CN201658735U - Local expanding gasbag catheter - Google Patents
Local expanding gasbag catheter Download PDFInfo
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- CN201658735U CN201658735U CN 201020174546 CN201020174546U CN201658735U CN 201658735 U CN201658735 U CN 201658735U CN 201020174546 CN201020174546 CN 201020174546 CN 201020174546 U CN201020174546 U CN 201020174546U CN 201658735 U CN201658735 U CN 201658735U
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Abstract
The utility model discloses a local expanding gasbag catheter which composes a catheter body, wherein the middle of the catheter body is sheathed with an expanding bag body, the connection between the wall of the expanding bag body and the catheter body is sealing connection, the catheter body is internally provided with a fluid passageway, the front port of the fluid passageway is communicated with the expanding bag body, the tail port of the fluid passageway extends into the tail end surface of the catheter body, and the tail end of the first fluid passageway is provided with a first one-way valve. The local expanding gasbag catheter has proper thickness, can provide enough support and expansion, and can not excessively compress the mucous membrane and the outer port of the urethra to cause uncomfortableness of patients and even new iatrogenic stenosis. Before injecting the liquid into the expanding bag body, the local expanding gasbag catheter is a thinner silica gel catheter; and after injecting a given amount of liquid, the local expanding gasbag catheter can be expanded to the required size, has the function of local compression hemostasis at the early time after the operation, and has the function of local intermittent expansion at the period of catheter indwelling.
Description
Technical field
This utility model relates to a kind of operating theater instruments, relates in particular to a kind of locally expanding balloon catheter.
Background technology
1.1 urethral stricture incidence rate
Urethral stricture after the injury of urethra is puzzlement patient and make the urological surgeon feel pain in the neck, and its treatment also is one of common and challenging difficult problem of facing of urological surgeon.Injury of urethra is the most common with bulb urethra (anterior urethra) damage and membranous urethra (back urethra) damage, and both modus operandis of treatment are a lot, but the various modus operandi postoperatives of bibliographical information all have the urethral stricture incidence rate of larger proportion.Therefore, the incidence rate of minimizing urethral stricture is the difficult problem that we must make great efforts to overcome.
Urethra bulb damage is many, and traditional open urinary anastomosis is simple because of straddle injury causes, but shortcoming is to have traumaticly, and complication such as urethral stricture can take place postoperative.Report such as Wu Guang adopts open urethra bulb kposthesis, and the postoperative urethral stricture incidence rate is 25% (3/12).In recent years along with the development of Urology Surgery chamber mirror technology, beginning is with urethral reunion operation treatment urethra bulb damage under the ureteroscope, has the low advantage of more traditional open surgery postoperative urethral stricture incidence rate, but report such as Wu Guang adopts ureteroscope urethra tube placing operation, and tube drawing posterior urethral stricture incidence rate still has 10% (1/10).Identical even the report of well unit adopts urethral reunion operation under the ureteroscope, and postoperative is pulled out after urethral catheterization 2-6 week 56.3% (9/16) patient and line occurred urinating and attenuate, and needs 3-12 month urethral dilatation of row.
Membranous part of urethra fracture is caused by fracture of pelvis that mostly its major complications is urethral stricture, erection disturbance.The early time treatment suggestion of fracture of pelvis posterior urethral rupture is ununified as yet at present, has multiple art formula available: after Zhao Xiaopei etc. found posterior urethral injury, simple fistulation group posterior urethral stricture incidence rate was 96%, wherein 94% needed the open operation on urethra of row; And the employing end-to-end anastomosis of urethra, report postoperative urethral stricture incidence rates such as Dan Fengzhi are 16.7% (1/6), Qiao Le is 0% (0/16) with report postoperative urethral stricture rate, but this art formula is complicated, operating time is long, wound is big, patient can not tolerate the strike of this kind art formula under the severe trauma situation, so its limitation is arranged.As adopt simple urethral reunion operation to treat posterior urethral rupture, postoperative is inserted the 18-20F double lumen catheter, domestic literature report urethral stricture rate 29.7%-41.3%, report such as Dan Fengzhi postoperative urethral stricture incidence rate 73.3% (11/15), Qiao Le is 12.5% (3/24) with report postoperative urethral stricture rate, all need urethral dilatation, even need the secondary intracavity operation to cut narrow ring; And adopt the urethral realignment of extensively being admitted clinically at present to add traction, insert the 18-20F double lumen catheter in the art, report such as Chou Guangming postoperative urethral stricture rate 14.8%, report postoperative urethral stricture rates such as Dan Fengzhi are 31.8% (7/22), Qiao Le is 7.1% (2/28) with report postoperative urethral stricture rate, and report postoperative urethral stricture rates such as Zhang Ruji are 41.7% (5/12).
