルにできる。さらに、ポリエステル−ポリアク
リレート−マルチ繊維のコードは、鋼ワイヤ，動物繊
維，ポリエチレン繊維等の高性能繊維等の物質のストラ
ンド又は端と、組合せてもよい。
はコード９６である。コードは、マルチ繊維の形の、コ
バルト滅菌可能、非毒性、液晶、ポリエステル−ポリア
クリレート重合体の単一のストランドである。所望によ
り、コードはマルチ繊維重合体の複数のストランドでも
よい。このような複数のストランドは、所望により編ん
でケーブルにできる。さらに、ポリエステル−ポリアク
リレート−マルチ繊維のコードは、鋼ワイヤ，動物繊
維，ポリエチレン繊維等の高性能繊維等の物質のストラ
ンド又は端と、組合せてもよい。
【００２１】コード９６は第二の顎７６の周りでほぼＵ
形であり、第二の顎７６からレバー７４の周りに延びて
いる。コード９６は、レバー７４から顎組立体の近位部
を越えて延びるが、ここで適当な手段により引かれても
よい。図１〜６に示される実施例では、器具支持部材４
６には開口部９８があり、コード９６はそこを通って顎
６１，７６から近位方向に延びる。好ましくは、コード
９６は、器具の近位部まで、例えば外科医により引くこ
とができるハウジング３４（図２）の近位端まで、延び
る。
形であり、第二の顎７６からレバー７４の周りに延びて
いる。コード９６は、レバー７４から顎組立体の近位部
を越えて延びるが、ここで適当な手段により引かれても
よい。図１〜６に示される実施例では、器具支持部材４
６には開口部９８があり、コード９６はそこを通って顎
６１，７６から近位方向に延びる。好ましくは、コード
９６は、器具の近位部まで、例えば外科医により引くこ
とができるハウジング３４（図２）の近位端まで、延び
る。
【００２２】コード９６を引く好ましいシステムを図２
に示す。このシステムは、ピン１０２でハウジング３４
に回転可能に取り付けられたＬ形レバーを含む。コード
９６のループは操作レバー１００の開口部１０４を通っ
て延びる。スプリング９０は通常は第二の顎７６を開位
置にバイアス力をかけるので、操作レバー１００をハウ
ジング３４の適当な止め具（図示せず）に対して前位置
へ引くように、コード９６は通常は遠位方向に引かれ
る。外科医はハウジング３４の近位端を掴み、コード９
６を近位方向に引くためにレバー１００を後ろに握り締
める。
に示す。このシステムは、ピン１０２でハウジング３４
に回転可能に取り付けられたＬ形レバーを含む。コード
９６のループは操作レバー１００の開口部１０４を通っ
て延びる。スプリング９０は通常は第二の顎７６を開位
置にバイアス力をかけるので、操作レバー１００をハウ
ジング３４の適当な止め具（図示せず）に対して前位置
へ引くように、コード９６は通常は遠位方向に引かれ
る。外科医はハウジング３４の近位端を掴み、コード９
６を近位方向に引くためにレバー１００を後ろに握り締
める。
【００２３】コード９６のループの遠位端は第二の顎７
６に係合する。この端では、第二の顎７６の外面に弓形
溝１０８（図４）があり、コード９６がそこに入る。コ
ード９６は第二の顎７６の両側の下に延び第一の顎６１
の溝部に入る。コード９６は長円形レバー７４の外面の
周りを辿り係合する。
６に係合する。この端では、第二の顎７６の外面に弓形
溝１０８（図４）があり、コード９６がそこに入る。コ
ード９６は第二の顎７６の両側の下に延び第一の顎６１
の溝部に入る。コード９６は長円形レバー７４の外面の
周りを辿り係合する。
【００２４】レバー７４は長円形である必要はないが、
第一の面１１１と第二の面１１２（図４）が必要で、第
一の面１１１のどの部分とレバー回転軸の間の距離は、
第二の面１１２のどの部分とレバー回転軸の間の距離よ
り少ない。好ましくは、レバー７４は第二の顎７６が十
分に開いたとき図４に示すような向きを有するように、
コード９６と係合して初めから取り付けられる。特に、
この状態ではレバー７４の最も長い部分（例えば、長円
形レバーの長軸）は下の顎６１とほぼ平行な位置であ
