IT202100005699A1 - Dispositivo intersomatico - Google Patents
Dispositivo intersomatico Download PDFInfo
- Publication number
- IT202100005699A1 IT202100005699A1 IT102021000005699A IT202100005699A IT202100005699A1 IT 202100005699 A1 IT202100005699 A1 IT 202100005699A1 IT 102021000005699 A IT102021000005699 A IT 102021000005699A IT 202100005699 A IT202100005699 A IT 202100005699A IT 202100005699 A1 IT202100005699 A1 IT 202100005699A1
- Authority
- IT
- Italy
- Prior art keywords
- pin
- elements
- teeth
- opening
- nut screw
- Prior art date
Links
- 230000033001 locomotion Effects 0.000 claims description 6
- 230000006641 stabilisation Effects 0.000 claims description 5
- 238000011105 stabilization Methods 0.000 claims description 5
- 238000005245 sintering Methods 0.000 claims description 3
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 claims description 2
- 230000005540 biological transmission Effects 0.000 claims description 2
- 229910052719 titanium Inorganic materials 0.000 claims description 2
- 239000010936 titanium Substances 0.000 claims description 2
- 238000000034 method Methods 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 230000003466 anti-cipated effect Effects 0.000 description 2
- 238000013459 approach Methods 0.000 description 2
- 230000007850 degeneration Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 125000006850 spacer group Chemical group 0.000 description 2
- 208000037873 arthrodesis Diseases 0.000 description 1
- 238000012512 characterization method Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 230000003292 diminished effect Effects 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 238000007430 reference method Methods 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000000087 stabilizing effect Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 238000011282 treatment Methods 0.000 description 1
Classifications
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/446—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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- A61F2/4465—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
- A61F2002/30962—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using stereolithography
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2002/4495—Joints for the spine, e.g. vertebrae, spinal discs having a fabric structure, e.g. made from wires or fibres
Description
DESCRIZIONE
Annessa a Domanda di Brevetto per invenzione Industriale avente per Titolo:
?DISPOSITIVO INTERSOMATICO?
DESCRIZIONE
L'invenzione riguarda un dispositivo intersomatico espandibile utilizzato per operazioni intersomatiche alla colonna vertebrale e appartiene al campo delle apparecchiature mediche.
Le patologie vertebrali hanno quale causa preminente la degenerazione dei dischi intervertebrali.
La diminuita capacit? del disco intervertebrale di assolvere ai propri compiti implica spesso la necessit? di intervenire sullo stesso con la conseguente possibile implicazione del danneggiamento del segmento di moto della colonna vertebrale.
Fra i trattamenti chirurgici per trattare detta degenerazione, oggi la metodica di riferimento ? la procedura di stabilizzazione vertebrale con artrodesi intersomatica, un intervento che mira a ristabilire la giusta distanza tra due o pi? dischi intervertebrali deteriorati che non sono pi? in grado di assolvere alla loro funzione.
La stabilizzazione intersomatica viene oggi ottenuta con metodiche chirurgiche differenti secondo il distretto anatomico interessato e la posizione della causa preminente del dolore. I dispositivi che vengono posti nello spazio intersomatico sono delle gabbiette di differenti materiali e forma.
L?inconveniente principale delle gabbiette risiede nel fatto che queste possono agire solo da spaziatori o da spaziatori/contenitori di sostanza atta alla stabilizzazione biologica del segmento sottoposto al trattamento.
Va anche detto che per alcune procedure chirurgiche vengono utilizzati dispositivi in grado di aumentare il loro ingombro in altezza, in quanto le gabbiette sono espandibili
Con lo scopo di ottimizzare l?area di contatto fra il dispositivo e il sito anatomico accogliente, l?invenzione concerne in un dispositivo che, mantenendo i presupposti di adeguatezza anatomica e meccanica, possa crescere di volume nello spazio intersomatico sino a coprire una area superiore dei piatti vertebrali accoglienti.
In aggiunta, l?espansione pu? avvenire sul piano anatomico trasverso, peculiarit? attualmente non disponibile nei dispositivi noti.
In maggior dettaglio, l?espansione del dispositivo potr? avvenire attraverso lo spostamento di sue componenti che possono reciprocamente scorrere ed allontanarsi una dall?altra per creare una maggiore copertura dello spazio intersomatico.
Grazie a detta caratteristica dell?invenzione, agli operatori sar? consentito effettuare approcci chirurgici minimamente invasivi altrimenti necessari per poter posizionare dispositivi intersomatici che debbano coprire un?area maggiore dei piatti vertebrali.