1.2 urinary catheter in time and postoperative urethral stricture
Hinder back 3d and promptly begin to grow granulation tissue at the urethral disruption place, and the 5-6d fibroblast produces collagen fiber, along with cicatrix can appear in increasing then of collagen fiber, and about 1 month cicatrization.If pull out the three-cavity air bag urinary catheter this moment, cicatrix is shunk, and will certainly cause urethral stricture.Collagen fiber reach the strongest at 3 months resistance to tensions, and this moment, scar tissue still can not soften, and scar tissue is softening gradually about 6 months, is in metastable state, and pull out the three-cavity air bag urinary catheter this moment, and it is less relatively that narrow probability takes place again.
Cai like just think the support catheter indwelling time with the damage urethra healing, the curative effect relation of being proportionate, promptly indwelling time is long more, healing rate is high more, late result is also good more.Pulling out the support catheter prematurely, may be one of not good enough reason of urethral reunion operation curative effect in the past.Stay the pipe time too short, urethra is not healing as yet, and urine extravasation easily infects to the other tissue of urethra, increases the weight of cicatrization.Urethra loses support in addition, and the broken ends of fractured bone is shifted, and causes cicatrix constriction and bending easily.Bibliographical information urethral realignment postoperative urethral stent keeps 7 weeks above cases need not go urethral dilatation basically, and it is narrow local scar seldom to occur, proposes placement and is advisable in 7-9 week, the longlyest reaches for 13 weeks.But catheterization time is long, increases the patient suffering, and easy infection, forms calculus, even produces new iatrogenic urethral stricture.
1.3 the material of catheter, diameter and postoperative urethral stricture
The F18-F20 of the conventional indwelling of adult male injury of urethra postoperative at present three-cavity air bag catheter, meticulous as indwelling catheter, support and dilating effect deficiency to the injury of urethra position, on the basis of cicatricial contracture, must form the narrow ring of damage location, and cause catheter to pull out the back patient and urinate thin, the dysuria of line.And if the urinary catheter of keeping somewhere is thick excessively, the patient is usually because the urethral stricture of injury of urethra postoperative is extracted the three-cavity air bag urinary catheter and easily cause in the compressing to anterior urethra (especially to external orifice of urethra) that catheter produces, sense of discomfort and can not adhere to for 8 weeks too early.And catheter is crossed slightly can cause repressive urethra necrosis or urethra overdistension, thus to adopt the F16-F18 three-cavity catheter comparatively suitable, should not be thick excessively, in order to avoid influence the circulation of urethra blood flow, cause iatrogenic urethral stricture.
Lu etc. think that the material of catheter and the formation of urethral stricture have substantial connection, and silicone catheter is than the iatrogenic urethral stricture of the difficult formation of latex catheter.Because of its histocompatibility, better tolerance, be difficult for the deposition calculus, also little to the zest of patient's urethra.
Urethral stricture is the common complication of injury of urethra and postoperative thereof in sum, no matter is damage of urethra bulb or membranous part of urethra damage, no matter is to adopt which kind of modus operandi also, and postoperative all has the urethral stricture incidence rate of larger proportion.It is support of repairing as the damage back and the effect that the lasting soft expansion of pair damage location is arranged that postoperative is kept somewhere silicone catheter, is the better measure of prevention of postoperative urethral stricture.
The utility model content
This utility model provides a kind of catheter that can make that the locally expanding balloon catheter that intermittent controlled local thickness changes takes place.
This utility model adopts following technical scheme:
A kind of locally expanding balloon catheter, comprise: the catheter body, being with being connected between expansion utricule and expansion utricule cyst wall and the catheter body at the middle part of catheter body is tightly connected, in the catheter body, be provided with the first fluid passage, the front port of described first fluid passage is communicated with described expansion utricule, the afterbody port of described first fluid passage extends to catheter body tail end face, is provided with first check valve at the afterbody of described first fluid passage.
