WO2013173954A1 - 一次性包皮环切吻合器 - Google Patents

一次性包皮环切吻合器 Download PDF

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Publication number
WO2013173954A1
WO2013173954A1 PCT/CN2012/001438 CN2012001438W WO2013173954A1 WO 2013173954 A1 WO2013173954 A1 WO 2013173954A1 CN 2012001438 W CN2012001438 W CN 2012001438W WO 2013173954 A1 WO2013173954 A1 WO 2013173954A1
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WO
WIPO (PCT)
Prior art keywords
disposable circumcision
circumcision stapler
fastening device
groove
stapler according
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.)
Ceased
Application number
PCT/CN2012/001438
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English (en)
French (fr)
Other versions
WO2013173954A8 (zh
Inventor
商建忠
商晶晶
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority to EP12877095.5A priority Critical patent/EP2856954B1/en
Priority to EA201492143A priority patent/EA028137B1/ru
Priority to LTEP12877095.5T priority patent/LT2856954T/lt
Priority to SI201231069T priority patent/SI2856954T1/sl
Priority to RS20170909A priority patent/RS56341B1/sr
Priority to ES12877095.5T priority patent/ES2639942T3/es
Priority to HRP20171401TT priority patent/HRP20171401T1/hr
Priority to AP2014008123A priority patent/AP2014008123A0/xx
Priority to DK12877095.5T priority patent/DK2856954T3/en
Application filed by Individual filed Critical Individual
Priority to PL12877095T priority patent/PL2856954T3/pl
Priority to CA2876510A priority patent/CA2876510C/en
Publication of WO2013173954A1 publication Critical patent/WO2013173954A1/zh
Anticipated expiration legal-status Critical
Priority to ZA2014/09503A priority patent/ZA201409503B/en
Publication of WO2013173954A8 publication Critical patent/WO2013173954A8/zh
Priority to CY20171100994T priority patent/CY1119700T1/el
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis, e.g. in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/326—Circumcision apparatus

Definitions

  • the present invention relates to a circumcision anastomat, and more particularly to a circumcision anastomat for preventing an external ring locking device from being bounced. Background technique
  • the role of circumcision in adults in reducing HIV transmission has been widely recognized.
  • the disposable circumcision anastomat invented by Mr. Shang Jianzhong proposed a method in which the upper and lower blades are staggered to prevent the meat from being caught during the operation. Causes pain to the patient.
  • the program has been modified several times to make the circumcision anastomosis further ensure the convenience, safety and effectiveness of the operation, and it is applicable to a wide range of people and can be standardized.
  • the fastening device (outer ring) and the glans ferrule (inner ring) of the existing circumcision anastomat are hard non-toxic medical plastic materials, which need to be worn on the human body for 10 to 7 days, during the wearing process.
  • the hard knife edge and the glans ferrule are directly clamped on the patient's foreskin, which is easy to cause pain and discomfort to the patient, affecting the normal life during wearing.
  • the most important consideration in the use of a circumcision stapler is to prevent accidental shedding of the instrument during surgery. If the circumcision stapler is accidentally uncoupled during wear, it will directly cause bleeding and cause a patient's fear.
  • the locking device of the outer ring of the existing commercial ring circumcision stapler adopts a stepped engaging block designed to cooperate with each other to prevent accidental bounce of the opening of the fastening device. Therefore, on the basis of the prior art, the inventor has further improved the locking device of the outer ring opening. Summary of the invention
  • the invention has been improved on the existing circumcision stapler to further improve the stability of the outer ring opening and locking device.
  • a disposable circumcision anastomat comprising a fastening device and a glans ferrule
  • the fastening device has an opening, and the two ends of the opening are provided with a corresponding upper half of the blade joint and the lower half
  • the open end of the fastening device is connected by a locking device
  • the fastening device has a ring wall and a knife edge, and the inner end of the knife edge is connected with a buffer gasket.
  • the first embodiment is as follows: The inner end of the knife edge is provided with a groove, and the buffer gasket is received in the groove.
  • the second embodiment is as follows: The buffer gasket is provided with a groove, and the inner end of the knife edge is accommodated in the groove or all the knife edges are accommodated in the groove.
  • the buffer gasket is made of silica gel, and is connected to the knife edge by a plastic-silicone one-time forming process.
  • the ring wall is further coated with a silica gel layer which is connected to the ring wall by a plastic-silica gel one-shot process.
  • the inner end of the knife edge is greater than or equal to the width of the connecting end of the blade edge and the ring wall.
  • a rubber mat is also included, which is sleeved on the outer wall of the glans ferrule.
  • the upper end opening of the glans ferrule has a first outer edge extending outwardly, and the lower end opening has a second outer edge extending outwardly.
  • An annular receiving space is formed between the first outer edge and the second outer edge, and the rubber pad is formed Placed in the annular accommodation space.
  • the cushioning washer and the rubber pad are provided with an anti-blocking structure for preventing skin adhesion.
  • the anti-blocking structure is a thousand pits or bumps; or a raised or recessed interlaced line; or a depressed groove or a raised groove; or a frosted structure.
  • the fastening device and the ring wall of the glans ferrule are elliptical or elliptical inclined structures that match the crown of the penis glans.
  • the glans ferrule is provided with a notch for the sheath strap.
  • the fastening device is a C-ring having an open end.
  • the fastening device is a tripartite ring, the open end of the fastening device is disposed above the position corresponding to the scrotum, and the connection end of the separation body is disposed at a position offset from the position of the scrotum.
  • the locking device includes a first stepped engaging block and a second stepped engaging block, and the first stepped engaging block and the second stepped engaging block are respectively provided with an anti-detaching hook and a retaining groove .
  • the locking device is a screw and a screw hole.
  • the locking device casing is provided with a protective cover that is shaped to match the locking device.
  • the cross section of the groove is a circular arc or a semicircle or a semi-ellipse or a triangle or a square; the upper half of the blade joint and the lower half of the blade joint are combined to form a circular or semicircular cross section. Or a semi-elliptical or triangular or square groove; the cushioning washer is matched thereto.
  • the cushioning washer is annular and the length of the annular circumference matches the length of the circumference of the knife edge.
