CN103415262A - 外科钉仓以及具有血管测量构造的端部执行器 - Google Patents
外科钉仓以及具有血管测量构造的端部执行器 Download PDFInfo
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Abstract
本发明公开了一种外科钉仓和端部执行器，其用于评估由钉仓缝合的或换句话讲由端部执行器操作的组织的尺寸。在各种形式中，钉仓具有平台基座上的至少一个系列的测量标记。当砧座正将组织夹持到钉仓上时，该测量标记可从平台表面的上方被观察。其它实施例包括用于在仓平台上形成记号的结构，该记号对应于支承在仓平台上的组织的尺寸。还公开了用于切断和缝合组织的方法。
Description
背景技术
技术领域
本发明涉及外科器械，并且在各种实施例中涉及用于操作和/或治疗组织的外科端部执行器，以及被设计成切割和缝合组织的外科缝合器械、端部执行器及其钉仓。
背景技术
外科切割和缝合器械已被用于同时在组织中切开纵向切口并在切口的相对侧上施用缝钉线。此类器械常常包括一对协同工作的钳口构件。如果意图将器械用于内窥镜式或腹腔镜式应用，则钳口构件能够穿过插管通道。钳口构件中的一者通常支承钉仓，该钉仓能够操作地支承其中的侧向间隔开的至少两排未成形缝钉。另一钳口构件限定具有缝钉成形凹坑的砧座。当砧座闭合时，缝钉成形凹坑与被支承在仓中的未成形缝钉排对齐。
在使用期间，临床医生能够在组织上闭合切割和缝合器械的钳口构件，以在致动器械之前定位组织。一旦临床医生已确定钳口构件正恰当地夹持靶组织，则临床医生可随后致动或“击发”器械，从而切断和缝合组织。同时进行切割及缝合能避免当利用分别仅切割或缝合的不同手术工具依次执行这些动作时可能产生的并发症。
已知有多种外科切割和缝合器械，其可用于腹腔镜式外科手术和/或结合各种“开放式”外科手术来使用。一些外科切割和缝合器械能够致动可替换仓，该可替换仓支承其中的未成形缝钉。此类装置通常采用可回缩切割构件。该可回缩切割构件属于缝钉器械并且可与多个仓一起被再利用。当缝钉在一个仓中被击发后，切割构件回缩并且用尽的仓被移除以使得能够安装新仓，如果需要的话。当切割构件通过仓朝远侧被驱动时，未成形缝钉在仓中从其相应的凹坑被击发出去，从而与砧座的下侧成形接触。此类装置的例子在2006年2月21日公布的名称为“Surgical StaplingInstrument Having Separate Distinct Closing and Firing Systems”的美国专利7,000,818中有所公开，该专利的公开内容全文以引用方式并入本文。
其它外科切割和缝合器械采用通常被称为“一次性加载单元”或“DLU”的装置。此类装置以“单元”的形式支承钉仓和新刀，该单元能够操作地附接到切割和缝合器械。单元被设计成在缝钉已被击发后该单元被丢弃。此类器械的例子在1999年2月2日公布的名称为“SurgicalStapling Apparatus”的美国专利5,865,361中有所公开，该专利的全部公开内容以引用方式并入本文。
在许多外科手术中，并且具体地在许多血管相关的外科手术中，对于外科医生而言可为有利的是其了解正在被横切和缝合的血管的尺寸（即直径）以用于止血目的。现有的外科切割和缝合装置中的一些在支承外科钉仓的通道的横向侧上提供测量线。然而，此类测量线通常从端部执行器的侧面可见，从而可被正在被切割及缝合的血管所遮掩。如果外科医生从上面观察端部执行器，则此类测量线是不可见的，并且在确定正被缝合的血管的尺寸方面用处不大。因此，需要如下外科钉仓和端部执行器构造，其提供关于正在被横切和缝合的组织的尺寸的反馈。
外科医生也可使用多种其它端部执行器构造来操作组织。此类装置例如外科抓紧装置包括用于抓紧其间组织的活动钳口。对于此类装置和用于治疗/操作血管组织等其它装置而言还将有利的是，向用户提供关于正在被治疗/操作的组织的尺寸的反馈。
上述讨论仅仅为了举例说明本技术领域内目前存在的一些不足之处，而不应看作是对权利要求范围的否定。
发明内容
根据至少一种形式的一般方面，提供了包括仓体的外科钉仓，该仓体能够操作地支承其中的多个外科缝钉。仓体具有近端和远端以及在近端和远端之间延伸的平台。组织测量装置设置在平台上，用于确定置于其上的组织的尺寸。