Alla peculiarit? ? quella che il dispositivo consente lo sviluppo sul piano coronale per poter eventualmente ottenere anche un migliore riempimento dello spazio di intervento.
Le caratteristiche dell?invenzione in oggetto risulteranno evidenti dalla seguente descrizione di preferite forme di realizzazione in accordo con quanto proposto nelle rivendicazioni e con l?ausilio delle allegate tavole di disegno, nelle quali:
- La figura 1 illustra il dispositivo oggetto dell?invenzione in configurazione chiusa, ossia compatta;
La figura 2 illustra il dispositivo oggetto dell'invenzione in configurazione espansa;
La figura 3 illustra, secondo una vista prospettica, il dispositivo di cui alle figure precedenti;
Le figure da 4 a 6 illustrano la sola struttura del dispositivo, per una migliore visualizzazione del meccanismo di azionamento.
Con riferimento alle figure indicate, si indica con 10 nel suo complesso, un dispositivo intersomatico espandibile costituito sostanzialmente da due elementi 20 e 30 mobili e reciprocamente scorrevoli; in tal modo il dispositivo 10, pur mantenendo i presupposti di adeguatezza anatomica e meccanica, pu? essere regolato in modo da crescere di volume nello spazio intersomatico sino a coprire una area superiore dei piatti vertebrali accoglienti.
Allo scopo, i due elementi 20 e 30 comprendono, rispettive porzioni di base 21, 31 configurate per l?appunto ad accrescere nello spazio intersomatico sino a coprire un?area superiore dei piatti vertebrali.
A ciascuna porzione di base 21, 32 sono associati uno o pi? prolungamenti, nel seguito definiti denti di scorrimento, configurati per l?appunto in modo da scorrere reciprocamente durante l?azionamento del dispositivo 10.
Pi? precisamente, nella forma d? realizzazione qui illustrata a titolo di esempio, la porzione base 21 ? provvista di un unico dente 22 che si protrae da essa ed ? atto ad essere alloggiato, in almeno una configurazione compatta del dispositivo 10, tra due corrispettivi denti 32 e 33 della porzione 30; resta intesto, tuttavia, che tale caratterizzazione sul numero dei denti non deve essere intesa come limitativa della protezione richiesta e altre forme equivalenti di realizzazione ovvie per un tecnico del settore formano parte dellambito di tutela della presente invenzione tutelate.
In buona sostanza, le porzioni 20 e 30 esse sono configurate per avvicinarsi e allontanarsi tra loro, anche supportate dai rispettivi denti di scorrimento 22, 32, 33, e da eventuali guide in seguito descritte; grazie a tale caratteristica il dispositivo 10 viene a trovarsi in due condizioni operative limite, ovvero:
una prima configurazione ?compatta" o chiusa dei dispositivo 10, in cui il primo elemento 20 ? pressoch? a contatto con il secondo elemento 30, ed uno o pi? denti del primo elemento 20 si trovano tra quelli del secondo elemento 30, una seconda configurazione ?estesa?, ossia aperta e di maggior volume, in cui il primo elemento 20 risulta distanziato dal secondo elemento 30, ovvero i denti del primo elemento 20 minimamente interferenti con quelli del secondo elemento 30.
In tal modo, il dispositivo 10 intersomat?co pu? passare dalla prima alla seconda configurazione, e viceversa; a tal riguardo, il dispositivo 10 viene agganciato ad uno strumento cosicch? una volta posizionato nello spazio intersomatico viene espanso orizzontalmente attraverso opportuno strumento dedicato che agisce su un meccanismo di regolazione 40, in seguito descritto, che genera l?allontanamento reciproco degli elementi e quindi l'apertura del dispositivo 10, cos? da riempire l?intero spazio intersomat?co.
Si osserva inoltre che il dispositivo 10 in configurazione ?compatta?, ossia chiusa, presenta le estremit? dei denti di un elemento pressoch? a contatto, o quanto meno in prossimit?, del lato interno della porzione di base dell?altro elemento, per ottenere il minimo ingombro del dispositivo stesso.
Come anticipato, secondo un aspetto vantaggioso dell?invenzione, il dispositivo 10 pu? comprendere uno o pi? perni 60 di guida, per una migliore azione di comando e stabilizzazione della configurazione ?estesa?.
Specificamente, nell?esempio illustrato si osserva la presenza di quattro perni 60 di stabilizzazione vincolati alla porzione di base 21 del corpo 20 e dalla quale si estendono linearmente, nella medesima direzione del dente 22 cosicch? ciascun perno 60 entra ed ? guidato da rispettivi fori ricavati nel corpo 30, precisamente nelle porzioni terminali dei denti 32 e 33.