  • the fastening device comprises one or two or three cutting edges.
  • the upper half of the knife edge joint and the lower half of the knife edge joint are provided with rounded corners.
  • the groove at the end of the knife edge has a groove for accommodating the cushioning washer, so that the soft non-toxic medical silica material cushioning washer is directly clamped on the surgical site of the foreskin.
  • the glans ferrule is further provided with a soft rubber pad, so that the soft material directly on both sides of the foreskin can provide a certain relaxation space for the foreskin, effectively alleviating the squeezing pain and discomfort during the operation. .
  • the groove at the end of the knife edge is provided on the basis of the support of the blade support, which increases the softness of the knife face.
  • the two ends of the opening of the fastening device are extended with the upper half of the blade joint and the lower half of the knife At the mouth joint, when the knife edge and the cushioning washer cooperate with each other, ⁇ extends the blade edge at the joint of the upper and lower blades, and when the outer ring opening is closed, the two are staggered up and down to gradually form a complete blade groove structure. Instead, the cushion washer is gradually squeezed into the groove of the knife edge. During the closing process, the cushion washer is not wrinkled and is caught in the closed portion of the opening, and the sheath is not clamped.
  • the anti-adhesive structure such as bumps and stripe lines for preventing skin adhesion is further provided on the cushion washer and the rubber pad to reduce the possibility of skin adhesion at the surgical site, so that the process of the lower ring is simple and painless after the surgery is completed.
  • the anti-decoupling and anti-de-sinking structure is added to the locking device, and the structure of the protective sleeve is further provided on the casing of the locking device, thereby absolutely preventing the possibility of the fastening device being opened.
  • the ring wall of the fastening device and the glans ferrule is an elliptical or elliptical inclined structure that matches the coronal groove of the penis glans, so that the entire instrument can perfectly match the human body structure. Further reduce the pain of the patient's nighttime penile erection traction strap and improve the comfort of the device.
  • the invention is also applicable to a flexible integrated C-shaped ring and a three-part ring, wherein the integrated ring is simple and convenient, the three-part ring, staggering the protruding joint portion of the fastening device, effectively avoiding the friction between the protruding joint portion and the body. .
  • the glans ferrule is provided with a notch for the sheath of the foreskin, and the device is perfectly matched with the body structure, and the tether is protected from the prolonged compression of the device.
  • FIG. 1A is a schematic view showing the overall structure of a circumcision anastomat according to the present invention, which comprises a fastening device, a glans ferrule, a cushioning washer and a rubber pad.
  • Figure 1B is a schematic view showing the structure of the fastening device and the cushioning washer.
  • Figure 1C is a schematic view showing the structure of the fastening device, the glans ferrule, the cushion washer and the rubber pad as a whole.
  • Fig. 1D is a cross-sectional structural view taken along line ⁇ - ⁇ in Fig. 1C.
  • 2 ⁇ and 2 ⁇ are the structural schematic diagrams of the left half ring and the right half ring of the fastening device, respectively.
  • 2C to 2B are schematic longitudinal sectional structural views of three kinds of fastening devices, respectively.
  • Fig. 2F to Fig. 2 ⁇ are schematic views showing the structure of the joint of the upper and lower half of the three kinds of fastening devices in Fig. 2C to Fig. 2, respectively.
  • 21 and 2G are schematic cross-sectional structural views of a fastening device having a double knife edge.
  • Figure 2 is a schematic view showing the structure of the upper and lower half of the blade joint of Figure 2G.
  • 3A to 3C are schematic views showing the structure of the annular cushion washer.
  • 3D is a schematic structural view of a linear buffer gasket.
  • FIG. 4A to 4H are schematic views showing the second cooperation structure of the cushion washer and the knife edge in the present invention.
  • Figure 5A to Figure 5A are schematic views showing the second cooperation structure of the cushion washer and the knife edge in the present invention.
  • 5C is a schematic structural view of a glans ferrule in the present invention.
  • Figure 6 is a schematic view showing the structure of a rubber mat in the present invention.
  • Figure 7 is a cross-sectional, cross-sectional view of a glans ferrule with a rubber pad.
  • Figure 8 is a cross-sectional structural view showing the cushioning washer disposed in the groove of the fastening device.
  • Figure 9 is a schematic cross-sectional view of the fastening device, the cushioning washer, the glans ferrule, and the rubber mat.
  • Fig. 10 is a schematic view showing the operation of the circumcision stapler of the present invention in a human body.
  • FIG. 11A to 11C are schematic views showing the structure of the anti-blocking structure provided on the cushion washer and the rubber pad.
  • Figures 12A and 12B show the securing device in an elliptical configuration that matches the coronal groove of the penis glans.
  • Figure 12C is a schematic illustration of the elliptical inclined structure of the fastening device and the glans ferrule ring wall matching the crown glans of the penis.
  • Figure 13 is a schematic view of an elliptical inclined structure matching the glans ferrule and the glans of the penis glans.
  • Fig. 14 is a schematic view showing the operation of an elliptical oblique circumcision anastomat in a human body.
  • Figure 15 is a schematic view showing the structure of a glans ferrule with a lacing.
  • FIG. 16 and FIG. 17 are schematic structural views of the locking device provided with anti-decoupling and anti-decogging.
  • Fig. 18A to Fig. 18D are schematic views showing the structure of the elliptical oblique circumcision anastomat provided with anti-decoupling and anti-decogging.
  • 19A to 19E are schematic views showing the structure of a protective cover for a locking device according to the present invention.
  • 20A and 20B are schematic views showing the structure of an overall C-shaped outer ring according to the present invention.
  • 21A and 21B are schematic views showing the structure of the fastening device of the present invention using a three-part ring. detailed description
  • the disposable circumcision stapler of the present invention comprises a fastening device 3 and a glans ferrule 1, the fastening device 3 has a ring wall 31 and a knife edge 32, and the fastening device 3 has an opening, and the opening is provided through The locking device 4 on the outer ring wall is closed.
  • a design of the cushioning washer 2 is provided on the fastening device 3. Referring to Figure 1B, the cushion washer 2 is attached to the inner end of the knife edge 32 (to the mating end of the glans ferrule).
  • a groove 33 is formed at the inner end of the knife edge 32.