り、コード９６のループの近位部は器具の長さ方向に添
って引かれるがその長さ方向とほぼ平行である。レバー
７４と第二の顎７６の間を延びるコード９６は、レバー
７４から近位方向に延びるコード９６の長さ方向に対し
て約９０度である。
第一の面１１１と第二の面１１２（図４）が必要で、第
一の面１１１のどの部分とレバー回転軸の間の距離は、
第二の面１１２のどの部分とレバー回転軸の間の距離よ
り少ない。好ましくは、レバー７４は第二の顎７６が十
分に開いたとき図４に示すような向きを有するように、
コード９６と係合して初めから取り付けられる。特に、
この状態ではレバー７４の最も長い部分（例えば、長円
形レバーの長軸）は下の顎６１とほぼ平行な位置であ
り、コード９６のループの近位部は器具の長さ方向に添
って引かれるがその長さ方向とほぼ平行である。レバー
７４と第二の顎７６の間を延びるコード９６は、レバー
７４から近位方向に延びるコード９６の長さ方向に対し
て約９０度である。
【００２５】コード９６は近位方向に引かれ、第一の面
１１１に添ったコードの長さは比較的短いレバーアーム
を通して張力をかけ、第二の面１１２に添ったコードの
部分は比較的長いレバーアームを通して張力をかける。
ケーブル９６が近位方向に引かれると、レバー７４が回
転する（図４に示すように反時計回り）。レバーが図５
に示す中間位置まで回転すると、レバー７４と第二の顎
７６の間のコードの長さは、比較的小さい力で比較的長
い移動する。コード９６が図５に示される向きから図６
に示される向きへ近位方向に引かれ続けると、第一の面
１１２と係合するコード９６の部分が比較的長いレバー
アームを通して張力をかけ、レバーアーム７４から第二
の顎７６に延びるコード９６の部分が比較的短いレバー
アームを通して張力をかけられる。従って、第二の面１
１２に隣接するコード９６の移動がより短くなり、より
大きい力を受ける。
１１１に添ったコードの長さは比較的短いレバーアーム
を通して張力をかけ、第二の面１１２に添ったコードの
部分は比較的長いレバーアームを通して張力をかける。
ケーブル９６が近位方向に引かれると、レバー７４が回
転する（図４に示すように反時計回り）。レバーが図５
に示す中間位置まで回転すると、レバー７４と第二の顎
７６の間のコードの長さは、比較的小さい力で比較的長
い移動する。コード９６が図５に示される向きから図６
に示される向きへ近位方向に引かれ続けると、第一の面
１１２と係合するコード９６の部分が比較的長いレバー
アームを通して張力をかけ、レバーアーム７４から第二
の顎７６に延びるコード９６の部分が比較的短いレバー
アームを通して張力をかけられる。従って、第二の面１
１２に隣接するコード９６の移動がより短くなり、より
大きい力を受ける。
【００２６】顎組立体の操作の効果は、初め第二の顎７
６を閉位置までの距離の比較的大きい割合（％）を比較
的小さい力で動かし、次に第二の顎７６を比較的大きい
力で短い残りの弓形を回転させ完全に閉じた位置にす
る。例えば、レバー７４が長円であり長軸の長さが短軸
の長さの２倍であるなら、第二の顎７６は初め加えられ
た引張力の１／２の力で完全に閉じた位置の方へ引か
れ、初めの引くストロークの長さの２倍の長さの弓形
（コード９６が第二の顎７６の上端に係合する半径で測
定する）に引かれる。続いて、レバー７６が約９０度回
転したとき（図５に示す位置まで）、第二の顎７６が最
後の引張ストローク長の１／２の長さの弓形を動き、第
二の顎７６は引張力の２倍の締付力を与える。
６を閉位置までの距離の比較的大きい割合（％）を比較
的小さい力で動かし、次に第二の顎７６を比較的大きい
力で短い残りの弓形を回転させ完全に閉じた位置にす
る。例えば、レバー７４が長円であり長軸の長さが短軸
の長さの２倍であるなら、第二の顎７６は初め加えられ
た引張力の１／２の力で完全に閉じた位置の方へ引か
れ、初めの引くストロークの長さの２倍の長さの弓形
（コード９６が第二の顎７６の上端に係合する半径で測
