JP2006187668A - Operation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an operation system by which an operator may optimally combine and execute functions required for a plurality of treatments the operator desires. <P>SOLUTION: The operation system includes a connector 14 to connect any of a plurality of handpieces 40 with treating parts for executing prescribed treatment on an organism, an ultrasonic oscillating circuit 51 to drive the treatment parts of the handpieces 40 connected to the connector 14 for executing treatment by ultrasonic vibration, a bipolar output circuit 52 to drive the treatment parts of the hand pieces 40 connected to the connector 14 for executing treatment by electric energy, a handpiece discriminating circuit 53 to discriminate the type of the handpiece 40 connected to the connector 14, and a control circuit 50 to change control methods for the ultrasonic oscillating circuit 51 and the bipolar output circuit 52 corresponding to the discriminating result by the handpiece discriminating circuit 53. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a surgical apparatus.

  Conventionally, various types of surgical devices have been known. For example, an ultrasonic coagulation / incision device that uses ultrasonic vibration to vibrate and incise a biological tissue by vibrating a treatment tool, or a biological tissue by heat action using high-frequency power There are an electric scalpel device that performs ablation of an ultrasonic wave, an ultrasonic suction device that crushes and sucks unnecessary living tissue, and the like. Since these various surgical devices have advantages and disadvantages, it has been proposed to perform surgery by appropriately combining the surgical devices.

  For example, by combining an ultrasonic suction device and a monopolar electric scalpel device, it is possible to stop bleeding from a thin blood vessel at the time of ultrasonic suction, which was a drawback of the ultrasonic suction device, by cauterization by the electric scalpel device. .

  However, when a monopolar electric scalpel device is used, a leakage current may be generated due to its configuration, which causes a problem that damages other than the affected area.

  Thus, International Publication No. WO95 / 17855 discloses a surgical apparatus that overcomes the problem of leakage current by combining an ultrasonic suction device and a bipolar electric scalpel device.

  However, the above-mentioned International Publication No. WO95 / 17855 discloses in detail the structure of the handpiece part in the combination of the ultrasonic suction device and the bipolar electric knife device, but the drive for driving the ultrasonic suction device is disclosed. The power source and the drive source for driving the bipolar electric scalpel device are configured separately, and how the output of each device is applied to the treatment section is left to the control by the individual drive source .

  The present invention has been made paying attention to such a problem, and the object of the present invention is to perform the operation with one apparatus by organically combining at least two apparatus outputs. An object of the present invention is to provide a surgical apparatus capable of providing a combination of functions necessary for a plurality of treatments.

  In order to achieve the above object, according to a first aspect of the present invention, there is provided a surgical apparatus for connecting any of a plurality of types of handpieces having a treatment unit for performing a predetermined treatment on a living body. A first circuit for driving to perform a predetermined first treatment on a treatment portion of the handpiece connected to the connector, and a treatment portion of the handpiece connected to the connector A second circuit different from the first circuit for performing driving for performing a second treatment different from the first treatment, and a type of the handpiece connected to the connector And a control means for changing the control method of the first and second circuits according to the identification result by the handpiece identification circuit.

  A second aspect of the present invention is a surgical apparatus, which has a treatment section for performing a predetermined treatment on a living body, a connector for connecting any of a plurality of types of handpieces, and the connector An ultrasonic output circuit for driving to treat the treatment part of the handpiece connected to the ultrasonic vibration, and a treatment part of the handpiece connected to the connector by electric energy An electrosurgical knife output circuit for performing a drive for the above, a handpiece identification circuit for discriminating the type of the handpiece connected to the connector, and the ultrasonic output circuit according to an identification result by the handpiece identification circuit, Control means for changing the control method of the electric knife output circuit.

  According to the present invention, since at least two device outputs can be organically combined, a single device can provide a combination of functions necessary for a plurality of treatments that an operator wants to perform. .

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

  FIG. 1 is a diagram showing a schematic configuration of the surgical apparatus according to the first embodiment of the present invention. The drive apparatus 16 is connected to a connector 21-2 via a connector 21-1 and a bipolar cord 14-1. And the ultrasonic cord 14-2, the handpiece 40 is connected, and a foot switch (F.SW) 15 is detachably connected. In addition to the power switch 22, the driving device 16 has a panel 20 provided with buttons for setting the output magnitude of each device and assigning the function of the foot switch (F.SW) 15 in addition to the power switch 22. On the same side, pinch valves 18-1 and 18-2 are provided so as to protrude from the side.