  • the cross section of the groove 33 is semicircular.
  • the cushioning gasket matched therewith is as shown in Figs. 3A to 3C, and has a circular cross section and a section diameter slightly smaller than or coincident with the cross-sectional diameter of the semicircular groove.
  • the circumferential circumference of the cushion washer 2 matches the circumferential circumference of the blade end after the fastening device 3 is closed, and the cushion washer 2 is received in the recess 32 to form a stable fit.
  • the groove 33 may also have a circular arc shape, a semi-elliptical shape, a square shape or a triangular shape, and the cushion washer 2 can be stably fitted thereto.
  • the inner end width HI of the knife edge may be equal to or larger than the width H2 of the blade end and the ring wall connection end.
  • the invention adopts an upper half blade joint 311A and a lower half edge joint 311B on the edge of the opening of the fastening device.
  • the upper and lower half edge joints are thinner than the adjacent edge, and the outer end is rounded. , when plugged in each other when used, form a complete knife edge structure after closing.
  • Fig. 2F to Fig. 2H it is a structural schematic view of the combination of the upper and lower half edge joints provided on the three different cutting edges. When the groove structure is provided on the knife edge, the upper and lower half edge joints are combined with each other to form the same groove shape as the adjacent knife edge.
  • the fastening device includes a connecting end in addition to the open end, and the fastening device 3 is a split ring including the left half ring member 3A and the right half ring member 3B, and the connecting end is connected through the connecting buckle. 35 is closed, the connecting buckle 35 includes a connecting hole 351 and a connecting post 352 disposed on the other half ring member.
  • the fastening device adopts a split structure to ensure the angle at which the instrument is opened, which is beneficial to the upper and lower rings, and can be made of a hard material to ensure the stability of the knife edge.
  • the two ends of the connecting end are also provided with the upper and lower half of the blade joint. This structure can effectively prevent the knife from being caught during the closing process.
  • the fastening device cooperates with the cushioning washer, it can effectively buffer.
  • the gasket is gradually guided into the groove of the knife edge without causing the buffer gasket to be exposed or clamped at the open end or the joint end.
  • the fastening device comprises two cutting edges, the ends of which are connected to the cushioning washer, and the two cutting edges are naturally formed.
  • the cavity 34 can be used to place a cotton wool or ointment.
  • the open end or the joint end of the double knife edge is closed, the left half ring member has two upper half edge joints 311A (inside), and the right half ring member has two lower half knife joint joints 311B ( The outer side, after closing, forms a complete closed structure in which the two lower half edge joints 311B are wrapped around the two upper half edge joints 311A.
  • the cushion washer 2 in addition to the closed ring structure shown in FIG. 3A, can also adopt the elongated shape shown in FIG. 3D, and is directly inserted into the groove 33 of the blade 32 when in use.
  • the upper and lower plug structures 21 1 and 212 are disposed at both ends of the opening, and when the fastening device is closed, the buffer gasket forms a complete annular closure. Structure, fully aligned with the fastening device.
  • the cushion washer 2' has a recess 21 which covers the inner end of the blade 32.
  • the groove 21 may cover a portion of the knife edge or may be applied to the entire knife edge as shown in Figs. 4F and 4G.
  • the inner end width HI of the knife edge may be equal to or larger than the width H2 of the joint end of the blade edge and the ring wall, in addition to the conventional width H2 of the connecting end of the ring wall.
  • Figure 4C shows the case where HI is equal to H2.
  • Figures 4D and 4E show the case where HI is greater than H2.
  • the cushion washer 2' is made of medical non-toxic silica gel, and the silica gel is directly attached to the inner end of the knife edge or the entire knife edge by a plastic-silica gel one-time forming process.
  • the ring wall 31 is further coated with a silica gel layer 22, which is connected to the ring wall by a plastic-silica gel one-shot process.
  • the entire fastening device is covered with a silicone layer that allows the wearer to directly touch the soft surface of the device, effectively enhancing the wearer's comfort.
  • FIG. 5A to FIG. 5C it is a schematic structural view of the glans ferrule 1 of the present invention.
  • the upper edge of the glans ferrule 1 has a first outer edge 11 extending outwardly and a second outer edge 12 extending outwardly from the lower edge.
  • An annular receiving space 13 is formed between the first outer edge 11 and the second outer edge 12.
  • the rubber mat 5 is a soft annular pad having a width which matches the annular accommodation space.
  • the rubber pad 5 When in use, the rubber pad 5 is sleeved on the glans ferrule 1, and as shown in FIG. 7, the rubber pad 5 is accommodated in the annular accommodating space 13.
  • the rubber pad 5 is set on the glans ferrule 1 during the operation, and the glans ferrule 1 is placed between the penis and the foreskin (traditional built-in circumcision operation method) or the foreskin 7 Eversion, so that the valgus wrapper covers the glans ferrule 1, (the circumcision circumcision invented by Mr.
  • Both the cushioning washer and the rubber pad are made of soft and non-toxic medical silicone material, so that the skin of the foreskin can be stretched within a certain limit, effectively avoiding pain and discomfort during the operation.
  • the outer end of the ring of the fastening device is curved, and the ring wall of the glans ferrule is concavely inward with a certain arc, and the matching rubber pad also has a certain arc to match it. This setting prevents the knife edge from sliding to both ends.
  • the anti-adhesion structure 6 for preventing skin adhesion is provided on the cushioning washer 2 and the rubber pad 5, and the anti-adhesion structure is a plurality of pits and/or bumps as shown in FIG. 11A. Or a plurality of raised or recessed interwoven lines as shown in Fig. 11B, or a plurality of depressed grooves or raised grooves as shown in Fig. 11C. If the bumper 2 is provided with a bump, and the rubber pad 5 is provided with a recessed groove, when the lower end of the surgery is finished, the adhesion of the skin is not caused by the presence of the anti-adhesion structure, making the lower ring process easier.
  • the fastening device 3 and the glans ferrule 1 of the present invention exhibit an elliptical structure matching the crown-shaped groove of the penis glans, or an elliptical inclined structure as shown in Figs. 12C and 13.
  • the circumcision anastomosis fits perfectly into the sloping structure of the glans' coronal sulcus, making the wearer more comfortable and at the same time facilitating surgical procedures.