定する）に引かれる。続いて、レバー７６が約９０度回
転したとき（図５に示す位置まで）、第二の顎７６が最
後の引張ストローク長の１／２の長さの弓形を動き、第
二の顎７６は引張力の２倍の締付力を与える。
【００２７】図４と５に示されるように、第二の顎７６
が初めに回転運動する間、スプリング９０がスロット８
４内で軸８６に上方向にバイアス力をかけるため、第二
の顎７６の近位端はほぼ上がったままである。従って、
図５に示されるように、第二の顎７６の遠位端が初めに
物（例えば、組織Ｔ１とＴ２の二層）を挟み、その後顎
７６のさらに近位の部分が物を挟める。これは、初めに
２つの顎の遠位端の間で物を掴み、回転軸が固定され回
転しない従来の顎のように顎に沿って物が動く傾向を排
除又は少なくするのに役立つ。
が初めに回転運動する間、スプリング９０がスロット８
４内で軸８６に上方向にバイアス力をかけるため、第二
の顎７６の近位端はほぼ上がったままである。従って、
図５に示されるように、第二の顎７６の遠位端が初めに
物（例えば、組織Ｔ１とＴ２の二層）を挟み、その後顎
７６のさらに近位の部分が物を挟める。これは、初めに
２つの顎の遠位端の間で物を掴み、回転軸が固定され回
転しない従来の顎のように顎に沿って物が動く傾向を排
除又は少なくするのに役立つ。
【００２８】第二の顎７６の遠位部がほぼ閉位置まで回
転した後、コード９６を引くことによりさらに発生する
力は、スプリング９０の力をまかすのに十分な程大き
く、図６に示すように顎組立体が完全に閉じるまで、第
二の顎７６の近位端は第一の顎６１の方に引かれる。
転した後、コード９６を引くことによりさらに発生する
力は、スプリング９０の力をまかすのに十分な程大き
く、図６に示すように顎組立体が完全に閉じるまで、第
二の顎７６の近位端は第一の顎６１の方に引かれる。
【００２９】図１〜６に示される顎組立体は関節式外科
用器具に使用できる。顎組立体は第一の顎６１を介して
ピボット様支持部材４６の部材５６に取り付けられるの
で、ピン５４による軸の周りを回転すると顎組立体は支
持部材４６と共に動く。
用器具に使用できる。顎組立体は第一の顎６１を介して
ピボット様支持部材４６の部材５６に取り付けられるの
で、ピン５４による軸の周りを回転すると顎組立体は支
持部材４６と共に動く。
【００３０】第一の顎６１と第二の顎７６はほぼ固形の
遠位端部を有しているように示されている。一つ又は両
方の顎は他の形状でもよく、中空部を有していてもよ
い。一つ又は両方の顎は顎に捕まれる又は顎に隣接する
組織に作用する補助部材を有していてもよい。例えば、
一つ又は両方の顎はセンサーライン，吸引管，灌注管等
を含むことができる。
遠位端部を有しているように示されている。一つ又は両
方の顎は他の形状でもよく、中空部を有していてもよ
い。一つ又は両方の顎は顎に捕まれる又は顎に隣接する
組織に作用する補助部材を有していてもよい。例えば、
一つ又は両方の顎はセンサーライン，吸引管，灌注管等
を含むことができる。
【００３１】さらに、顎はクリップやステープル等の組
織締め具を用いることができる。例えば、二つの顎が線
状ステープルとして機能できるように、第一の顎６１は
一列又は複数列のステープルを備え、第二の顎７６はア
ンビル設計であることができる。ステープル付顎に、組
織を通してアンビル顎にステープルを放てるように適当
な機構を備えることができる。このような機構は、器具
の近位端からステープル付顎に延びる作動部材によって
作動できる。本発明への適用に適した線状ステープルは
米国特許第 4,610,383号に記載されている。
織締め具を用いることができる。例えば、二つの顎が線
状ステープルとして機能できるように、第一の顎６１は
一列又は複数列のステープルを備え、第二の顎７６はア
ンビル設計であることができる。ステープル付顎に、組
織を通してアンビル顎にステープルを放てるように適当
な機構を備えることができる。このような機構は、器具
の近位端からステープル付顎に延びる作動部材によって