The design considerations of locally expanding balloon catheter described in the utility model is:
2.1 male urethra is dissected
Male urethra to external orifice of urethra, is about 16-22cm from the internal urethral orifice of bladder neck.Caliber average out to 5~7mm.Can be divided into penis portion (cavernous part), bulb, membranous part and prostatic part.Clinically penis portion and bulb are called anterior urethra, claim the back urethra prostatic part and membranous part.Anterior urethra ends from urethral orifice to bulb, is about 15cm; Back urethra till bladder neck, is about 4cm from the membranous part of urethra.
Prostatic urethra is that urethra passes prostatic part, is about 2.5-3cm.Membranous part is the part that urethra passes urogenital diaphragm, compressor urethrae is arranged around, luminal stenosis on every side, is the most fixed one section of the shortest and position in four ones, is about 1.2cm.Be vulnerable to most damage when fracture of pelvis or perineal position are subjected to the violence extruding, it is improper also injured easily to use urethra apparatus maneuver.The bulb urethra originates in the membranous part below, and apart from the about 4cm of bladder neck, bulb injury of urethra place often is positioned at below the membranous part apart from bladder neck 5~6cm place during the perineal position straddle injury.
2.2 male urethra expansion ratio
The maximum model of the Foley catheter that uses clinically at present is F22, and the per urethra TURP is used F24, F26, F26.7 extra sheath always, rubble F24 cystoscope epitheca commonly used under the per urethra cystoscope, and the maximum model of metal divulsor is F24-F26.Practice shows that most Chinese adult male urethras can illustrate the urethral dilatation Du Keda F26 of normal male smoothly by the apparatus of above-mentioned model.
Compared with prior art, the utlity model has following advantage:
To effectively reduce the postoperative urethral stricture incidence rate, catheterization time should be more than 8 weeks, and the catheter thickness wants appropriateness, and enough support and expansions should be provided, unlikely again urethral mucosa and external orifice of urethra are produced excessively compressing, cause patient's sense of discomfort even new iatrogenic narrow.This utility model was promptly being expanded utricule before being heaved to expansion utricule injection liquid (liquids in general is a normal saline), this utility model is a thinner silicone catheter (F16-F20), after injecting certain amount of fluid, can be extended to the size that needs, postoperative plays the effect of local pressing type hemostasia in early days, can play local intermittent dilating effect during the indwelling catheter.Just can keep somewhere more than 8 weeks of this thinner silicone catheter (F16-F20) at the urethral stricture postoperative, to guarantee the urethra healing, avoid urine extravasation to the other tissue of urethra, cause infection, increase the weight of cicatrization, and avoid because urethra loses support the displacement of fractured ends taking place, cause cicatrix constriction and bending.When promptly expanding utricule after being heaved to expansion utricule injection liquid, catheter described in the utility model is in the differentially expanding state, support and the dilating effect of F20-F26 just can be provided in the injury of urethra part, and this acting in the whole therapeutic process is adjustable, the intermittent urethral dilatation of incremental formula can be provided, after pulling out stay pipe, can avoid or reduce to greatest extent the incidence rate of urethral stricture.This utility model is by pouring liquid or liquid being extracted out from the expansion utricule to the expansion utricule, local thickness of the present utility model is changed realization control, therefore, support of the present utility model and dilating effect are controlled, are that the locally expanding balloon catheter that intermittent controlled local thickness changes takes place himself a kind of can making.
When this utility model makes one's options to the shape of expansion utricule after the shape that is about to expand utricule selects elongated cylindrical, because the shape after expansion utricule water-filling is heaved also is elongated cylindrical, like this, expansion balloon shapes and urethra after the expansion are matched, expansion or hemostasis by compression even action unanimity to the broken ends of fractured bone and far and near side urethra thereof do not influence the healing of anastomotic stoma.Urine stream because of the thickness unanimity, can not form urine stream whirlpool through herein the time behind the tube drawing.
Description of drawings
Fig. 1 is the structural front view of this utility model embodiment.
Fig. 2 is the structure cutaway view of this utility model embodiment, and wherein, 2a is the A-A cutaway view Amplified image, and 2b is the B-B amplification view, and 2c is the C-C cutaway view Amplified image, and 2d is the D-D cutaway view Amplified image.