  • a ligament notch 14 is provided on any one of the upper and lower end faces of the glans ferrule 1, and the end of the glans ferrule 1 having the ligament notch 14 is matched with the penis lacing end during use. Then adjust the position and install it with the fastening device 3, which can effectively protect the penis ligament and prevent its damage, so that the whole instrument can perfectly match the human body structure. Further reduce the pain of the patient's nighttime penis erection traction strap, and improve the comfort of the device.
  • the opening of the fastening device is closed and locked by the locking device.
  • the locking device may be a screw and a screw hole structure disposed at both ends of the opening, or may be a snap block closing structure as shown in FIG.
  • a stepped engaging block 41 and a second stepped engaging block 42 are vertically offset as shown in FIG.
  • the upper half of the blade joint 311A is located at the upper end of the first stepped engaging block 41, and the lower half of the blade joint 311B is located below the second stepped engaging block 42.
  • the first stepped engaging block 41 and the second stepped engaging block 42 are provided with a matching hook and a card slot structure, as shown in FIG. 16 and FIG.
  • the first stepped engaging block 41 is provided with a first hook 13 at its outer end and a second card slot 14 at its inner end.
  • a second hook 14 is disposed at an outer end of the second ladder-shaped engaging block 42, and a first card slot 15 is disposed at the inner end. After being closed, the first hook 13 is engaged with the first card slot 15, and the second hook 14 and the second card slot 16 are latched.
  • the inner end surface of the first stepped engaging block 41 and the second stepped engaging block extending outward is an inclined surface, and is matched with the ring wall. Tilt the boss.
  • the first inclined surface 411 and the second inclined boss 412 disposed on the first stepped engaging block 41 and the second inclined surface 421 and the first inclined boss disposed on the second stepped engaging block 42 are shown. 422.
  • the first hook 13 is disposed at an outer end of the first inclined surface 411
  • the second hook 14 is disposed at an outer end of the second inclined surface 421.
  • the first card slot and the second card slot are linear grooves or circular grooves that cooperate with the hooks.
  • the hook and the slot structure further cooperate with the first serrated engaging block and the second serrated engaging block to ensure effective clamping in both the vertical and horizontal directions, thereby effectively preventing artificial snoring or accidental opening.
  • an unlocking hole 43 is provided in the second step-shaped engaging block 42, and after the surgery is finished, the opening hole 43 is opened by a special tool to open the opening and the lower ring.
  • the protective sleeve 6 which is sleeved outside the locking device.