Il passaggio dalla configurazione compatta a quella estesa (e viceversa) viene attuata, come anticipato, per mezzo di un meccanismo di regolazione 40 ospitato allinteno del dispositivo 10 configurato per cooperare con i rispettivi elementi 20 e 30 per il tramite d? una madrevite 50.
In maggior dettaglio, il meccanismo di regolazione 40 comprende un primo perno 41 filettato che viene collegato ad un secondo perno 42 per il tramite di un organo di trasmissione quale un cardano 70 che permette di trasmettere il moto tra i rispettivi due assi disallineati dei perni 41 e 42, i cui prolungamenti sono per l?appunto incidenti in un punto.
La filettatura del primo perno 41 si impegna nella corrispondente madrevite 50 solidale ad uno dei due elemento del dispositivo, mentre il secondo perno 42 ? solidale all?altro elemento essendo ospitato in un foro 80 circolare di alloggiamento che ne consente la sola rotazione sul proprio asse.
Vantaggiosamente gli assi dei due perni 41 e 42 sono disposti su un medesimo piano che corrisponde al piano di scorrimento degli elementi 20 e 30, ovvero di apertura del dispositivo 10.
Perno 41 e madrevite 50 sono disposti in modo che l?asse di rotazione risulti coincidente con la direzione di apertura/chiusura del dispositivo 10.
Il secondo perno 42, che risulta incidente rispetto al primo perno e inclinato di un angolo variabile d? circa 45?, comprende una sede 43 a geometr?a anti rotazionale ricavata all?interno della porzione di testa; tramite la sede ? consentito l'accoppiamento con uno strumento di comando (non illustrato per un?agevole apertura/chiusura del dispositivo 10.
METODO DI REALIZZAZIONE PREFERITO DEL DISPOSITIVO
Secondo un aspetto vantaggioso dell'invenzione, il meccanismo di apertura 40 per l'apertura del dispositivo 10 ? realizzato in un unico pezzo e non ? assemblato ma realizzato tramite sinterizzazione in titanio gi? assemblato con il movimento calibrato.
Sempre per sinterizzazione sono realizzati anche gli elementi 20 e 30 del dispositivo 10; essi sono costituiti da uno scheletro strutturale che ripercorre essenzialmente i contorni dei vari elementi, ?alleggerita" sia al suo interno (in quanto gli elementi sono cavi), ma anche in superficie per la presenza di una trama reticolare che garantisce un'elevata resistenza meccanica con l?impegno di meno materiale ed una migliorata stabilit? biomeccanica del dispositivo intersomatico.
FUNZIONAMENTO DEL DISPOSITIVO
Il dispositivo 10 intersomatico ad espansione viene azionato da un porta impianti, vale a dire uno strumento chirurgico, sul quale si aggancia mediante il suo foro 90 di fissaggio filettato.
Attraverso una procedura chirurgica denominata OLIF (oblique lumbar interbodi fusion) accede allo spazio intersomatico lombare.
Una volta posizionata il dispositivo 10 all'interno dello spazio intersomatico, questo viene espanso attraverso lo strumento chirurgico dedicato, che si aggancia nella sede 43 esagonale accanto al foro d? fissaggio filettato; attraverso una rotazione in senso orario del manipolo, si genera l?apertura del dispositivo 10 che in tal modo va a riempire l?intero spazio intersomatico.
Claims (4)
1. Dispositivo (10), in particolare per stabilizzazione vertebrale intersomatico, caratterizzato dal fatto di comprendere almeno due corpi (20, 30) reciprocamente scorrevoli uno nell?altro e cooperanti in modo da crescere di volume nello spazio intersomatico sino a coprire una area superiore dei piatti vertebrali accoglienti; e in cui un meccanismo di regolazione (40) interagisce con detti corpi (20, 30) per definire:
a. una prima condizione ?compatta? o chiusa in cui il dispositivo (10) reca i denti del primo elemento (20) tra quelli del secondo elemento (30), o viceversa, e
b. una seconda configurazione ?estesa?, ossia aperta e di maggior volume, in cui i denti del primo elemento (20) sono spostati e minimamente interferenti con quelli del secondo elemento (30).
2. Dispositivo (10), secondo la rivendicazione 1 in cui il meccanismo di regolazione (40)
a. ? ospitato all?interno del dispositivo (10) ed ? configurato per cooperare con i rispettivi elementi (20) e (30) per il tramite di una madrevite (50) solidale ad uno di detti elementi (20, 30);
b. comprende un primo perno (41) ed un secondo perno (42) collegati tra loro per il tramite di un organo di trasmissione quale un cardano (70) che permette di trasmettere il moto tra gli assi disallineati dei perni (41) e (42)
ed in cui il primo perno (41) ? dotato di filettatura atta a impegnare la corrispondente madrevite (50), ed il secondo perno (42) ? ospitato in un foro (80) circolare di alloggiamento che ne consente la sola rotazione sul proprio asse.