  A tube 14-3 is further connected to the handpiece 40, and the tube 14-3 is branched. One of the branched tubes is connected to the physiological saline bottle 17 through a recess of the pinch valve 18-1. The other tube is connected to the suction bottle 19 through a recess of the pinch valve 18-2. The suction bottle 19 is connected to the wall suction part 23. Physiological saline is stored in the physiological saline bottle 17, and physiological saline corresponding to the tightening of the pinch valve 18-1 is supplied to the treated portion via the tube 14-3. Further, by suction by the wall suction part 23, unnecessary tissue is sucked and stored from the treated part into the suction bottle 19 through the tube 14-3 in accordance with the tightening of the pinch valve 18-2.

  The handpiece 40 includes a handle 13, a handpiece main body 19 in which an ultrasonic transducer (not shown) is built, and a probe 11 that transmits the vibration of the ultrasonic transducer to the treatment unit 8. This probe 11 has an aspiration path 11-1 over the length of the probe for ultrasonically aspirating tissue. The probe 11 is surrounded by a sheath 12 except for its tip. The treatment section 8 is provided with a gripping tool 10 called a jaw that is driven to open and close with respect to the tip of the probe 11. The gripping tool 10 is connected to the distal end portion of the sheath 12 so as to be rotatable about a rotation pin (not shown). When the handle 13 is operated, the gripping tool 10 is opened / closed with respect to the tip of the probe 11, and a living tissue is sandwiched between the tip of the probe 11 and the gripping tool 10 to perform ultrasonic coagulation and incision. . Further, the gripping tool 10 and the tip of the probe 11 are composed of bipolar conductive parts, and also have a function as a bipolar electric knife.

  FIG. 2 is a diagram showing a first internal configuration of the driving device 16 shown in FIG. 1, for generating electric energy for vibrating the ultrasonic transducer in order to perform ultrasonic suction, ultrasonic coagulation, and incision. Identify which ultrasonic hand 51 is connected via the connector 21-1 from the ultrasonic oscillation circuit 51, the bipolar output circuit 52 that generates electric energy to be supplied to the bipolar electric knife, and the plural types of hand pieces The operation of each of the above-described circuits is integrated with the handpiece identification circuit 53 for driving, the valve driving circuit 54 for driving the pinch valve 18-1, the valve driving circuit 55 for driving the pinch valve 18-2. And a control circuit 50 for controlling. A water supply source 56 corresponds to the physiological saline bottle 17 in FIG. Reference numeral 57 denotes a suction source, which corresponds to the wall suction unit 23 in FIG.

  The control circuit 50 can determine the type of the handpiece connected to the driving device 16 by the handpiece identification circuit 53 and change the control parameter to change the control method of each energy source. Accordingly, at least two treatments among tissue coagulation and incision by ultrasonic vibration, ultrasonic suction, and tissue cauterization by an electric knife can be performed simultaneously or by switching. As the kind of handpiece, as shown in FIG. 1, a type capable of simultaneously performing tissue coagulation and incision by ultrasonic vibration, ultrasonic suction, and tissue cauterization with an electric knife, There are types that can simultaneously perform coagulation and incision of tissue by ultrasonic vibration and tissue cauterization with an electric scalpel, and types that can simultaneously perform ultrasonic aspiration and tissue cauterization with an electric scalpel.

  In addition, when the first pedal 15-1 (FIG. 1) is operated in the foot switch (F.SW) 15, the ultrasonic oscillation circuit 51 is driven to perform ultrasonic coagulation and incision, and the second pedal 15-2 (FIG. 1). When 1) is operated, the bipolar output circuit 52 is driven to supply electric energy to the electric knife.

  FIG. 3 is a diagram showing a second internal configuration of the driving device 16. In the configuration of the driving device 16 shown in FIG. 2 described above, an oscillation source for performing ultrasonic coagulation, incision, and ultrasonic suction, a bipolar source for performing an operation with an electric knife, and a valve driving source are combined into one main body. However, in this configuration, each drive source is configured separately and connected via the connection portions 156 and 157, and the main control unit 50-1 provided in the main body for ultrasonic output is used for bipolar output. Each drive source is integratedly controlled while communicating between the control circuit 50-2 and the valve drive control circuit 50-3. The panel 20-2 is used for performing various settings when only an operation with an electric knife is performed.

