CA2529450A1 - Surgical system with a stapling instrument and a retractor - Google Patents
Surgical system with a stapling instrument and a retractor Download PDFInfo
- Publication number
- CA2529450A1 CA2529450A1 CA002529450A CA2529450A CA2529450A1 CA 2529450 A1 CA2529450 A1 CA 2529450A1 CA 002529450 A CA002529450 A CA 002529450A CA 2529450 A CA2529450 A CA 2529450A CA 2529450 A1 CA2529450 A1 CA 2529450A1
- Authority
- CA
- Canada
- Prior art keywords
- surgical system
- cartridge
- anvil
- retractor
- fastening assembly
- 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.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00818—Treatment of the gastro-intestinal system
- A61B2017/00827—Treatment of gastro-esophageal reflux
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
- A61B2017/07221—Stapler heads curved
Landscapes
- 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
In a surgical system, a stapling instrument comprises a flexible shaft device, a handle, and a staple fastening assembly. The staple fastening assembly includes a curved cartridge and a curved anvil. Preferably, the staple fastening assembly is adapted to allow unobstructed access towards concave inner faces of the cartridge and of the anvil. The anvil can be moved relatively with respect to the cartridge, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue. The surgical system further includes a retractor adapted to draw tissue into the space between the cartridge and the anvil, when the cartridge and the anvil are in the spaced position. In a preferred application, the surgical system is used in the treatment of gastroesophageal reflux desease (GERD).
Claims (31)
1. Surgical system, with - a stapling instrument (1; 100) comprising:
- a flexible shaft device (4) and a handle (2) extending from the shaft device (4) in the proximal end region of the stapling instrument (1; 100), - a staple fastening assembly (6; 6') in the distal end region of the stapling instrument (1; 100), the staple fastening assembly (6; 6') including a curved cartridge (10; 10'), which comprises at least one curved open row of staples (40; 40'), and, opposite to the cartridge (10;
10'), a curved anvil (20; 20'), which has a staple for-ming face (24) and is adapted to cooperate with the car-tridge (10, 10') for forming the ends of the staples (40;
40') exiting from the cartridge (10; 10'), - wherein optionally the staple fastening assembly (6;
6') is adapted to allow unobstructed access towards con-cave inner faces of the cartridge (10; 10') and of the anvil (20; 20'), - a moving device (9, 26, 28, 47, 50) adapted to move the anvil (20; 20~) relatively with respect to the cartridge (10; 10'), essentially in parallel relationship, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue, and - a staple driving device (8, 49, 52, 54, 56) adapted to drive the staples (40; 40') out of the cartridge (10;
10') towards the anvil (20; 20'); and - a retractor (90; 110) adapted to draw tissue into the space between the cartridge (10; 10') and the anvil (20;
20'), when the cartridge (10; 10') and the anvil (20;
20') are in the spaced position.
- a flexible shaft device (4) and a handle (2) extending from the shaft device (4) in the proximal end region of the stapling instrument (1; 100), - a staple fastening assembly (6; 6') in the distal end region of the stapling instrument (1; 100), the staple fastening assembly (6; 6') including a curved cartridge (10; 10'), which comprises at least one curved open row of staples (40; 40'), and, opposite to the cartridge (10;
10'), a curved anvil (20; 20'), which has a staple for-ming face (24) and is adapted to cooperate with the car-tridge (10, 10') for forming the ends of the staples (40;
40') exiting from the cartridge (10; 10'), - wherein optionally the staple fastening assembly (6;
6') is adapted to allow unobstructed access towards con-cave inner faces of the cartridge (10; 10') and of the anvil (20; 20'), - a moving device (9, 26, 28, 47, 50) adapted to move the anvil (20; 20~) relatively with respect to the cartridge (10; 10'), essentially in parallel relationship, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue, and - a staple driving device (8, 49, 52, 54, 56) adapted to drive the staples (40; 40') out of the cartridge (10;
10') towards the anvil (20; 20'); and - a retractor (90; 110) adapted to draw tissue into the space between the cartridge (10; 10') and the anvil (20;
20'), when the cartridge (10; 10') and the anvil (20;
20') are in the spaced position.