作動できる。本発明への適用に適した線状ステープルは
米国特許第 4,610,383号に記載されている。
【００３２】本発明の他の実施例を図７〜図１０に示
す。この実施例では、器具の軸に対して角度を持って器
具の操作端を動かすために、コバルト滅菌可能、非毒
性、液晶、ポリエステル−ポリアクリレート重合体の操
縦部材を使用する。図示されるこの実施例において、器
具１５０は、外科処置で何らかの操作（例、結紮クリッ
プの適用、組織を把握、ステープルの適用）を行う遠位
即ち操作端１５１を有する。
す。この実施例では、器具の軸に対して角度を持って器
具の操作端を動かすために、コバルト滅菌可能、非毒
性、液晶、ポリエステル−ポリアクリレート重合体の操
縦部材を使用する。図示されるこの実施例において、器
具１５０は、外科処置で何らかの操作（例、結紮クリッ
プの適用、組織を把握、ステープルの適用）を行う遠位
即ち操作端１５１を有する。
【００３３】器具の近位端１５２には器具の操作端を作
動して所望の機能を実施するための作動手段１５５があ
る。器具の遠位端と近位端は、長形軸１５６により連結
される。長形軸により、器具の操作端はトロカールを通
って手術部位へ適切に配置される。
動して所望の機能を実施するための作動手段１５５があ
る。器具の遠位端と近位端は、長形軸１５６により連結
される。長形軸により、器具の操作端はトロカールを通
って手術部位へ適切に配置される。
【００３４】所望の機能を実施するために、器具の近位
端にかかる力を器具の遠位端に伝える様々なタイプの機
械的手段が、この軸に備えられる。このような手段はこ
の分野では既知であり、実施する機能によって大きく異
なる。
端にかかる力を器具の遠位端に伝える様々なタイプの機
械的手段が、この軸に備えられる。このような手段はこ
の分野では既知であり、実施する機能によって大きく異
なる。
【００３５】器具の操作端の遠位端は、回転手段１５９
によって軸に接続される。この回転手段により、器具の
遠位端が軸との並びから外れて動くこと、即ち、角度を
持って動くことが（図７の点線の形状で示される）、可
能となる。所望により軸もまた回転可能とすると、軸と
操作端の両方が回転でき、操作端は軸との並びから外れ
角度を持って動くことができ、器具の操作端がかなり自
由に動けるようになる。これにより、手術部位で器具の
操作端が非常に操縦しやすくなる。
によって軸に接続される。この回転手段により、器具の
遠位端が軸との並びから外れて動くこと、即ち、角度を
持って動くことが（図７の点線の形状で示される）、可
能となる。所望により軸もまた回転可能とすると、軸と
操作端の両方が回転でき、操作端は軸との並びから外れ
角度を持って動くことができ、器具の操作端がかなり自
由に動けるようになる。これにより、手術部位で器具の
操作端が非常に操縦しやすくなる。
【００３６】ピン１５９は軸の直径を通って延び、図８
に明瞭に示すように溝１６０がある。器具の近位端には
関節式レバー１６１がある。レバーは回転ピン１６２に
あり、回転ピン１６２は軸の直径を通って延び器具の操
作端の回転ピンと並ぶ。図８に示されるように、関節式
レバー回転ピンにも溝１６３がある。操縦部材１６４は
コードの形をしたコバルト滅菌可能、非毒性、液晶、ポ
リエステル−ポリアクリレート重合体であり、連続する
輪として二つの回転ピンの間に延び溝１６０，１６３に
はまる。
に明瞭に示すように溝１６０がある。器具の近位端には
関節式レバー１６１がある。レバーは回転ピン１６２に
あり、回転ピン１６２は軸の直径を通って延び器具の操
作端の回転ピンと並ぶ。図８に示されるように、関節式
レバー回転ピンにも溝１６３がある。操縦部材１６４は
コードの形をしたコバルト滅菌可能、非毒性、液晶、ポ
リエステル−ポリアクリレート重合体であり、連続する
輪として二つの回転ピンの間に延び溝１６０，１６３に
はまる。
【００３７】図９に示されるように、コード１６４は関
節式レバー回転ピン１６２の溝１６３に摩擦接触しては