  FIG. 4 is a time chart for explaining the operation of controlling the water supply amount and the suction amount by driving the pinch valves 18-1 and 18-2.

  The water supply source 56 and the suction source 57 (FIG. 2) generate a certain water supply pressure and suction pressure, but each pressure drives the pinch valves 18-1 and 18-2 to squeeze the tube 14-3. Thus, it can be adjusted by changing the degree of opening and closing. That is, the degree of opening and closing of the pinch valves 18-1 and 18-2 is preset from the panel 20 based on the time ratio (duty) of the pulse opening / closing signal, and the foot switch (F.SW) 15 is operated. Adjusted water supply or suction can be performed.

  According to the first embodiment described above, by combining at least two or more circuit outputs, it is possible to provide a combination of functions necessary for a plurality of treatments that an operator wants to perform with one apparatus.

  FIG. 5 is a diagram showing a configuration of a surgical apparatus according to the second embodiment of the present invention, and shows a configuration in the case where ultrasonic coagulation, incision and bipolar coagulation with an electric knife are performed simultaneously or by switching. Is a diagram for explaining the action.

  The drive device 70 includes an ultrasonic output circuit 60 that generates electric energy for vibrating the ultrasonic vibrator 63 incorporated in the handpiece 71, and a bipolar conductive portion, and serves as a bipolar electric knife. Allocation of functions of the bipolar output circuit 61 for generating electric energy to be supplied to the jaw 66 having the function and the tip of the probe 67, and the function of the foot switch (F.SW) 64 and the magnitude of the output of each device are set. And a control circuit 62 for controlling the output of the ultrasonic output circuit 60 and the output of the bipolar output circuit 61 based on the operation of the foot switch (F.SW) 64.

  When the operator holds the handle 65, the jaw 66 is driven to open and close with respect to the tip of the probe 67, and ultrasonic coagulation and incision are performed by sandwiching a living tissue between the jaw 66 and the tip of the probe 67. Further, by supplying electric energy from the bipolar output circuit 61 to the jaw 66 and the probe 67, coagulation with an electric knife is performed.

  As shown in FIG. 6, when performing ultrasonic incision, the pedal 64-1 of the foot switch (F.SW) 64 is operated to increase the ultrasonic output and weaken the bipolar output. Incision can be performed by ultrasonic output while increasing the speed of tissue metamorphosis by output. When ultrasonic coagulation is performed, the pedal 64-2 of the foot switch (F.SW) 64 is operated to weaken the ultrasonic output and increase the bipolar output, thereby coagulating the tissue without sticking. Can only do. In this way, the tissue can be slowly coagulated and dissected at an appropriate temperature, but the ultrasonic coagulation incision device has the disadvantage that the treatment speed is relatively slow. It becomes possible to perform an efficient treatment by combining an electric scalpel device having the disadvantage of being cauterized.

  FIG. 7 is a diagram showing the configuration inside the hand piece of an ultrasonic surgical apparatus having the functions of ultrasonic suction and bipolar electric scalpel in the third embodiment of the present invention. A probe 100 connected to the child 103, an insulating layer 101 formed at least around the tip of the probe 100, and a conductive layer 102 formed adjacent to the upper layer and insulated from the probe 100 by high-frequency insulation. A bipolar electric knife is configured between the probe 100 and the conductive layer 102. The insulating layer 101 is formed of an insulating ceramic or insulating plastic coating. An operation switch to be described later is provided outside the handpiece.

  FIG. 8 is an external perspective view of the handpiece according to the third embodiment, in which a sheath 32 surrounding the probe 100 shown in FIG. 7 and a handpiece main body 30 incorporating the ultrasonic transducer 103 shown in FIG. 7 are illustrated. ing. A bipolar cord 34-1, an ultrasonic cord 34-2 and a tube 34-3 are drawn out from the handpiece body 30, and these are connected to a drive circuit which will be described later. The handpiece body 30 is provided with operation switches 33-1 and 33-2 having functions equivalent to those of a foot switch (F.SW).