Fig. 3 is the structure vertical view of this utility model embodiment.
The specific embodiment
The Design Conception of locally expanding balloon catheter described in the utility model is:
Locally expanding balloon catheter is to be the designed special-purpose urethral support catheter of male urethral injury postoperative, divides I, II amphitypy.The I type is applicable to membranous urethra damage (being posterior urethral injury) postoperative, and the II type is used for bulb injury of urethra (being the anterior urethra damage) postoperative.Amphitypy all has four chambeies, two capsule pipes or Sengstaken-Blakemore tube (whether needs bladder continual rinsing and row bladder stoma are selected for use according to postoperative), silica gel material, length overall 38cm, active length 33cm, head are that arc-shaped bend is slightly thin, are convenient to insert, body diameter 5.35mm (F16) or 6.00mm (F18).The afterbody band valve in two chambeies is respectively the air bag waterflood path in the two capsule pipes of four chambeies, and two chambeies are urine drainage and bladder irrigation passage (being opened on catheter head different parts) in addition; Two chambeies are the air bag waterflood path in the Sengstaken-Blakemore tube, and another chamber is urine drainage passage (being opened on the catheter head end).Similar with ordinary urethral catheter, at the intravesical air bag that a band valve is being arranged near the catheter head end, after the water filling can intravesical fixedly catheter and go deep into bladder with partial according to how many catheter ends of water filling in the air bag and have<the adjusting length of 1cm with anti-slip.We have designed the elongated cylindrical differentially expanding air bag of a band valve at intravesical air bag nearside, and the expansion capsule of I type is positioned at intravesical air bag nearside 2.0cm place, and the long 2.5cm of this expansion capsule is used for membranous urethra fracture postoperative; II type differentially expanding air bag is positioned at the nearside 4.2cm place of intravesical air bag, and the long 2.5cm of expansion capsule is used for bulb injury of urethra postoperative.
According to cylindrical volume computing formula [pi * (balloon radius
2-bar portion radius
2) * length], amphitypy catheter differentially expanding air bag can be extended to diameter 8.7mm (F26) at most after filling with physiological saline solution 2.2ml; Can be extended to diameter 8.0mm (F24) behind the water filling 1.8ml; Can be extended to diameter 7.3mm (F22) behind the water filling 1.6ml; Can be extended to diameter 6.7mm (F20) behind the water filling 1.2ml.(annotate: water injection rate has comprised that valve is to the conduit volume 0.4ml between air bag)
Innovative point of the present utility model: the common Foley catheter that uses clinically mostly is two chambeies or three chambeies at present, only an air bag is arranged at head, play fixedly behind this air bag water-filling that catheter prevents slippage, and can be used for the hemostasis by compression behind neck of bladder and the operation on prostate; And when injury of urethra, use this pipe only fracture place to be played a supporting role, do not have local pressing type hemostasia and intermittent dilating effect.
The locally expanding balloon catheter (four chambeies, two capsules or three chambeies, two capsules) of this utility model design designs the elongated cylindrical air bag of a long 2.5cm respectively in the nearside 2.0cm of head end air bag (I type) and 4.2cm place (II type), and Long Circle was expanded capsule and is positioned at the injury of urethra position when this distance and the length of expanding capsule can guarantee to use.(membranous part or bulb)
Locally expanding balloon catheter bar portion is F16,18,20, and how many expansion capsules can be extended to F20,22,24,26 according to water filling, can guarantee during indwelling catheter that like this urethra is comfortable, water injection rate makes the part can be extended to F20,22,24,26 to the postoperative different time in the expansion capsule by regulating, thereby postoperative plays the local pressing type hemostasia effect in early days, plays intermittent dilating effect during the indwelling catheter.The effect of irrigation and drainage urine is played in two chambeies in addition.
I type locally expanding balloon catheter is applicable to the posterior urethral injury postoperative, and II type locally expanding balloon catheter is applicable to anterior urethra damage postoperative.
Embodiment 1
A kind of locally expanding balloon catheter, comprise: catheter body 5, being with being connected between expansion utricule 9 and expansion utricule 9 cyst walls and the catheter body 5 at the middle part of catheter body 5 is tightly connected, in catheter body 5, be provided with first fluid passage 4, the front port of described first fluid passage 4 is communicated with described expansion utricule 9, the afterbody port of described first fluid passage 4 extends to catheter body 5 tail end faces, is provided with first check valve at the afterbody of described first fluid passage 4.The described structure of present embodiment is applicable to three chambeies and four chamber catheters.