根据至少一种形式的其它一般方面，提供了与外科器械一起使用的外科端部执行器。在各种形式中，端部执行器包括能够操作地联接到外科器械的细长通道。具有仓体的钉仓能够操作地支承在细长通道中。仓体具有平台表面，该平台表面由纵向狭槽基本上分成第一平台部分和第二平台部分，该纵向狭槽在第一平台部分和第二平台部分之间延伸。仓体能够操作地支承其中的第一组多个未成形缝钉，该第一组多个未成形缝钉对应于第一平台部分。仓体还能够操作地支承第二组多个未成形缝钉，该第二组多个未成形缝钉对应于第二平台部分。组织切割构件能够操作地支承在仓体中，以在外科器械将切割致动运动施加到组织切割构件时，该组织切割构件在纵向狭槽中轴向行进。砧座被支承以响应于由外科器械施加到砧座的打开运动和闭合运动而使砧座能够活动地朝向和远离平台表面行进。测量装置设置在平台表面和砧座中的至少一者上，以用于确定置于其上的组织的尺寸。
根据至少一种形式的其它一般方面，提供了用于切断和缝合组织的方法。在各种形式中，方法包括在外科钉仓和砧座之间夹持一块组织，并且在外科钉仓的平台部分上形成标记，该标记对应于被夹持的组织的尺寸。方法还包括切割被夹持的组织以形成两个切断的端部部分，并且缝合每个切断的端部部分。
附图说明
通过结合附图参考本发明实施例的以下说明，本发明的上述和其它特征及优点及其获取方法将会变得更加明显，并可更好地理解发明本身，其中：
图1为外科切割和缝合器械的一种形式的透视图，该外科切割和缝合器械可与本发明的一种形式的各种仓和端部执行器实施例一起使用；
图2为本发明的端部执行器实施例的分解图；
图3为本发明的一种形式的钉仓实施例的透视图；
图4为处于打开位置并在将其中的一块组织夹持之前的图1的器械的端部执行器部分的局部透视图；
图5为在砧座及其钉仓之间夹持血管的端部执行器实施例的一部分的平面图；
图6为在砧座及其钉仓之间夹持血管的另一个端部执行器实施例的一部分的平面图；
图7为本发明的一种形式的另一个外科钉仓实施例的透视图；
图8为夹持其中的血管的另一个端部执行器实施例的一部分的平面图；并且
图9为在砧座已运动到打开位置并且组织块已从其被移除后的图8的端部执行器的局部透视图。
具体实施方式
现在将描述某些示例性实施例，从而得到对本文所公开的器械和方法的结构、功能、制造和使用原理的全面理解。这些实施例的一个或多个例子在附图中示出。本领域的普通技术人员将会理解，本文特别描述和在附图中示出的装置和方法为非限制性的示例性实施例，并且本发明多个实施例的范围仅由权利要求书限定。本说明书通篇引用的“各种实施例”、“一些实施例”、“一个实施例”或“实施例”等，是指结合所述实施例描述的具体特征、结构或特性包括在至少一个实施例中。因此，本说明书通篇出现的短语“在多个实施例中”、“在一些实施例中”、“在一个实施例中”或“在实施例中”等并不一定都指相同的实施例。此外，在一个或多个实施例中，具体特征、结构或特性可按任何合适的方式组合。因此，在无限制的情况下，结合一个实施例示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其它实施例的特征、结构或特性结合。此类修正形式和变型旨在被包括在本文所公开的各种发明实施例及其各自的等同物中。
本文所用术语“近侧”和“远侧”是相对于操纵外科器械柄部的临床医生而言的。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”是指远离临床医生的部分。还应当理解，为简洁和清楚起见，本文可以结合附图使用诸如“竖直”、“水平”、“上”和“下”之类的空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性器械和方法用于执行腹腔镜式和微创外科手术。然而，本领域的普通技术人员将容易认识到，本文所公开的各种方法和器械可用于许多外科手术和应用中，包括例如与“开放式”外科手术相关的外科手术和应用。继续参阅本具体实施方式，本领域的普通技术人员将进一步认识到，本文所公开的各种器械可以任何方式***体内，例如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可被直接***患者体内，或可通过具有工作通道的进入装置诸如套管针***，外科器械的端部执行器和细长轴可通过该工作通道行进。