  FIG. 9 is an overall configuration diagram of an ultrasonic surgical apparatus in which the circuit configuration of the main body is added to the handpiece configured as described above. The drive unit 110 includes a bipolar output circuit 105 that generates electric energy supplied to the bipolar electric knife, an ultrasonic oscillation circuit 106 that generates electric energy for vibrating the ultrasonic vibrator 103, an operation switch 33-1 and A control circuit 107 for controlling these two circuits based on a signal from 33-2, and a panel 108 for setting the output of each device and assigning the functions of operation switches 33-1 and 33-2. is doing.

  When the operation switch 33-1 is operated, the ultrasonic oscillation circuit 106 is turned on by the control circuit 107, whereby electric energy is supplied to the ultrasonic transducer 103, and the ultrasonic transducer 103 vibrates to enable ultrasonic suction. Become. Further, when the operation switch 33-2 is operated, the bipolar output circuit 105 by the control circuit 107 is turned on, whereby electric energy is supplied to the bipolar electric knife and cauterization can be performed.

  The electrode 104 and the conductive layer 102 are in contact with each other in the vicinity of the vibration node of the ultrasonic transducer 103 as shown in FIG. FIG. 10A shows a contact state when the electrode 104 is made of conductive rubber (O-ring), and FIG. 10B shows a contact state when the electrode 104 is made of a spring contact.

  According to the third embodiment described above, since a bipolar output can be applied to the ultrasonic treatment apparatus, the treatment site is not concerned, and a counter electrode plate is not required. Therefore, a safe and easy-to-use surgical apparatus can be provided.

  FIG. 11 is a diagram showing a modification of the above-described third embodiment of the present invention. In the handpiece of the ultrasonic surgical apparatus, an ultrasonic transducer 103 and a probe connected to the ultrasonic transducer 103 are shown. 100 and a plurality of conductive layers 102-1 and 102-2 and insulating layers 101-1 and 101-2 formed around the probe 100, and the conductive layers 102-1 and 102-2 are insulated. The layers 101-1 and 101-2 are insulated from each other at high frequency, and a bipolar electric knife is formed between the conductive layers 102-1 and 102-2. FIG. 12 shows a cross-sectional view of FIG.

  FIG. 13 is an overall configuration diagram of an ultrasonic surgical apparatus in which a circuit configuration of a drive unit is added to the handpiece configured as described above. Since this configuration, operation, and effect are exactly the same as those in FIG.

  Here, the electrode 104 and the conductive layers 102-1 and 102-2 are in contact with each other in the vicinity of the vibration node of the ultrasonic transducer 103 as shown in FIG. Here, the contact state when the electrode 104 is made of conductive rubber (O-ring) is shown.

  FIG. 15 is a diagram showing a configuration of an ultrasonic surgical apparatus according to the fourth embodiment of the present invention. As shown in FIG. 15, the handpiece 210 includes a probe 200 having a suction path 200-1, an ultrasonic transducer 201, and a built-in suction pump 202. In addition, the suction pump 202 is connected to the suction object storage container 204 via a suction tube 203 extending from the inside of the handpiece 210 to the outside. The main body 211 includes an ultrasonic oscillation circuit 205, a control circuit 206, a pinch valve 207, and an operation panel 208. A foot switch (F.SW) 209 is connected to the control circuit 206.

  In the above configuration, when the operator operates the ultrasonic output pedal 209-2 of the foot switch (F.SW) 209 to turn it on, the control circuit 206 vibrates the ultrasonic transducer 201 in response thereto. This vibration is transmitted to the tip of the probe 200. When the suction pedal 209-1 is operated and turned on in this state, the control circuit 206 operates the suction pump 202 in response to this and controls the pinch valve 207 to open. As a result, unnecessary tissue at the tip of the probe 200 is sucked and stored in the aspirate storage container 204 via the probe 200 and the suction tube 203. When the suction pedal 209-1 is turned off, the suction pump 202 is stopped and the pinch valve 207 is closed to stop the suction operation.

  Here, the electrode 104 and the conductive layers 102-1 and 102-2 are in contact with each other in the vicinity of the vibration node of the ultrasonic transducer 103 as shown in FIG. Here, the contact state when the electrode 104 is made of conductive rubber (O-ring) is shown.