  • the protective sleeve is matched in shape to the locking device, and includes a sleeve 61 and a cover 62 which cooperate with each other.
  • the casing 61 has a bottom plate, two side walls and a top wall, and the bottom plate, the two side walls and the top wall enclose an accommodating space, and the locking device is accommodated in the accommodating space of the casing.
  • the sleeve 6 and the cover 62 are connected by means of a slot 63 and a post 64.
  • the protective cover can also be constructed of a flexible silicone sleeve for ease of use.
  • the protective cover structure of the present invention can effectively prevent the risk of collapse from the penis expansion to the first and second serrated engaging blocks, ensuring a 100% surgical success rate.
  • the fastening device 30 is a C-shaped ring having only an open end. To ensure a certain degree of opening, the device is made of a soft material.
  • the fastening device may also adopt a three-part ring, the open end of the fastening device is disposed above the position corresponding to the scrotum, and the connection end of the separation body is disposed at a position offset from the position of the scrotum.
  • the split structure except that the open end is provided with the combination of the upper half of the blade joint and the lower half of the blade joint, the same upper and lower staggered plug structure is provided at each joint end, so that the links of the respective joints are not Produces meat or prevents the buffer gasket from being installed smoothly.

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Description

一次性包皮环切吻合器 技术领域
本发明涉及一种包皮环切吻合器， 尤其针对外环锁固装置防止其弹开的包皮 环切吻合器。 背景技术
成年人包皮环切手术在降低 HIV传播的作用已经被广泛认可，商建忠先生发明 的一次性包皮环切吻合器， 提出了上下半部刀口相互错开的方式， 以防止在手术 过程中夹肉造成患者痛苦。 该方案进行了多次改良设计， 使得包皮环切吻合器进 一步确保了手术的便捷性、 安全性， 有效性， 适用人群广泛， 可标准化操作。
现有包皮环切吻合器的固紧装置 （外环） 和龟头套圈 （内环） 均为硬质无毒 医用塑料材质， 由于需要在人体上佩带 10至 7天时间， 在佩戴的过程中， 坚硬的刀 口和龟头套圈直接夹持作用在患者的包皮上， 容易造成患者的疼痛和不适， 影响 佩戴期间的正常生活。
另外， 使用包皮环切吻合器最为重要的注意事项就是防止手术过程中的器械 意外脱落， 如果包皮环切吻合器在佩带过程中意外脱环， 将会直接导致流血并造 成患者的恐惧感。 为了防止器械脱落， 现有的商环牌包皮环切吻合器的外环的锁 固装置采用两端相互配合的阶梯状卡合块设计， 防止固紧装置开口的意外弹开。 故此， 在现有技术的基础上， 发明人对外环开口的锁固装置进行了进一步的改进。 发明内容
本发明针对现有包皮环切吻合器进行了改良， 进一步提高了外环开口锁固装 置的稳固性。
本发明采用的技术方案为： 一次性包皮环切吻合器， 包含有固紧装置和龟头 套圈， 固紧装置具有开口， 开口两端设有相互对应的上半部刀口结合处和下半部 刀口结合处， 该固紧装置的开口端通过锁固装置连接， 其改进在于： 该固紧装置 具有环壁和刀口， 刀口内端连接缓冲垫圈。
其第一种实施方式为： 该刀口内端设有凹槽， 缓冲垫圈容置于凹槽内。 其第二种实施方式为： 该缓冲垫圈设置有凹槽， 刀口内端容置于该凹槽内或 全部刀口容置于该凹槽内。 其中， 该缓冲垫圈为硅胶材质， 其通过塑料一硅胶一 次成型工艺与刀口连接。 该环壁上进一步包覆有硅胶层， 该硅胶层通过塑料一硅 胶一次成型工艺与环壁连接。
基于上述技术方案， 该刀口内端大于或等于刀口与环壁的连接端的宽度。 还 包含有橡皮垫， 该橡皮垫套设于龟头套圈的外壁。 该龟头套圈上端开口向外延伸 有第一外沿， 下端开口向外延伸有第二外沿， 该第一外沿和第二外沿之间形成有 环形容置空间， 所述橡皮垫容置于该环形容置空间内。 该缓冲垫圈和橡皮垫上设 置有防止皮肤粘连的防粘连结构。 该防粘连结构为若千凹点或凸点； 或凸起或凹 陷交织线； 或凹陷槽或凸起槽； 或磨砂结构。 该固紧装置和龟头套圈的环壁呈与 阴茎龟头冠状沟相匹配的椭圆或椭圆倾斜结构。 该龟头套圈上设有供包皮系带容 置的缺口。 该固紧装置为 C型环， 具有开口端。 该固紧装置为三分体环， 固紧装置 的开口端设置在与阴囊位置相对应的上方， 分体的连接端设置在与阴囊位置错开 的位置。 该锁固装置包含第一阶梯状卡合块和第二阶梯状卡合块， 该第一阶梯状 卡合块和第二阶梯状卡合块上分别设置有相互配合的防脱钩和防脱槽。 该锁固装 置为螺杆和螺孔的配合方式。 该锁固装置外套设有保护套， 该保护套的形状和锁 固装置相匹配。 所述凹槽的横截面为圆弧或半圆形或半椭圆形或三角形或方形； 所述上半部刀口结合处和下半部刀口结合处组合后形成横截面为圆弧或半圆形或 半椭圆形或三角形或方形的凹槽； 所述缓冲垫圈与之相匹配。 该缓冲垫圈为环形， 环形圆周长度与刀口圆周长度相匹配。 所述固紧装置包含一个或二个或三个刀口。 所述上半部刀口结合处和下半部刀口结合处设置有圆角。