2. Surgical system according to claim 1, characterized in that the staple forming face (24) of the anvil (20; 20') is gene-rally planar and is arranged transversally with respect to the longitudinal axis of the staple fastening assembly (6;
6').
6').
3. Surgical system according to claim 1 or 2, characterized in that the cartridge (10; 10') and the anvil (20; 20') have a generally arc-like shape in the cross-sectional plane, the arc extending over an angle in the range 90° to 350°.
4. Surgical system according to one of claims 1 to 3, charac-terized in that the anvil (20; 20') is supported by means of at'least one arm (26) extending from an end of the anvil (20; 20') and generally running in parallel to the longi-tudinal axis of the staple fastening assembly (6; 6').
5. Surgical system according to claim 4, characterized in that the moving device (47, 50) is connected to the arm (26).
6. Surgical system according to one of claims 1 to 5, charac-terized in that the staple fastening assembly (6; 6') includes a curved holder (12) which is adapted to accomodate the cartridge (10; 10 ').
7. Surgical system according to claims 5 and 6, characterized in that the holder (12) comprises a guide (28) adapted to slidably guiding the arm (26).
8. Surgical system according to one of claims 1 to 7, charac-terized in that the distance between the cartridge (10; 10') and the anvil (20; 20') in the closed position is adjusta-ble.
9. Surgical system according to one of claims 1 to 8, charac-terized in that the staple fastening assembly (6) comprises a retaining pin (30) adapted to move, preferably to slide, between the cartridge (10) and the anvil (20) to align the cartridge (10) and the anvil (20).
10. Surgical system according to claim 9, characterized in that the movement of the retaining pin (30) is actuateable via an actuating member located at the handle (2).
11. Surgical system according to one of claims 1 to 10, charac-terized in that the staple driving device (8, 49, 52, 54, 56) is adapted to simultaneously drive the staples (40; 40') out of the cartridge (10; 10') towards the anvil (20; 20').
12. Surgical system according to one of claims 1 to 11, charac-terized in that the flexible shaft device (4; 4') comprises a plurality of vertebra members (60), which are longitudi-nally arranged and are surrounded by a flexible sheath (64).
13. Surgical system according to claim 12, characterized in that the each of the vertebra members (60) has at least one ope-ning, the openings of the longitudinally arranged vertebra members (60) forming at least one channel (62) adapted to accomodate force transmitting devices (47, 49) for transmit-ting forces from actuating members (8, 9) located at the handle (2) to the staple fastening assembly (6; 6').
14. Surgical system according to claim 13, characterized in that the force transmitting devices include a flexible band (47) associated to the moving device (9, 26, 28, 47, 50) and a flexible band (49) associated to the staple driving device (8, 49, 52, 54, 56).
15. Surgical system according to one of claims 1 to 14, charac-terized in that the staple fastening assembly is removably mounted in the distal end region of the flexible shaft devi-ce.
16. Surgical system according to one of claims 1 to 15, charac-terized in that the cartridge (10; 10') is replaceable.
17. Surgical system according to one of claims 1 to 16, charac-terized in that the retractor (90) is an instrument separate from the stapling instrument (1).
18. Surgical system according to one of claims 1 to 16, charac-terized in that the retractor (110) is integrated in the stapling instrument (100).
19. Surgical system according to claim 17, characterized in that the retractor (90) comprises a screw (92) which is adapted to pierce and to be screwed into tissue and which is mounted at one end of a flexible retractor shaft (98).
20. Surgical system according to claim 19, characterized in that the screw (92) is designed as a coil.
21. Surgical system according to claim 18, characterized in that the retractor (110) comprises a hollow needle (116) with an internal channel and an expandable balloon (120), which is adapted to be pushed out of the piercing tip (117) of the needle (116) via the channel.