まる。好ましくは、回転ピン１５９の溝１６０には鉄鈎
１６５がある。コード１６４を鉄鈎１６５に結んで又は
取り付けて、回転ピンからコードが外れる可能性を減ら
す。関節式レバー１６１をどちらの方向に回転しても、
器具の操作端は軸との並びから外れる。
節式レバー回転ピン１６２の溝１６３に摩擦接触しては
まる。好ましくは、回転ピン１５９の溝１６０には鉄鈎
１６５がある。コード１６４を鉄鈎１６５に結んで又は
取り付けて、回転ピンからコードが外れる可能性を減ら
す。関節式レバー１６１をどちらの方向に回転しても、
器具の操作端は軸との並びから外れる。
【００３８】特に好ましい回転ピン１６０，１６２は、
それぞれ溝１６０，１６３から延びる延長部１６５，１
６７を有する。これにより、操縦部材を延長部１６５，
１６７の周りに回したり結んだりできる。コード１６４
は回転ピン１６０，１６２の一つ又は両方と摩擦接触し
て係合できる。所望により、図７〜１０に示すように、
コード１６４は回転ピン１６０，１６２と係合してもよ
い。これにより、コード１６４と回転ピン１６０，１６
２の間のずれの可能性を除ける。
それぞれ溝１６０，１６３から延びる延長部１６５，１
６７を有する。これにより、操縦部材を延長部１６５，
１６７の周りに回したり結んだりできる。コード１６４
は回転ピン１６０，１６２の一つ又は両方と摩擦接触し
て係合できる。所望により、図７〜１０に示すように、
コード１６４は回転ピン１６０，１６２と係合してもよ
い。これにより、コード１６４と回転ピン１６０，１６
２の間のずれの可能性を除ける。
【００３９】本発明の実施例は例示だけを意図してい
る。本発明の精神と範囲から外れることなく当業者は多
くの変更をなすことができる。さらに、ここに述べた全
ての又はある好ましい実施例は、ここで述べた１以上の
目的を達成し１以上の効果をもたらす。本発明は示した
全ての目的を持たなくても実施できる。従って、特許請
求の範囲による実施以外は、本発明の目的と効果は本発
明の一部を構成しない。
る。本発明の精神と範囲から外れることなく当業者は多
くの変更をなすことができる。さらに、ここに述べた全
ての又はある好ましい実施例は、ここで述べた１以上の
目的を達成し１以上の効果をもたらす。本発明は示した
全ての目的を持たなくても実施できる。従って、特許請
求の範囲による実施以外は、本発明の目的と効果は本発
明の一部を構成しない。
【００４０】
【発明の効果】以上のように、本発明によれば、優れた
操縦部材を有する外科用器具を提供することができる。
操縦部材を有する外科用器具を提供することができる。
【図１】本発明による器具の一部である遠位端の簡略化
した分解斜視図である。
した分解斜視図である。
【図２】遠位端操作のためのハンドルとレバーを示す器
具の近位部の簡略化した概略図である。
具の近位部の簡略化した概略図である。
【図３】図１に示す遠位端顎組立体の部分平面図である
が、図３は内部の詳細を示すために第二（上）の顎の一
部を切り欠いた開位置での顎組立体を示す。
が、図３は内部の詳細を示すために第二（上）の顎の一
部を切り欠いた開位置での顎組立体を示す。
【図４】図３の面４−４にほぼ添った部分断面図であ
る。
る。
【図５】図４と同様な図であるが、図５は顎組立体が一
部閉じた状態を示す。
部閉じた状態を示す。
【図６】図５と同様な図であるが、図５は顎組立体が完
全に閉じた状態を示す。
全に閉じた状態を示す。
【図７】本発明による器具の他の実施例の簡略化した斜
視図である。
視図である。
【図８】図７に示す器具に使用する操縦機構の斜視図で
ある。
ある。
【図９】図８に示す関節式ピンの拡大概略断面図であ
る。
る。
【図１０】図８に示す回転ピンの拡大概略断面図であ
る。
る。
３４ ハウジング（近位端） ６１ 第一の顎（遠位端） ７６ 第二の顎（遠位端） ９６ コード（操縦部材） １５０ 器具（外科用器具） １５１ 操作端（遠位端） １５２ 近位端 １５６ 長形軸（構造体） １６４ コード（操縦部材）
Claims (4)