参见附图，其中在多个视图中的类似的数字代表类似的部件。图1示出了外科缝合和切断器械10的一个实施例，该外科缝合和切断器械能够实践本发明的至少一种形式的各种独特的有益效果。外科器械10的各种形式在名称为“Endoscopic Surgical Instrument With a Handle That Can ArticulateWith Respect to the Shaft”的美国专利7,753,904中有所公开，该专利的全部公开内容以引用方式并入本文。同样地，无需用以理解本发明的各种实施例和形式的关于器械的构造和操作的细节将不在本文具体重复。在图1中示出的外科器械为马达驱动或“动力式器械”。继续参阅本具体实施方式，技术人员将认识到发明实施例中的至少一些的各种独特且新颖的方面还可结合外科缝合和切断器械来被有效地采用。外科缝合和切断器械采用机械（非动力式）***，用于在不脱离本发明的实质和范围的情况下击发缝钉并切割组织。另外，尽管各种器械实施例已在本文被描述为具有手持式“柄部”，但是本文所公开的器械可适于从机器人装置或类似的装置接收夹持和/或击发运动，用于向其施加致动运动。因此本文所公开的各种端部执行器和仓实施例要求保护的范围不应以任何方式被限制为仅与手持式外科器械一起使用。
如在图1中可见，外科器械10的一种形式包括柄部6，该柄部具有能够操作地附接至其的细长管组件30。该细长管组件能够传输致动运动到附接至细长管组件30的远端部分的端部执行器12。端部执行器12包括通道22。该通道被联接以支承本发明的各种形式的钉仓，如下文将更详细地论述。砧座24响应于由细长管组件30的各部分施加至其的打开运动和闭合运动而相对于通道22被能够活动地支承。
柄部6包括***式握把26，由临床医生将闭合触发器18枢转地拉向***式握把26，以使得砧座24朝向端部执行器12的缝钉通道22夹紧或闭合。击发触发器20在闭合触发器18的更外侧。如图2所示，除了先前提及的通道22和砧座24之外，端部执行器12可包括刀和滑动件驱动构件32、支承其中的多个未成形缝钉90的钉仓50、螺旋状螺杆轴36、以及附接到通道结构22的轴承38。砧座24可枢转地连接至近侧枢转位置处的通道22。在一个实施例中，例如，砧座24包括在其近端处侧向突出的枢轴销25，该枢轴销枢转地接合形成于通道22的近端附近的枢轴孔23。当闭合触发器18被致动，即被器械10的使用者拉动时，砧座24的凸耳25可围绕枢转位置在通道22中的枢轴孔23内枢转至夹紧或闭合位置。如果端部执行器12的夹持效果令人满意，则操作者可致动击发触发器20。该击发触发器启动柄部6中的马达/传动装置（未示出）；该马达/传动装置施加旋转运动到螺旋式螺杆轴36以使刀/滑动件驱动构件32沿通道22行进，从而切割被夹持在端部执行器12内的组织，并将未成形缝钉90驱动成与砧座24的下侧成形接触。如本文所用，有关缝钉的术语“击发”是指如下动作，该动作涉及将未成形缝钉90在钉仓内从其各自的缝钉凹坑92驱动出，并且使未成形缝钉与砧座的对应部分成形接触。然而，继续参阅本具体实施方式，读者将认识到各种发明实施例的独特且新颖的方面中的至少一些还可结合多种其它外科缝合器来被有利地采用。外科缝合器械包括那些外科缝合单元，该外科缝合单元能够与所谓的一次性加载单元一起使用，例如，公开于名称为“Surgical Stapler With Universal Articulation and Tissue Pre-Clamp”的美国专利申请公开2006/0011699A1中的那些装置，该专利申请的公开内容全文以引用方式并入本文。因此，本发明的各种实施例要求保护的范围不应被限制为与外科器械和/或端部执行器的一种特定类型一起使用。
在刀/滑动件驱动构件32已被驱动到钉仓50的远端之后，临床医生释放击发触发器20，以使击发触发器20返回到打开位置，这将导致旋转回缩运动被施加到刀/滑动件驱动构件32以使其朝近侧运动到起始位置。一旦刀/滑动件驱动构件32已从钉仓50运动出来到起始位置，则临床医生可通过柄部上的释放按钮30将闭合触发器18解锁，以允许闭合触发器18运动到打开位置，从而使砧座24枢转打开并且释放分离的及缝合的组织。