22. Surgical system according to claim 21, characterized in that the needle (116) is designed as a curved needle.
23. Surgical system according to claim 21 or 22, characterized in that the needle (116) is slidably mounted in a retractor sheath (112) having a proximal end and a distal end (115), wherein the needle (116) can be moved out of the distal end region of the retractor sheath (112) by means of a force transmitter (118) operated via the proximal end region of the retractor sheath (112).
24. Surgical system according to claim 23, characterized in that the retractor sheath (112) is movable, generally in parallel to the longitudinal axis of the staple fastening assembly (6').
25. Surgical system according to one of claims 21 to 24, charac-terized in that the balloon (120) is mounted on a catheter (122).
26. Surgical system according to one of claims 1 to 25, further comprising an endoscope (80), which preferably has a working channel (84).
27. Surgical system according to claim 26, characterized in that the endoscope (80) is a steerable gastroscope adapted to be inserted through the esophagus (72) as far as into the sto-mach (70).
28. Stapling instrument (1) of the surgical system according to claim 17, 19 or 20.
29. Retractor (90) of the surgical system according to claim 17, 19 or 20.
30. Staple fastening assembly (6; 6') of the surgical system according to one of claims 1 to 27.
31. Cartridge (10; 10'), which is adapted to the stapling in-strument (1; 100) of the surgical system according to claim 16.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/EP2003/006352 WO2004110285A1 (en) | 2003-06-16 | 2003-06-16 | Surgical system with a stapling instrument and a retractor |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2529450A1 true CA2529450A1 (en) | 2004-12-23 |
| CA2529450C CA2529450C (en) | 2012-04-17 |
Family
ID=33547558
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA2529450A Expired - Lifetime CA2529450C (en) | 2003-06-16 | 2003-06-16 | Surgical system with a stapling instrument and a retractor |
Country Status (9)
| Country | Link |
|---|---|
| EP (1) | EP1633256A1 (en) |
| JP (1) | JP4463762B2 (en) |
| CN (1) | CN1859874A (en) |
| AU (1) | AU2003245952A1 (en) |
| BR (1) | BR0318356A (en) |
| CA (1) | CA2529450C (en) |
| MX (1) | MXPA05013759A (en) |
| RU (1) | RU2006101219A (en) |
| WO (1) | WO2004110285A1 (en) |
Families Citing this family (52)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101810521B (en) | 2001-08-27 | 2015-05-13 | 辛尼科有限责任公司 | Satiation devices and methods |
| US7097665B2 (en) | 2003-01-16 | 2006-08-29 | Synecor, Llc | Positioning tools and methods for implanting medical devices |
| US6675809B2 (en) | 2001-08-27 | 2004-01-13 | Richard S. Stack | Satiation devices and methods |
| US7146984B2 (en) | 2002-04-08 | 2006-12-12 | Synecor, Llc | Method and apparatus for modifying the exit orifice of a satiation pouch |
| US8206456B2 (en) | 2003-10-10 | 2012-06-26 | Barosense, Inc. | Restrictive and/or obstructive implant system for inducing weight loss |
| US20050247320A1 (en) | 2003-10-10 | 2005-11-10 | Stack Richard S | Devices and methods for retaining a gastro-esophageal implant |
| US7361180B2 (en) | 2004-05-07 | 2008-04-22 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
| US8252009B2 (en) * | 2004-03-09 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
| US9028511B2 (en) | 2004-03-09 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
| US8628547B2 (en) | 2004-03-09 | 2014-01-14 | Ethicon Endo-Surgery, Inc. | Devices and methods for placement of partitions within a hollow body organ |