  According to the fourth embodiment described above, by providing the suction pump 202 in the handpiece 210, a suction force can be exerted at both ends of the suction tube 203, so that a stable suction force can be obtained. In addition, since it is possible to minimize the influence of a decrease in suction force due to duct resistance, it is possible to suction tissue stably.

  FIG. 16 is a view showing a modification of the above-described fourth embodiment. The basic configuration and the operation thereof are the same as those in FIG. 15, but here, the suction pump 202 in the handpiece 210 is connected to the external suction means 212 via the suction tube 203 and the suction substance storage container 204. Is different.

  According to such a configuration, since the suction pressure of the external suction means 212 is always kept constant, the time lag until the suction pressure is generated at the tip of the probe 200 after the operation of the suction pedal 209-1 is reduced. effective.

  FIG. 17 is a view showing a further modification of the above-described fourth embodiment. The basic configuration and the operation thereof are the same as those in FIG. 15, but in this modification, the diameter of the suction tube 203-1 connecting the suction pump 202 and the suctioned material storage container 204 is small, and the external suction means 212 is used. The suction tube 203-3 connecting the suction material storage container 204 and the suction material storage container 204 is formed with a large diameter. That is, since the suction tube 203-1 on the handpiece 210 side is related to operability, the diameter is reduced in order to improve operability, and the tube diameter of the other part is increased in order to minimize pressure loss. . Furthermore, in this modification, the aspirated material storage container 204 is composed of a disposable container 204-1 that can be removed and discarded when the aspirated material is fully stored, and a container 204-2 for holding the same. The two containers 204-1 and 204-2 are connected by a large-diameter suction tube 203-2.

  The specific embodiments described above include inventions having the following configurations.

1.
A handpiece having an ultrasonic transducer, and a treatment unit having at least two bipolar conductive units, wherein vibration energy from the ultrasonic transducer is transmitted and ultrasonically vibrates;
Water supply / suction means for performing water supply to the treatment site through the handpiece and performing suction from the treatment site;
An ultrasonic output circuit for generating electric energy for vibrating the ultrasonic vibrator and supplying the ultrasonic vibrator to the ultrasonic vibrator; and generating electric energy for cauterizing the tissue to the at least bipolar conductive portion. An electric scalpel output circuit to be supplied, the water supply / suction means, the ultrasonic output circuit, and a drive device having a control means for controlling the electric scalpel output circuit in an integrated manner;
Comprising
Based on the control of the control means, at least two treatments among tissue coagulation and incision by ultrasonic vibration, ultrasonic suction and cauterization of tissue by an electric knife are performed simultaneously or by switching. Surgical device.

1-1.
1. The water supply / suction means includes a pinch valve for opening and closing the tube in order to control the amount of water supplied to the treated portion via the tube and the amount of suction from the treated portion via the tube.

1-2.
The pinch valve of 1.1 controls the water supply amount and the suction amount by changing the ratio of the opening and closing time for opening and closing the tube.

1-3.
1. The water supply / suction means is configured integrally with the driving device.

1-4.
1. The control means switches the control method of each energy source in accordance with the type of handpiece connected to the driving device.

1-5.
1. The ultrasonic output circuit, the electric knife output circuit, and the water supply / suction means are configured separately from each other. Each of these means is provided with a control circuit, and one of the control circuits of each means is a main control circuit. As a whole, control is performed while communicating with other control circuits.

1-6.
1. The control means has a mode in which a specific treatment is preferentially performed among tissue coagulation by ultrasonic vibration, incision, ultrasonic suction, and cauterization of the tissue by an electric knife.

2.
An ultrasonic transducer, a probe that transmits ultrasonic vibration generated by the ultrasonic transducer to a treatment target portion, and a conductive action member that is arranged to be electrically insulated from the probe and that acts on the treatment portion. Including handpieces,
Driving device including an ultrasonic oscillation source, a bipolar electric knife oscillation source, and a control means for simultaneously supplying the oscillation outputs of both oscillation sources to the probe and the working member in a combination pattern consisting of timing and magnitude thereof When,
A surgical apparatus comprising:

2-1.
2. There is a setting means for arbitrarily setting the combination pattern.