在图3和4所示的实施例中，钉仓50包括支承其中的多个未成形缝钉90的仓体51。仓体51具有平台53，该平台具有其中的设置在中心的狭槽56，该狭槽将平台53分成第一平台部分54和第二平台部分55。当刀/滑动件驱动构件32（图2）在仓体51内沿纵向被驱动时，狭槽56容纳刀/滑动件驱动构件32。一般来讲，狭槽56从近端57延伸到仓体51的远端58。
在各种实施例中，一般表示为60的测量装置位于钉仓50和砧座24中的至少一者上。例如在图3和4所示的实施例中，测量装置60包括在第一平台部分54上邻近其第一侧向边缘59的第一系列的测量标记62。在各种实施例中，第一系列的测量标记62包括分隔开预定距离的一系列有刻度的测量标记63。预定距离可对应于有颜色的记号64，该颜色不同于平台53的颜色。例如，对于具有30mm缝钉线长度的钉仓50而言，第一系列的测量标记可例如从0mm扩展至30mm或32.5mm，如图所示。即，每个黑色记号和其间的空格可大约为2.5mm长。也可使用其它形式的有刻度的测量标记（例如测量尺度的区段等）。
同样在图3所示的实施例中，测量装置60还包括在第二平台部分55上邻近其第二侧向边缘59’的第二系列的测量标记66。在各种实施例中，第二系列的测量标记66包括分隔开预定距离的一系列有刻度的测量标记67。预定距离可对应于有颜色的记号68，该颜色不同于平台53的颜色。记号68的颜色可对应于或可不对应于记号64的颜色。每个记号68的长度可对应于每个记号64的长度。可使用其它形式的有刻度的测量标记（例如以毫米和/或英寸为单位的测量尺度的区段等）。在其它实施例中，仅提供一个系列的测量标记。在至少一个实施例中，系列测量标记仅执行测量功能。即，至少一个实施例中的测量标记包括如下标记，该标记除了向使用者提供用以评估被夹持在平台53和砧座24的下侧之间的血管80的尺寸的方法外，该标记不在钉仓和/或砧座上执行任何其它功能。参见例如图4和5。本领域的普通技术人员将会认识到，测量标记62,66的此类布置使得当临床医生从上方观察端部执行器12时（例如在图5和6中所示），能够评估被夹持在端部执行器12中的组织的直径或其它尺寸。在图6所示的实施例中，测量标记系列62,66设置在砧座24上。与上述实施例一样，测量标记系列中的仅一者可在砧座24上被采用。测量标记系列可基本上涵盖砧座24的整个上表面或仅其部分。
图7示出了另一个钉仓实施例150，除了下文描述的差别，该钉仓实施例基本上与上述钉仓50相同。钉仓150包括仓体151，该仓体支承其中的缝钉凹坑192内的多个未成形缝钉。仓体151具有平台153，该平台具有其中的设置在中心的狭槽156，该狭槽将平台153分成第一平台部分154和第二平台部分155。在该实施例中，测量装置60包括平台153上的记号成形材料190。在使用期间，当血管80已如图9所示被夹持在砧座24和仓150之间后，已被组织压缩的记号成形材料190的部分191改变颜色或改变明暗度（shade）或色调（tint）（例如颜色的暗度），使得已被组织压缩或仅被组织接触的记号成形材料190的部分可区别于没有被夹持的组织压缩或换句话讲被夹持的组织接触的记号成形材料190的部分。此类布置因此向临床医生提供反馈，该反馈可用于评估被横切的组织以用于止血目的。另外，此类布置提供了组织在仓平台上的位置的指示，以用于生产询问调查（production inquiry investigation）。此外，此类布置在不穿透组织的情况下还向使用者提供缝钉在何处被击发直接进入砧座的指示。
在各种实施例中，记号成形材料190可作为涂层被施用在仓平台上。在其它实施例中，记号成形材料190可包括基底，该基底附接到仓平台或端部执行器的非缝合器形式的钳口部分。记号成形材料可包括例如含有指示剂的材料，该指示剂基于其PH或化学组成来识别组织。例如，记号成形材料190可包括如下材料，当记号成形材料190仅由组织接触而无需组织在其上被压缩时，该材料改变颜色或改变同一种颜色的色调或明暗度。