| US8277373B2 (en) | 2004-04-14 | 2012-10-02 | Usgi Medical, Inc. | Methods and apparaus for off-axis visualization |
| US8562516B2 (en) | 2004-04-14 | 2013-10-22 | Usgi Medical Inc. | Methods and apparatus for obtaining endoluminal access |
| US8512229B2 (en) | 2004-04-14 | 2013-08-20 | Usgi Medical Inc. | Method and apparatus for obtaining endoluminal access |
| EP1740132B1 (en) | 2004-04-26 | 2014-12-31 | Synecor, LLC | Restrictive and/or obstructive implant for inducing weight loss |
| US8057511B2 (en) | 2004-05-07 | 2011-11-15 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
| US8257394B2 (en) | 2004-05-07 | 2012-09-04 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
| US7931661B2 (en) | 2004-06-14 | 2011-04-26 | Usgi Medical, Inc. | Apparatus and methods for performing transluminal gastrointestinal procedures |
| US7210609B2 (en) | 2004-07-30 | 2007-05-01 | Tools For Surgery, Llc | Stapling apparatus having a curved anvil and driver |
| WO2006027014A1 (en) * | 2004-09-10 | 2006-03-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
| US9055942B2 (en) * | 2005-10-03 | 2015-06-16 | Boston Scienctific Scimed, Inc. | Endoscopic plication devices and methods |
| WO2007131110A2 (en) | 2006-05-03 | 2007-11-15 | Raptor Ridge, Llc | Systems and methods of tissue closure |
| US8870916B2 (en) | 2006-07-07 | 2014-10-28 | USGI Medical, Inc | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
| WO2008030403A1 (en) | 2006-09-02 | 2008-03-13 | Synecor, Llc | Intestinal sleeves and associated deployment systems and methods |
| EP2068719B1 (en) | 2006-09-15 | 2017-10-25 | Boston Scientific Scimed, Inc. | System for anchoring stomach implant |
| US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
| ATE468074T1 (en) * | 2006-12-14 | 2010-06-15 | Ethicon Endo Surgery Inc | LAPAROSCOPIC CLAP DEVICE |
| EP1949863B1 (en) * | 2006-12-14 | 2011-10-19 | Ethicon Endo-Surgery, Inc. | A tissue clamp for endolumenal local excision of tissue |
| US8540128B2 (en) * | 2007-01-11 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with a curved end effector |
| AU2008276523B2 (en) | 2007-07-18 | 2014-08-21 | Boston Scientific Scimed, Inc. | Endoscopic implant system and method |
| WO2009011881A1 (en) * | 2007-07-18 | 2009-01-22 | Barosense, Inc. | Overtube introducer for use in endoscopic bariatric surgery |
| US20090171383A1 (en) | 2007-12-31 | 2009-07-02 | David Cole | Gastric space occupier systems and methods of use |
| US8561870B2 (en) * | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
| US8020741B2 (en) * | 2008-03-18 | 2011-09-20 | Barosense, Inc. | Endoscopic stapling devices and methods |
| PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
| US7832612B2 (en) | 2008-09-19 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Lockout arrangement for a surgical stapler |
| US7934631B2 (en) | 2008-11-10 | 2011-05-03 | Barosense, Inc. | Multi-fire stapling systems and methods for delivering arrays of staples |
| US8961539B2 (en) | 2009-05-04 | 2015-02-24 | Boston Scientific Scimed, Inc. | Endoscopic implant system and method |
| EP2571427B1 (en) | 2010-05-21 | 2017-07-19 | Boston Scientific Scimed, Inc. | Tissue-acquisition and fastening devices |
| CN102429693B (en) * | 2011-12-14 | 2013-05-29 | 北京中法派尔特医疗设备有限公司 | Nail cabin assembly of linear cutting anastomat and anastomat applying nail cabin assembly |
| US10485545B2 (en) | 2013-11-19 | 2019-11-26 | Datascope Corp. | Fastener applicator with interlock |
| JP6643249B2 (en) * | 2014-04-16 | 2020-02-12 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | Fastener cartridge including a layer mounted on the fastener cartridge |