- 【請求項１】外科処置において操作を実施する遠位端、 前記遠位端の操縦を作動する近位端、 前記遠位端と前記近位端をつなぐ構造体、及び前記近位
端から前記遠位端を操縦できるように前記近位端の前記
作動手段から前記構造体を通って前記遠位端へ延びる部
材であって、前記部材の少なくとも一部はコバルト滅菌
可能，非毒性，液晶，ポリエステルーポリアクリレート
重合体であり、前記重合体は高い引張特性と低い伸び率
を有している、 とを具備する外科用器具。 - 【請求項２】外科処置において操作を実施する遠位端、 前記遠位端を操縦する近位端、 前記遠位端と前記近位端をつなぐ構造体であって、前記
遠位端は前記構造体に接続し前記遠位端は前記構造体に
対して角度を持って動ける、及び角度を持って動けるよ
うに前記遠位端から前記構造体を通って前記近位端へ延
びる部材であって、前記部材の少なくとも一部はコバル
ト滅菌可能，非毒性，液晶，ポリエステルーポリアクリ
レート重合体であり、前記重合体は高い引張特性と低い
伸び率を有している、 とを具備する外科用器具。 - 【請求項３】外科処置において操作を実施する遠位端、 前記遠位端の操縦を作動する近位端、 前記遠位端と前記近位端をつなぐ構造体、及び前記近位
端から前記遠位端を操縦できるように前記近位端の前記
作動手段から前記構造体を通って前記遠位端へ延びる部
材であって、前記部材の少なくとも一部は滅菌可能，非
毒性の重合体コードである、 とを具備する外科用器具。 - 【請求項４】外科処置において操作を実施する遠位端、 前記遠位端を操縦する近位端、 前記遠位端と前記近位端をつなぐ構造体であって、前記
遠位端は前記構造体に接続し前記遠位端は前記構造体に
対して角度を持って動ける、及び角度を持って動けるよ
うに前記遠位端から前記構造体を通って前記近位端へ延
びる部材であって、前記部材の少なくとも一部は滅菌可
能，非毒性の重合体コードである、 とを具備する外科用器具。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US130065 | 1987-12-08 | ||
| US13006593A | 1993-09-30 | 1993-09-30 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JPH07163573A true JPH07163573A (ja) | 1995-06-27 |
Family
ID=22442893
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP6258993A Pending JPH07163573A (ja) | 1993-09-30 | 1994-09-29 | 外科用器具 |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP0646357A1 (ja) |
| JP (1) | JPH07163573A (ja) |
| AU (1) | AU7431494A (ja) |
| CA (1) | CA2133159A1 (ja) |
Cited By (434)
| Publication number | Priority date | Publication date | Assignee | Title |
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Also Published As
| Publication number | Publication date |
|---|---|
| AU7431494A (en) | 1995-04-13 |
| CA2133159A1 (en) | 1995-03-31 |
| EP0646357A1 (en) | 1995-04-05 |
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