Present embodiment is a kind of three chambeies or four chamber catheters, that is: a kind of locally expanding balloon catheter, comprise: catheter body 5, being with being connected between expansion utricule 9 and expansion utricule 9 cyst walls and the catheter body 5 at the middle front part of catheter body 5 is tightly connected, in catheter body 5, be provided with first fluid passage 4, the front port of described first fluid passage 4 is communicated with described expansion utricule 9, the afterbody port of described first fluid passage 4 extends to catheter body 5 tail end faces, afterbody at described first fluid passage 4 is provided with first check valve, front end at catheter body 5 is provided with inlet opening 6 and conduction hole 7, be with in the front portion of catheter body 5 fixing utricule 8 and fixedly being connected between the cyst wall of utricule 8 and the catheter body 5 be tightly connected, in catheter body 5, be provided with passage of irrigation fluid 1, the drain liquid passage 2 and second fluid passage 3, the front port of described passage of irrigation fluid 1 is communicated with described inlet opening 6, the front port of described drain liquid passage 2 is communicated with described conduction hole 7, the afterbody port of the afterbody port of described passage of irrigation fluid 1 and drain liquid passage 2 extends to catheter body 5 tail end faces, the front port of described second fluid passage 3 is communicated with described fixedly utricule 8, and the afterbody port of second fluid passage 3 extends to catheter body 5 tail end faces, afterbody in second fluid passage 3 is provided with second check valve, and described expansion utricule 9 is the elongated cylindrical utricule.
Using method of the present utility model is:
According to the patient is that a kind of injury of urethra, selects I type or II type locally expanding balloon catheter for use, and promptly posterior urethral injury is selected I type pipe for use, and II type pipe is selected in the anterior urethra damage for use; According to postoperative whether needs continuous bladder irrigation and row bladder stoma select four chambeies, two capsule pipes or three chambeies, two capsule pipes for use, promptly need continuous bladder irrigation person to select four chambeies, two capsule pipes for use, do not need then available three chambeies of continuous bladder irrigation person two capsule pipes; Select expanding balloon catheter such as F16, F18, the F20 etc. of different thicknesses for use according to patient age, urethra size.With the operation of adult's posterior urethral injury is example, selects F18I type four chambeies two capsule expanding balloon catheters for use.The injury of urethra postoperative is inserted locally expanding balloon catheter, the fixedly catheter of intravesical air bag water filling of going ahead of the rest, and water filling 1.6~2.2ml in the differentially expanding air bag can make the damage differentially expanding to F22~F26 then.The reason of delivering a child in addition saline injects the row continuous bladder irrigation by passage of irrigation fluid to intravesical, connects drainage bag constant drainage flushing liquor and urine by drain liquid passage.Regulate flushing speed to keep urine drainage unobstructed according to the shade that flushes out liquid, prevent that clot from stopping up urinary catheter (passage of irrigation fluid and drain liquid passage can exchange use in case of necessity).This moment, the differentially expanding air bag was based on local pressing type hemostasia, emitting the interior part water of expansion capsule after 2~4 hours makes the expansion capsule maintain F20, F22, be interrupted the capable batch (-type) expansion of the water injection rate of regulating in the differentially expanding capsule according to patient's recovery situation and subjective feeling then, each expansion time should keep 2~4 hours, until pulling out locally expanding catheter (2~8 weeks of postoperative).Thereby in the effect of the early stage performance of operation local pressing type hemostasia, the local batch (-type) dilating effect of performance during urinary catheter in is to avoid or to reduce the generation of postoperative urethral stricture.
Line attenuates or the per urethra contrast examination turns out to be former pars affecta urethral stricture for postoperative appearance at a specified future date is urinated as the patient, can be after urethral dilatation or direct-view under cut rearmounted locally expanding catheter of going into respective model in the cryoprobe and carry out the intermittent soft expansion of urethral stricture portion, be easy to insert because its head is convexly curved and omit trivial matter, this method can significantly reduce the urethral dilatation treatment that postoperative uses the metal divulsor, have safe, easy, economy, effect significantly, painful characteristics such as little.