| EP3009085A1 (en) | 2014-10-14 | 2016-04-20 | Coloplast A/S | Extraction device for removing foreign body from a patient |
| CN104840228B (en) * | 2015-05-28 | 2017-03-01 | 江培颜 | Coincide outside a kind of chamber anastomat outside method and eversion type chamber |
| US10610219B2 (en) * | 2015-12-31 | 2020-04-07 | Ethicon Llc | Surgical stapler with curved outer surface on anvil |
| US11547439B2 (en) * | 2017-12-12 | 2023-01-10 | Covidien Lp | Surgical instruments including devices for sensing tissue properties and methods thereof |
| BR112020012245B1 (en) * | 2017-12-21 | 2023-10-10 | Ethicon Llc | SURGICAL STAPLER COMPRISING A SHOOTING TRAJECTORY DISPLAY |
| US11653928B2 (en) | 2018-03-28 | 2023-05-23 | Datascope Corp. | Device for atrial appendage exclusion |
| EP3932439A4 (en) * | 2019-03-28 | 2022-04-27 | TERUMO Kabushiki Kaisha | Medical device |
| WO2021248458A1 (en) * | 2020-06-12 | 2021-12-16 | Covidien Lp | Curved surgical stapling device |
| CN111588343A (en) * | 2020-06-22 | 2020-08-28 | 妙思医疗科技(上海)有限公司 | Endoscope top end assembly for emergency treatment during failure of fundus folding |
| CN113648008A (en) * | 2021-08-16 | 2021-11-16 | 南昌大学第二附属医院 | Laparoscope linear cutting anastomat device |
| CN114601519A (en) * | 2022-03-30 | 2022-06-10 | 淮安市金瓯医疗生物科技有限公司 | Esophagus-stomach asymmetric anastomat with anti-reflux effect |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5403326A (en) * | 1993-02-01 | 1995-04-04 | The Regents Of The University Of California | Method for performing a gastric wrap of the esophagus for use in the treatment of esophageal reflux |
| US6119913A (en) * | 1996-06-14 | 2000-09-19 | Boston Scientific Corporation | Endoscopic stapler |
| US6371943B1 (en) * | 1997-09-08 | 2002-04-16 | Epimed International, Inc. | Spring tip needle combination |
| FR2768324B1 (en) * | 1997-09-12 | 1999-12-10 | Jacques Seguin | SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER |
| US6139563A (en) * | 1997-09-25 | 2000-10-31 | Allegiance Corporation | Surgical device with malleable shaft |
| US6494888B1 (en) * | 1999-06-22 | 2002-12-17 | Ndo Surgical, Inc. | Tissue reconfiguration |
| DE10026683C2 (en) * | 2000-05-30 | 2003-07-10 | Ethicon Endo Surgery Europe | Surgical stapling device |
| US6817508B1 (en) * | 2000-10-13 | 2004-11-16 | Tyco Healthcare Group, Lp | Surgical stapling device |
-
2003
- 2003-06-16 BR BRPI0318356-4A patent/BR0318356A/en not_active Application Discontinuation
- 2003-06-16 WO PCT/EP2003/006352 patent/WO2004110285A1/en not_active Application Discontinuation
- 2003-06-16 RU RU2006101219/14A patent/RU2006101219A/en not_active Application Discontinuation
- 2003-06-16 EP EP03738043A patent/EP1633256A1/en not_active Ceased
- 2003-06-16 JP JP2005500693A patent/JP4463762B2/en not_active Expired - Fee Related
- 2003-06-16 AU AU2003245952A patent/AU2003245952A1/en not_active Abandoned
- 2003-06-16 MX MXPA05013759A patent/MXPA05013759A/en active IP Right Grant
- 2003-06-16 CA CA2529450A patent/CA2529450C/en not_active Expired - Lifetime
- 2003-06-16 CN CNA03826806XA patent/CN1859874A/en active Pending
Also Published As
| Publication number | Publication date |
|---|---|
| CA2529450C (en) | 2012-04-17 |
| MXPA05013759A (en) | 2006-06-27 |
| WO2004110285A1 (en) | 2004-12-23 |
| JP2006527600A (en) | 2006-12-07 |
| BR0318356A (en) | 2006-08-01 |
| JP4463762B2 (en) | 2010-05-19 |
| AU2003245952A1 (en) | 2005-01-04 |
| EP1633256A1 (en) | 2006-03-15 |
| CN1859874A (en) | 2006-11-08 |
| RU2006101219A (en) | 2007-07-27 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKEX | Expiry |
Effective date: 20230616 |