本发明的有益效果如下。
1、 刀口末端具有容置缓冲垫圈的凹槽， 使得柔软的无毒医用硅胶材质的缓冲 垫圈直接夹持在包皮的手术部位上。 加之龟头套圈上进一步套设有柔软材质的橡 皮垫， 使得直接作用在包皮两面的均为具有弹性的柔软物质， 能够为包皮提供一 定的舒张空间， 有效缓解手术过程中的挤压疼痛和不适。
2、 刀口的末端设置凹槽， 保留了刀口支撑固定作用的基础上， 增加了刀口手 术作用面的柔软程度。
3、 固紧装置开口的两端延伸设置有相互对应的上半部刀口结合处和下半部刀 口结合处， 当刀口与缓冲垫圈相互配合时， ιίι于上、 下半部刀口结合处延伸出刀 口， 当外环开口闭合时， 两者上下交错， 逐渐闭合形成完整的刀口凹槽结构。 而， 缓冲垫圈则被逐渐被挤压至刀口的凹槽内。 在闭合的过程中， 不会使缓冲垫圈褶 皱而被卡在开口的闭合处， 更不会夹持包皮。
4、 在缓冲垫圈和橡皮垫上进一步设置有防止皮肤粘连的凸点、 条纹线等防粘 连结构， 降低手术部位皮肤粘连的可能， 使得手术完成后， 下环过程简单而无痛。
5、 在锁固装置上加设有防脱钩和防脱槽结构， 并进一步在锁固装置外套设有 保护套的结构， 绝对杜绝固紧装置弹开的可能。
6、 固紧装置和龟头套圈的环壁呈与阴茎龟头冠状沟相匹配的椭圆或椭圆倾斜 结构， 使得整个器械能够与人体结构完美匹配。 进一步降低患者夜间阴茎勃起牵 拉系带的疼痛感， 提高器械使用的舒适感。
7、 本发明还适用于柔性一体 C形环和三分体环， 其中一体环简单方便， 三分 体环， 错开固紧装置的凸出结合部位， 有效避免该凸出结合部位与身体的摩擦。
8、 本发明中龟头套圈上设置有供包皮系带容置的缺口， 再器械与身体结构完 美匹配的同时， 又能保护系带不受长时间的器械压迫。 附图说明
图 1A为本发明包皮环切吻合器整体结构示意图， 其包含有固紧装置、 龟头套 圈、 缓冲垫圈和橡皮垫。
图 1B为固紧装置与缓冲垫圈配合的结构示意图。
图 1C为固紧装置、 龟头套圈、 缓冲垫圈和橡皮垫闭合为整体的结构示意图。 图 1D为图 1C中沿 Α-Α方向的剖视结构示意图。
图 2Α和图 2Β分别为固紧装置的左半圈件和右半圈件的结构示意图。
图 2C至图 2Ε分别为三种固紧装置的纵向剖视结构示意图。
图 2F至图 2Η分别为图 2C至图 2Ε中三种固紧装置上、 下半部刀口结合处的结构 示意图。
图 21和图 2G为具有双刀口的固紧装置剖视结构示意图。
图 2Κ为图 2G的上、 下半部刀口结合处的结构示意图。
图 3Α至图 3C为环形缓冲垫圈的结构示意图。 图 3D为线形缓冲垫圈的结构示意图。
图 4A至图 4H为本发明中缓冲垫圈与刀口的第二种配合结构示意图。图 5A至图
5C为本发明中龟头套圈的结构示意图。
图 6为本发明中橡皮垫的结构示意图。
图 7为套设有橡皮垫的龟头套圈的截面剖视示意图。
图 8为缓冲垫圈设置于固紧装置刀口凹槽内的剖视结构示意图。
图 9为固紧装置、缓冲垫圈、龟头套圈、橡皮垫配合使用时的剖面结构示意图。 图 10为本发明包皮环切吻合器实施于人体的手术示意图。
图 11A至图 11C为缓冲垫圈和橡皮垫上设置的防粘连结构的结构示意图。
图 12A和图 12B为固紧装置呈与阴茎龟头冠状沟相匹配的椭圆结构。
图 12C为固紧装置和龟头套圈环壁呈与阴茎龟头冠状沟相匹配的椭圆倾斜结 构的示意图。
图 13和龟头套圈与阴茎龟头冠状沟相匹配的椭圆倾斜结构的示意图。
图 14为椭圆倾斜的包皮环切吻合器实施于人体的手术示意图。
图 15为带有系带缺口的龟头套圈的结构示意图。
图 16和图 17锁固装置上设置有防脱钩和防脱槽的结构示意图。
图 18A至图 18D椭圆倾斜包皮环切吻合器上设置有防脱钩和防脱槽的结构示 意图。
图 19A至图 19E为本发明中锁固装置保护套的结构示意图。
图 20A和图 20B为本发明采用整体 C形外环的结构示意图。
图 21A和图 21B为本发明固紧装置采用三分体环的结构示意图。 具体实施方式
如图 1A所示， 本发明一次性包皮环切吻合器包含有固紧装置 3和龟头套圈 1， 固紧装置 3具有环壁 31和刀口 32， 固紧装置 3具有开口， 开口通过设置于外环环壁 上的锁固装置 4闭合。
本发明中， 为了防止固紧装置 3和龟头套圈 1夹持在包皮上造成手术者的疼痛， 提出在固紧装置 3上设置缓冲垫圈 2的设计方案。 请参阅图 1B所示， 在刀口 32内端 (与龟头套圈配合端） 连接缓冲垫圈 2。
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更正页 （细则第 91条） ISA/CN 本发明中缓冲垫圈的第一种实施方式是在刀口 32的内端开设有凹槽 33， 请结 合图 2C所示，凹槽 33的横切面为半圆形。与之配合的缓冲垫圈如图 3A至图 3C所示， 其横截面为圆形， 截面直径略小于半圆形凹槽的截面直径或与之相一致。 缓冲垫 圈 2的圆周周长与固紧装置 3闭合后的刀口端圆周周长相匹配， 缓冲垫圈 2容置于凹 槽 32内形成稳固配合。 当然， 凹槽 33也可以为圆弧形、 半椭圆形、 方形或三角形 等形状， 缓冲垫圈 2与之能够稳固配合即可。 如图 2D和图 2E所示， 为了节省材料， 本实施例中， 刀口内端宽度 HI可以等于或大于刀口与环壁连接端宽度 H2。
本发明沿用了在固紧装置开口两端的刀口上设置上半部刀口结合处 311A和下 半部刀口结合处 311B, 上、 下半部刀口结合处薄于相邻刀口， 外端设有圆角， 使 用时相互插接， 闭合后形成完整的刀口结构。 如图 2F至图 2H所示， 其为三种不同 刀口上设置的上、 下半部刀口结合处闭合后的结构示意图。 当于刀口上设置有凹 槽结构时， 该上、 下半部刀口结合处相互结合后形成与相邻刀口相同的凹槽形状。
如图 2A和 2B所示， 固紧装置除包含开口端外， 还包含有连接端， 固紧装置 3 为包含左半圈件 3A和右半圈件 3B的分体环， 连接端通过连接扣 35闭合， 该连接扣 35包括连接孔 351和设置在另一半圈件上的连接柱 352。 固紧装置采用分体结构可 以保证器械打开的角度， 有利于上下环， 且可以采用硬质材料制成， 保证刀口的 稳固性。 连接端两端同样设置有上下半部刀口结合处， 此结构一方面有效防止刀 口在闭合过程中夹肉的现象发生， 另一方面， 当固紧装置与缓冲垫圈配合时， 能 够有效的将缓冲垫圈逐渐导引至刀口的凹槽内， 不会造成缓冲垫圈的外露或被夹 持在开口端或连接端。