3.
A vibrator,
A probe connected to this transducer;
An insulating layer laminated at least around the tip of the probe;
A conductive layer formed adjacent to the upper layer and insulated from the probe by high frequency;
Comprising
An ultrasonic surgical apparatus comprising a bipolar electric knife between the probe and the conductive layer.

3-1.
3. A plurality of conductive layers and insulating layers are formed around the probe, and the conductive layers are insulated from each other at high frequency with the insulating layer interposed therebetween, and constitute a bipolar electric knife between the conductive layers.

3-2.
3. The insulating layer is formed of an insulating ceramic coating.

3-3.
3. The insulating layer is formed of an insulating plastic coating.

4).
A probe having a vibrator and a suction path;
A built-in suction pump;
An ultrasonic surgical apparatus comprising a handpiece comprising:

4-1.
4). The built-in suction pump in the handpiece and the external suction means are connected via a suction tube and a suction substance storage container.

4-2.
4). The diameter of the suction tube connecting the external suction means and the suction substance storage container is formed to be larger than the diameter of the suction tube connecting the built-in suction pump and the suction substance storage container.

1 is a diagram illustrating a schematic configuration of a surgery system according to a first embodiment of the present invention. It is a figure which shows the 1st internal structure of the drive device shown in FIG. It is a figure which shows the 2nd internal structure of the drive device shown in FIG. It is a time chart for demonstrating the operation | movement which drives a pinch valve and controls water supply amount and suction amount. It is a figure which shows the structure of the surgery apparatus which concerns on 2nd Embodiment of this invention. It is a figure for demonstrating the effect | action of 2nd Embodiment. It is a figure which shows the structure inside the handpiece of 3rd Embodiment of this invention. It is an external appearance perspective view of the handpiece which concerns on 3rd Embodiment of this invention. It is a whole block diagram of the ultrasonic surgery apparatus which added the circuit structure of the main-body part to the handpiece in 3rd Embodiment. In 3rd Embodiment, it is a figure for demonstrating the contact state of an electrode and a conductive layer. It is a figure which shows the modification of 3rd Embodiment of this invention. FIG. 12 shows a cross-sectional view of the handpiece shown in FIG. 11. It is a whole block diagram of the ultrasonic surgery apparatus which added the circuit structure of the main-body part to the handpiece in the modification of 3rd Embodiment. In the modification of 3rd Embodiment, it is a figure for demonstrating the contact state of an electrode and a conductive layer. It is a figure which shows the structure of the ultrasonic surgery apparatus which concerns on 4th Embodiment of this invention. It is a figure which shows the structure of the modification of 4th Embodiment of this invention. It is a figure which shows the structure of the further modification of 4th Embodiment of this invention.

Explanation of symbols

10 Grip (Jaw)
11 Probe 12 Sheath 13 Handle 14-1 Bipolar Code 14-2 Ultrasonic Code 14-3 Tube 15 Foot Switch (F.SW)
Reference Signs List 16 Drive device 17 Saline bottle 18 Pinch valve 19 Handpiece body 23 Wall suction part 40 Handpiece

Claims (2)

A connector for connecting any of a plurality of types of handpieces, having a treatment section for performing a predetermined treatment on a living body;
A first circuit for driving to perform a predetermined first treatment on the treatment portion of the handpiece connected to the connector;
A second circuit different from the first circuit for driving the treatment part of the handpiece connected to the connector to perform a second treatment different from the first treatment;
A handpiece identification circuit for determining the type of the handpiece connected to the connector;
Control means for changing the control method of the first and second circuits according to the identification result by the handpiece identification circuit;
A surgical apparatus characterized by comprising: A connector for connecting any of a plurality of types of handpieces having a treatment section for performing a predetermined treatment on a living body;
An ultrasonic output circuit for driving to perform treatment by ultrasonic vibration on the treatment portion of the handpiece connected to the connector;
An electric knife output circuit for performing a drive for performing a treatment with electric energy on a treatment portion of the handpiece connected to the connector;
A handpiece identification circuit for determining the type of the handpiece connected to the connector;
Control means for changing the control method of the ultrasonic output circuit and the electric knife output circuit according to the identification result by the handpiece identification circuit,
A surgical apparatus characterized by comprising:

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