3. Dispositivo (10), secondo la rivendicazione 1 in cui gli assi dei due perni (41) e (42) sono disposti su un medesimo piano che corrisponde al piano di scorrimento degli elementi (20) e (30), ovvero di apertura del dispositivo (10) ed il perno (41) e madrevite (50) essendo disposti con asse di rotazione coincidente con detta direzione di apertura.
4. Dispositivo (10), secondo la rivendicazione 1 in cui il secondo perno (42) comprende una sede (43) a geometria anti rotazionale ricavata all?interno della porzione di testa.
5, Dispositivo (10), secondo la rivendicazione 1 in cui il meccanismo di apertura 40 ? realizzato in un unico pezzo e non ? assemblato ma realizzato tramite sinterizzazione in titanio gi? assemblato con il movimento calibrato.
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
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IT102021000005699A IT202100005699A1 (it) | 2021-03-18 | 2021-03-18 | Dispositivo intersomatico |
EP22714768.3A EP4308045A1 (en) | 2021-03-18 | 2022-03-11 | Interbody device |
PCT/EP2022/000026 WO2022194420A1 (en) | 2021-03-18 | 2022-03-11 | Interbody device |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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IT102021000005699A IT202100005699A1 (it) | 2021-03-18 | 2021-03-18 | Dispositivo intersomatico |
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IT202100005699A1 true IT202100005699A1 (it) | 2022-09-18 |
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IT102021000005699A IT202100005699A1 (it) | 2021-03-18 | 2021-03-18 | Dispositivo intersomatico |
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EP (1) | EP4308045A1 (it) |
IT (1) | IT202100005699A1 (it) |
WO (1) | WO2022194420A1 (it) |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005112834A2 (en) * | 2004-05-12 | 2005-12-01 | Moskowitz Nathan C | 3-d expansile intervertebral disc implant |
WO2016049784A1 (en) * | 2014-09-29 | 2016-04-07 | Startech Engineering Ag | Expandable spinal implant |
WO2017004503A1 (en) * | 2015-07-02 | 2017-01-05 | DePuy Synthes Products, Inc. | Expandable implant |
US20180116819A1 (en) * | 2016-11-01 | 2018-05-03 | DePuy Synthes Products, Inc. | Curved expandable cage |
DE102018206693B3 (de) * | 2018-05-01 | 2019-02-14 | I-Pego Ug (Haftungsbeschränkt) | Platzhalter für die Wirbelsäulenchirurgie |
WO2019169302A1 (en) * | 2018-03-01 | 2019-09-06 | Integrity Implants Inc. | Expandable fusion device with independent expansion systems |
US20200383798A1 (en) * | 2013-03-13 | 2020-12-10 | Life Spine, Inc. | Expandable implant assembly |
-
2021
- 2021-03-18 IT IT102021000005699A patent/IT202100005699A1/it unknown
-
2022
- 2022-03-11 EP EP22714768.3A patent/EP4308045A1/en active Pending
- 2022-03-11 WO PCT/EP2022/000026 patent/WO2022194420A1/en active Application Filing
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005112834A2 (en) * | 2004-05-12 | 2005-12-01 | Moskowitz Nathan C | 3-d expansile intervertebral disc implant |
US20200383798A1 (en) * | 2013-03-13 | 2020-12-10 | Life Spine, Inc. | Expandable implant assembly |
WO2016049784A1 (en) * | 2014-09-29 | 2016-04-07 | Startech Engineering Ag | Expandable spinal implant |
WO2017004503A1 (en) * | 2015-07-02 | 2017-01-05 | DePuy Synthes Products, Inc. | Expandable implant |
US20180116819A1 (en) * | 2016-11-01 | 2018-05-03 | DePuy Synthes Products, Inc. | Curved expandable cage |
WO2019169302A1 (en) * | 2018-03-01 | 2019-09-06 | Integrity Implants Inc. | Expandable fusion device with independent expansion systems |
DE102018206693B3 (de) * | 2018-05-01 | 2019-02-14 | I-Pego Ug (Haftungsbeschränkt) | Platzhalter für die Wirbelsäulenchirurgie |
Also Published As
Publication number | Publication date |
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EP4308045A1 (en) | 2024-01-24 |
WO2022194420A1 (en) | 2022-09-22 |
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