本发明还适用于两个以上刀口的固紧装置， 请参阅图 21和图 2G， 固紧装置包 含两个刀口， 两个刀口的末端均与缓冲垫圈连接， 而两个刀口之间自然形成的腔 体 34， 可以用于放置药棉或药膏。 如图 2K所示， 双刀口的开口端或连接端闭合处， 左半圈件具有两个上半部刀口结合处 311A (内侧）， 右半圈件具有两个下半部刀口 结合处 311B (外侧）， 闭合后形成两个下半部刀口结合处 311B包覆于两个上半部刀 口结合处 311A的完整闭合结构。
本实施例中，缓冲垫圈 2除采用图 3A所示的闭合圆环结构外，还可以采用图 3D 所示的长条形， 使用时直接塞入刀口 32的凹槽 33内。 同理， 其在开口的两端设置 有上、 下插接结构 21 1、 212， 当固紧装置闭合后， 缓冲垫圈形成完整的环形闭合 结构， 与固紧装置完全吻合。
本发明中缓冲垫圈的第二种实施方式， 如图 4A和图 4B所示， 缓冲垫圈 2'具有 凹槽 21， 凹槽 21包覆刀口 32内端。 凹槽 21可以包覆部分刀口也可以如图 4F和图 4G 所示包覆于整个刀口。
本发明中刀口的内端宽度 HI除采用传统的小于环壁连接端宽度 H2外， 还可以 等于或大于刀口与环壁连接端宽度 H2。 一方面可以节省材料， 另一方面可以方便 缓冲垫圈 2，套设于刀口上。 其中图 4C为 HI等于 H2的情况。 图 4D和图 4E为 HI大于 H2的情况。 当需要配合缓冲垫圈 2时， 此 HI大于等于 H2的方式有利于缓冲垫圈 2' 稳固套设于刀口上。
基于现代工艺的发展，缓冲垫圈 2'采用医用无毒硅胶，通过塑料一硅胶一次成 型工艺将硅胶直接附着于刀口内端或整个刀口上。 在此基础上， 进一步在环壁 31 上包覆有硅胶层 22， 该硅胶层 22通过塑料一硅胶一次成型工艺与环壁连接。 整个 固紧装置包覆有硅胶层， 使得佩戴者直接接触到器械的软面， 有效提升佩戴者的 舒适感。
如图 5A至图 5C所示， 其为本发明龟头套圈 1的结构示意图， 龟头套圈 1的上沿 向外延伸有第一外沿 11，下沿向外延伸有第二外沿 12，该第一外沿 11和第二外沿 12 之间形成有环形容置空间 13。 如图 6所示， 橡皮垫 5是具有一定宽度的软性环形垫， 宽度与环形容置空间相匹配。
是具有一定宽度的软性垫， 使用时， 橡皮垫 5套于龟头套圈 1上， 如图 7所示， 橡皮垫 5容置于该环形容置空间 13内。
如图 8及图 9所示， 手术时将橡皮垫 5套设于龟头套圈 1上， 将龟头套圈 1放置于 阴茎与包皮之间 （传统内置式包皮环切手术方式） 或将包皮 7外翻， 使得外翻包皮 包覆龟头套圈 1， （商建忠先生发明的外翻式包皮环切手术）， 将环形缓冲垫圈 2套 设于包皮外侧， 将固紧装置 1的凹槽 33对准缓冲垫圈 2， 使得缓冲垫圈 2卡设于固紧 装置 3的凹槽内， 最终形成如图 10所示的包皮上环后的示意图。 由于上下半部刀口 结合处的设置， 使得上环的过程中， 有效避免皮肤被夹持在开口端和连接端处， 并使得缓冲垫圈能够被逐渐导引至刀口的凹槽内。 缓冲垫圈和橡皮垫均为柔软无 毒的医用硅胶材质， 使得包皮的皮肤能够在一定限度内得到舒展， 有效避免手术 过程中的疼痛和不适。 请参阅 1C和图 ID所示， 固紧装置环壁外端呈弧线形， 龟头套圈的环壁向内凹 设有一定弧度， 与之相配合的橡皮垫也具有一定弧度与之相匹配， 此种设置可以 防止刀口向两端滑动。
为了避免造成下环过程的皮肤粘连， 在缓冲垫圈 2和橡皮垫 5上均设置有防止 皮肤粘连的防粘连结构 6， 该防粘连结构为图 11A所示的若干凹点和 /或凸点， 或如 图 11B所示的若干凸起或凹陷的交织线， 或如 11C所示的若干凹陷槽或凸起槽。 如 在缓冲垫圈 2上设置有凸点， 同时在橡皮垫 5上设置有凹陷槽， 当手术结束下环时， 由于防粘连结构的存在， 不会造成皮肤的粘连， 使得下环过程更加容易。
如图 12A和图 12B所示， 本发明中的固紧装置 3和龟头套圈 1呈现与阴茎龟头冠 状沟相匹配的椭圆结构， 或如图 12C和图 13所示的椭圆倾斜结构。 如图 14所示， 包 皮环切吻合器可以完美契合龟头冠状沟的倾斜结构， 使得佩戴者更加舒适， 同时， 便于手术的操作。
同时， 如图 15所示， 龟头套圈 1上下端面中任一面上设置有系带缺口 14， 在使 用过程中将龟头套圈 1具有系带缺口 14的一端与阴茎系带端匹配放入， 然后调整位 置并与固紧装置 3相配合安装， 可以有效保护阴茎系带， 防止其损伤， 使得整个器 械能够与人体结构完美匹配。 进一步降低患者夜间阴茎勃起牵拉系带的疼痛感， 提高器械使用的舒适感。
固紧装置的开口通过锁固装置闭合锁紧， 锁固装置可以为设置于开口两端的 螺杆和螺孔结构， 也可以是图 16所示的卡合块闭合结构， 该锁固装置包含有第一 阶梯状卡合块 41和第二阶梯状卡合块 42， 如图 17所示， 两者上下错开。 上半部刀 口结合处 311A位于第一阶梯状卡合块 41的上端， 下半部刀口结合处 311B位于该第 二阶梯状卡合块 42下方。 开口闭合后， 形成稳固的闭合结构。
为了进一步避免锁固装置意外打开， 在上述第一阶梯状卡合块 41和第二阶梯 状卡合块 42上设置有相互配合的卡勾和卡槽结构， 请参见图 16和图 17所示， 第一 阶梯状卡合块 41外端设置有第一卡勾 13， 内端设置有第二卡槽 14。 在第二梯状卡 合块 42外端设置有第二卡钩 14， 内端设置有第一卡槽 15。 闭合后， 第一卡勾 13与 第一卡槽 15相卡置， 第二卡勾 14和第二卡槽 16相卡置。
考虑到卡勾和卡槽的配合便利性， 第一阶梯状卡合块 41和第二阶梯状卡合块 向外延伸的内端面为倾斜面， 与之相配合的是设置在环壁上的倾斜凸台。 如图所 示， 设置在第一阶梯状卡合块 41上的第一倾斜面 411和第二倾斜凸台 412和设置在 第二梯状卡合块 42上的第二倾斜面 421和第一倾斜凸台 422。 第一卡勾 13设置于第 一倾斜面 411的外端， 第二卡勾 14设置于第二倾斜面 421的外端。 第一卡槽和第二 卡槽是与卡勾配合的线性凹槽或者圆形凹槽。 卡勾和卡槽结构进一步与第一锯齿 状卡合块和第二锯齿状卡合块配合， 保证在垂直和水平两个方向均得到有效的卡 固， 有效防止人为打幵或意外开启。
请参阅图 18B至图 18D所示， 在第二梯状卡合块 42上设置有开锁孔 43， 手术结 束后， 通过专用工具敲开开锁孔 43， 从而打开开口并下环。
同时， 如图 19A至 19E所示， 其为一种套设在锁固装置外的保护套 6， 该保护套 形状和锁固装置相匹配， 包含相互配合的套体 61及盖体 62。 其中， 套体 61具有底 板、 两侧壁及顶壁， 底板、 两侧壁及顶壁围成容置空间， 锁固装置容置于套体的 容置空间中。 套体 6和盖体 62通过插槽 63和插柱 64的方式连接。 该保护套亦可以是 具有弹性的硅胶套构成， 方便好用。 本发明中的保护套结构可以有效的防止来自 阴茎膨胀给第一、 第二锯齿状卡合块卡合连接带来的崩开的危险， 确保了 100%的 手术成功率。
如图 20所示， 固紧装置 30为 C形环， 其仅具有开口端， 为保证一定的开度， 器 械采用软性材料制成。