可将本发明所公开的装置设计为单次使用后即进行处理，或者可将它们设计为可多次使用。然而，在任一种情况下，所述装置均可进行修复，以在至少一次使用后再次使用。重新恢复可包括如下步骤的任意组合：拆卸该装置、然后清洗或置换某些部分以及随后组装。特别是，所述装置可以拆卸，而且可以任意组合选择性地置换或移除该装置任意数目的特定零件或部分。清洗和/或置换特定部分后，该装置可以在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科手术团队重新组装。本领域的技术人员将会知道，装置的修复可利用多种用于拆卸、清洗/置换和重新组装的技术。这些技术的使用以及所得的修复装置均在本发明的范围内。
优选的是，在手术前处理本文所述的装置。首先，获取新的或用过的器械，并在必要时对器械进行清洁。然后对器械进行消毒。在一种消毒技术中，将该器械置于闭合并密封的容器中，例如塑料或TYVEK袋中。然后将容器和器械置于能够穿透该容器的辐射区，例如γ辐射、x-射线或高能电子。辐射将器械上和容器中的细菌杀死。然后将灭菌后的器械保存在消毒容器中。该密封容器将器械保持无菌，直到在医疗设备中打开该容器。
以引用方式全文或部分地并入本文的任何专利、公布或其它公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其它公开材料相冲突的范围内并入本文。由此，在必要的程度下，本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突的材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
尽管已经将本发明作为示例性设计进行了描述，但还可以在本公开的实质和范围内对本发明进行修改。因此本专利申请旨在涵盖采用本发明一般原理的任何变型、用途或适应型式。此外，本专利申请旨在涵盖本发明所属领域中出自已知或惯有实践范围内的背离本公开的型式。
Claims (20)
1.一种外科钉仓，包括：
能够操作地支承其中的多个外科缝钉的仓体，所述仓体具有近端和远端以及在所述近端和远端之间延伸的平台；和
所述平台上的测量装置，所述测量装置用于确定置于其上的组织的尺寸。
2.根据权利要求1所述的外科钉仓，其中，所述测量装置包括所述平台上的至少一个系列的测量标记。
3.根据权利要求2所述的外科钉仓，其中，所述平台具有第一侧向边缘和第二侧向边缘，并且其中，所述至少一个系列的测量标记包括：
在所述平台上邻近其所述第一侧向边缘的第一系列的有刻度的测量标记；和
在所述平台上邻近其所述第二侧向边缘的第二系列的有刻度的测量标记。
4.根据权利要求2所述的外科钉仓，其中，至少一个所述系列的测量标记包括彼此分隔开预定距离的一系列记号。
5.根据权利要求4所述的外科钉仓，其中，所述平台具有第一颜色，并且其中，每个所述记号具有不同于所述第一颜色的颜色。
6.根据权利要求3所述的外科钉仓，其中，所述第一系列的测量标记包括彼此分隔开第一预定距离的第一系列的第一记号，并且其中，所述第二系列的测量标记包括彼此分隔开预定距离的第二系列的第二记号。
7.根据权利要求6所述的外科钉仓，其中，所述平台具有平台颜色，并且其中，每个所述第一记号和第二记号具有不同于所述平台颜色的第一颜色。
8.根据权利要求1所述的外科钉仓，其中，所述装置包括所述平台上的具有第一颜色的材料，所述材料被组织接触的地方变为不同的颜色。
9.根据权利要求1所述的外科钉仓，其中，所述装置包括用于在所述平台上形成记号的装置，当所述用于形成记号的装置由所述组织接触时，所述记号基本上对应于置于所述用于形成记号的装置上的组织的尺寸。
10.根据权利要求9所述的外科钉仓，其中，用于形成记号的装置包括所述平台上的压敏材料。
11.根据权利要求10所述的外科钉仓，其中，所述材料包括附接到所述平台的压敏基底。
12.一种与外科器械一起使用的外科端部执行器，所述外科端部执行器包括：
细长通道，所述细长通道能够操作地联接到所述外科器械；
钉仓，所述钉仓具有能够操作地支承在所述细长通道中的仓体，所述仓体具有由纵向狭槽基本上分成第一平台部分和第二平台部分的平台表面，该狭槽在第一平台部分和第二平台部分之间延伸，所述仓体能够操作地支承其中的对应于所述第一平台部分的第一组多个未成形缝钉、以及对应于所述第二平台部分的第二组多个未成形缝钉；