Claims (3)
1. locally expanding balloon catheter, comprise: catheter body (5), it is characterized in that, being with being connected between expansion utricule (9) and expansion utricule (9) cyst wall and the catheter body (5) at the middle part of catheter body (5) is tightly connected, in catheter body (5), be provided with first fluid passage (4), the front port of described first fluid passage (4) is communicated with described expansion utricule (9), the afterbody port of described first fluid passage (4) extends to catheter body (5) tail end face, is provided with first check valve at the afterbody of described first fluid passage (4).
2. locally expanding balloon catheter according to claim 1, it is characterized in that, front end at catheter body (5) is provided with inlet opening (6) and conduction hole (7), be with in the front portion of catheter body (5) fixing utricule (8) and fixedly being connected between the cyst wall of utricule (8) and the catheter body (5) be tightly connected, in catheter body (5), be provided with passage of irrigation fluid (1), drain liquid passage (2) and second fluid passage (3), the front port of described passage of irrigation fluid (1) is communicated with described inlet opening (6), the front port of described drain liquid passage (2) is communicated with described conduction hole (7), the afterbody port of the afterbody port of described passage of irrigation fluid (1) and drain liquid passage (2) extends to catheter body (5) tail end face, the front port of described second fluid passage (3) is communicated with described fixedly utricule (8), and the afterbody port of second fluid passage (3) extends to catheter body (5) tail end face, and the afterbody in second fluid passage (3) is provided with second check valve.
3. locally expanding balloon catheter according to claim 1 is characterized in that, expansion utricule (9) is the elongated cylindrical utricule.
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CN 201020174546 CN201658735U (en) | 2010-04-27 | 2010-04-27 | Local expanding gasbag catheter |
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CN 201020174546 CN201658735U (en) | 2010-04-27 | 2010-04-27 | Local expanding gasbag catheter |
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
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CN101862500A (en) * | 2010-04-27 | 2010-10-20 | 南京明基医院有限公司 | Locally expanding balloon catheter |
CN103272321A (en) * | 2013-05-30 | 2013-09-04 | 中南大学湘雅三医院 | Body cavity drainage tube suit |
CN103495258A (en) * | 2013-10-24 | 2014-01-08 | 河南科技大学第一附属医院 | Asepsis catheter |
CN104874033A (en) * | 2015-05-28 | 2015-09-02 | 上海慧达医疗器械有限公司 | Novel thrombus aspiration catheter |
CN111248964A (en) * | 2020-01-16 | 2020-06-09 | 张跃国 | Cardiovascular internal medicine intervention device |
CN112263741A (en) * | 2020-10-23 | 2021-01-26 | 河南科技大学第一附属医院 | Urinary surgery urinary tract anesthesia washing unit |
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2010
- 2010-04-27 CN CN 201020174546 patent/CN201658735U/en not_active Expired - Fee Related
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN101862500A (en) * | 2010-04-27 | 2010-10-20 | 南京明基医院有限公司 | Locally expanding balloon catheter |
CN103272321A (en) * | 2013-05-30 | 2013-09-04 | 中南大学湘雅三医院 | Body cavity drainage tube suit |
CN103272321B (en) * | 2013-05-30 | 2016-08-31 | 中南大学湘雅三医院 | Body cavity drainage tube suit |
CN103495258A (en) * | 2013-10-24 | 2014-01-08 | 河南科技大学第一附属医院 | Asepsis catheter |
CN103495258B (en) * | 2013-10-24 | 2016-04-27 | 河南科技大学第一附属医院 | A kind of sterilized catheter |
CN104874033A (en) * | 2015-05-28 | 2015-09-02 | 上海慧达医疗器械有限公司 | Novel thrombus aspiration catheter |
CN111248964A (en) * | 2020-01-16 | 2020-06-09 | 张跃国 | Cardiovascular internal medicine intervention device |
CN111248964B (en) * | 2020-01-16 | 2020-11-13 | 张跃国 | Cardiovascular internal medicine intervention device |
CN112263741A (en) * | 2020-10-23 | 2021-01-26 | 河南科技大学第一附属医院 | Urinary surgery urinary tract anesthesia washing unit |
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Granted publication date: 20101201 Termination date: 20140427 |