如图 21A或如 21B所示， 固紧装置还可以采用三分体环， 该固紧装置的开口端 设置在与阴囊位置相对应的上方， 分体的连接端设置在与阴囊位置错开的位置。 当采用分体结构时， 除开口端设置有上半部刀口结合处和下半部刀口结合处外， 在各连接端均设置有同样上下错层插接结构， 使得各个连接的环节均不会产生夹 肉或妨碍缓冲垫圈顺利安装的情况。

Claims

权利要求书
1、一次性包皮环切吻合器， 包含有固紧装置和龟头套圈， 固紧装置具有开口， 开口两端设有相互对应的上半部刀口结合处和下半部刀口结合处， 该固紧装置的 开口端通过锁固装置连接， 其特征在于：
该固紧装置具有环壁和刀口， 刀口内端连接缓冲垫圈。
2、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该刀口内端设 有凹槽， 缓冲垫圈容置于凹槽内。
3、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该缓冲垫圈设 置有凹槽， 刀口内端容置于该凹槽内。
4、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该缓冲垫圈设 置有凹槽， 全部刀口容置于该凹槽内。
5、 如权利要求 1或 3或 4所述的一次性包皮环切吻合器， 其特征在于： 该缓冲 垫圈为硅胶材质， 其通过塑料一硅胶一次成型工艺与刀口连接。
6、 如权利要求 5所述的一次性包皮环切吻合器， 其特征在于： 该环壁上包覆 有硅胶层， 该硅胶层通过塑料一硅胶一次成型工艺与环壁连接。
7、 如权利要求 1或 2或 3或 4所述的一次性包皮环切吻合器， 其特征在于： 该刀 口内端大于或等于刀口与环壁的连接端的宽度。
8、 如权利要求 1或 2或 3或 4所述的一次性包皮环切吻合器， 其特征在于： 还包 含有橡皮垫， 该橡皮垫套设于龟头套圈的外壁。
9、 如权利要求 8所述的一次性包皮环切吻合器， 其特征在于： 该龟头套圈上 端开口向外延伸有第一外沿， 下端开口向外延伸有第二外沿， 该第一外沿和第二 外沿之间形成有环形容置空间， 所述橡皮垫容置于该环形容置空间内。
10、 如权利要求 9所述的一次性包皮环切吻合器， 其特征在于： 该缓冲垫圈和 橡皮垫上设置有防止皮肤粘连的防粘连结构。
11、 如权利要求 10所述的一次性包皮环切吻合器， 其特征在于： 所述防粘连 结构为若干凹点或凸点； 或凸起或凹陷交织线； 或凹陷槽或凸起槽； 或磨砂结构。
12、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该固紧装置和 龟头套圈的环壁呈与阴茎龟头冠状沟相匹配的椭圆或椭圆倾斜结构。
13、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该龟头套圈上 设有供包皮系带容置的缺口。
14、 如权利要求 1或 12所述的一次性包皮环切吻合器， 其特征在于： 该固紧装 置为 C型环， 具有开口端。
15、 如权利要求 1或 12所述的一次性包皮环切吻合器， 其特征在于： 该固紧装 置为三分体环， 固紧装置的开口端设置在与阴囊位置相对应的上方， 分体的连接 端设置在与阴囊位置错开的位置。
16、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该锁固装置包 含第一阶梯状卡合块和第二阶梯状卡合块， 该第一阶梯状卡合块和第二阶梯状卡 合块上分别设置有相互配合的防脱钩和防脱槽。
17、 如权利要求 1所述的一次性包皮环切吻合器， 其特征在于： 该锁固装置为 螺杆和螺孔的配合方式。
18、 如权利要求 1或 16所述的一次性包皮环切吻合器， 其特征在于： 该锁固装 置外套设有保护套， 该保护套的形状和锁固装置相匹配。
19、 如权利要求 2所述的一次性包皮环切吻合器， 其特征在于： 所述凹槽的横 截面为圆弧或半圆形或半椭圆形或三角形或方形； 所述上半部刀口结合处和下半 部刀口结合处组合后形成横截面为圆弧或半圆形或半椭圆形或三角形或方形的凹 槽； 所述缓冲垫圈与之相匹配。
20、 如权利要求 2所述的一次性包皮环切吻合器， 其特征在于： 该缓冲垫圈为 环形， 环形圆周长度与刀口圆周长度相匹配。
21、 如权利要求 1或 3或 4所述的一次性包皮环切吻合器， 所述固紧装置包含一 个或二个或三个刀口。
22、 如权利要求 1或 3或 4所述的一次性包皮环切吻合器， 所述上半部刀口结合 处和下半部刀口结合处设置有圆角。
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CN112006754A (zh) * 2020-09-15 2020-12-01 微尔创（武汉）医疗科技有限公司 一种自动式包皮弹力线套扎吻合组件
CN112006752B (zh) * 2020-09-15 2022-06-21 微尔创（武汉）医疗科技有限公司 一种弹力线套扎包皮罩组件
CN112006753A (zh) * 2020-09-15 2020-12-01 微尔创（武汉）医疗科技有限公司 一种手动式包皮弹力线套扎吻合组件
CN113925574A (zh) * 2021-11-18 2022-01-14 长沙汇顶医疗科技有限责任公司 一种含有套扎器和套扎枪的包皮套扎组件
CN113925574B (zh) * 2021-11-18 2024-05-24 长沙汇顶医疗科技有限责任公司 一种含有套扎器和套扎枪的包皮套扎组件
CN116327354A (zh) * 2023-03-03 2023-06-27 赫美康健(北京)医疗器械有限公司 一种基于激光技术的包皮环切器固定装置及操作方法
CN116327354B (zh) * 2023-03-03 2024-04-05 赫美康健(北京)医疗器械有限公司 一种基于激光技术的包皮环切器固定装置及操作方法

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EA032400B9 (ru) 2019-07-31
EP2856954A1 (en) 2015-04-08
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CA2876510C (en) 2020-01-07
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EA201790347A1 (ru) 2017-06-30
EA028137B1 (ru) 2017-10-31
RS56341B1 (sr) 2017-12-29
CN102743211B (zh) 2015-08-19
CN102743211A (zh) 2012-10-24
SI2856954T1 (sl) 2017-11-30
LT2856954T (lt) 2017-11-27
CY1119700T1 (el) 2018-04-04
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