组织切割构件，所述组织切割构件能够操作地支承在所述仓体中，用于在外科器械将切割致动运动施加到所述组织切割构件时，所述组织切割构件在所述纵向狭槽中轴向行进；
砧座，所述砧座被支承以响应于由外科器械施加至砧座的打开运动和闭合运动能够活动地朝向和远离所述平台表面行进；和
测量装置，所述测量装置在所述平台表面和所述砧座中的至少一者上，用于确定置于其上的组织的尺寸。
13.根据权利要求12所述的外科端部执行器，其中，所述装置包括：
第一测量装置，所述第一测量装置在所述第一平台部分上，以当从所述平台表面上方观察时评估被夹持在所述砧座和所述平台表面之间的组织的尺寸；和
第二测量装置，所述第二测量装置在所述第二平台部分上，以当从所述平台表面上方观察时评估被夹持在所述砧座和所述平台表面之间的组织的尺寸。
14.根据权利要求13所述的外科端部执行器，其中，所述平台具有第一侧向边缘和第二侧向边缘，并且其中，所述第一测量装置包括在所述平台上邻近其所述第一侧向边缘的第一系列的有刻度的测量标记，并且其中，所述第二测量装置包括在所述平台上邻近其所述第二侧向边缘的第二系列的有刻度的测量标记。
15.根据权利要求14所述的外科端部执行器，其中，所述第一系列的测量标记包括彼此分隔开第一预定距离的第一系列的第一记号，并且其中，所述第二系列的测量标记包括彼此分隔开预定距离的第二系列的第二记号。
16.根据权利要求15所述的外科端部执行器，其中，所述平台具有第一颜色，并且其中，每个所述第一记号和第二记号具有不同于所述第一颜色的颜色。
17.一种用于切断和缝合组织的方法，包括：
将一块组织夹持在外科钉仓和砧座之间；
在所述外科钉仓的平台部分上形成记号，所述记号对应于所述被夹持的组织的尺寸；
切割所述被夹持的组织以形成两个切断的端部部分；以及
缝合每个切断的端部部分。
18.根据权利要求17所述的方法，还包括评估所述被夹持的组织的尺寸。
19.根据权利要求18所述的方法，其中，所述评估包括观察所述平台部分上的记号。
20.根据权利要求19所述的方法，其中，所述观察包括从所述平台部分的上方观察所述平台部分上的记号。
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN108289666A (zh) * | 2014-09-05 | 2018-07-17 | 伊西康有限责任公司 | 其中一个传感器影响第二传感器的输出或判读的多个传感器 |
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Also Published As
| Publication number | Publication date |
|---|---|
| RU2013145918A (ru) | 2015-04-20 |
| CA2829981C (en) | 2019-09-10 |
| EP3388000A1 (en) | 2018-10-17 |
| CA2829981A1 (en) | 2012-09-20 |
| WO2012125624A2 (en) | 2012-09-20 |
| CN103415262B (zh) | 2016-04-06 |
| BR112013023486A2 (pt) | 2016-12-06 |
| US20120234895A1 (en) | 2012-09-20 |
| JP2014515638A (ja) | 2014-07-03 |
| RU2607530C2 (ru) | 2017-01-10 |
| AU2012230048B2 (en) | 2016-08-25 |
| WO2012125624A3 (en) | 2013-05-16 |
| EP2685910A2 (en) | 2014-01-22 |
| BR112013023486B1 (pt) | 2020-11-24 |
| JP6009473B2 (ja) | 2016-10-19 |
| AU2012230048A1 (en) | 2013-09-12 |
| EP2685910B1 (en) | 2018-05-30 |
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