JP7483690B2 - リアルタイムクロック情報に基づく器具追跡配置 - Google Patents
リアルタイムクロック情報に基づく器具追跡配置 Download PDFInfo
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Description
本出願は、その開示が参照によりその全体が本明細書に組み込まれる、2019年9月5日に出願された、リアルタイムクロック情報に基づいた、「INSTRUMENT TRACKING ARRANGEMENT BASED ON REAL TIME CLOCK INFORMATION」という名称の米国仮特許非仮出願第16/562,175号に対する利益を主張する。
・「METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES」と題する米国特許出願整理番号第END9067USNP1/180679-1M号、
・「METHOD FOR ENERGY DISTRIBUTION IN A SURGICAL MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9069USNP1/180681-1M号、
・「SURGICAL MODULAR ENERGY SYSTEM WITH A SEGMENTED BACKPLANE」と題する米国特許出願整理番号第END9069USNP2/180681-2号、
・「SURGICAL MODULAR ENERGY SYSTEM WITH FOOTER MODULE」と題する米国特許出願整理番号第END9069USNP3/180681-3号、
・「POWER AND COMMUNICATION MITIGATION ARRANGEMENT FOR MODULAR SURGICAL ENERGY SYSTEM」と題する米国特許出願整理番号END9069USNP4/180681-4号、
・「MODULAR SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING WITH VOLTAGE DETECTION」と題する米国特許出願整理番号第END9069USNP5/180681-5号、
・「MODULAR SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS SENSING WITH TIME COUNTER」と題する米国特許出願整理番号第END9069USNP6/180681-6号、
・「MODULAR SURGICAL ENERGY SYSTEM WITH MODULE POSITIONAL AWARENESS WITH DIGITAL LOGIC」と題する米国特許出願整理番号第END9069USNP7/180681-7号、
・「METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT」と題する米国特許出願整理番号第END9068USNP1/180680-1M号、
・「ENERGY MODULE FOR DRIVING MULTIPLE ENERGY MODALITIES」と題する米国特許出願整理番号第END9068USNP2/180680-2号、
・「GROUNDING ARRANGEMENT OF ENERGY MODULES」と題する米国特許出願整理番号第END9068USNP3/180680-3号、
・「BACKPLANE CONNECTOR DESIGN TO CONNECT STACKED ENERGY MODULES」と題する米国特許出願整理番号第END9068USNP4/180680-4号、
・「ENERGY MODULE FOR DRIVING MULTIPLE ENERGY MODALITIES THROUGH A PORT」と題する米国特許出願整理番号第END9068USNP5/180680-5号、
・「SURGICAL INSTRUMENT UTILIZING DRIVE SIGNAL TO POWER SECONDARY FUNCTION」と題する米国特許出願整理番号第END9068USNP6/180680-6号、
・「METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE」と題する米国特許出願整理番号第END9038USNP1/180529-1M号、
・「PASSIVE HEADER MODULE FOR A MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9038USNP2/180529-2号、
・「CONSOLIDATED USER INTERFACE FOR MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9038USNP3/180529-3号、
・「AUDIO TONE CONSTRUCTION FOR AN ENERGY MODULE OF A MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9038USNP4/180529-4号、
・「ADAPTABLY CONNECTABLE AND REASSIGNABLE SYSTEM ACCESSORIES FOR MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9038USNP5/180529-5号、
・「METHOD FOR COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL SYSTEM」と題する米国特許出願整理番号第END9070USNP1/180682-1M号、
・「FLEXIBLE HAND-SWITCH CIRCUIT」と題する米国特許出願整理番号第END9070USNP2/180682-2号、
・「FIRST AND SECOND COMMUNICATION PROTOCOL ARRANGEMENT FOR DRIVING PRIMARY AND SECONDARY DEVICES THROUGH A SINGLE PORT」と題する米国特許出願整理番号第END9070USNP3/180682-3号、
・「FLEXIBLE NEUTRAL ELECTRODE」と題する米国特許出願整理番号第END9070USNP4/180682-4号、
・「SMART RETURN PAD SENSING THROUGH MODULATION OF NEAR FIELD COMMUNICATION AND CONTACT QUALITY MONITORING SIGNALS」と題する米国特許出願整理番号第END9070USNP5/180682-5号、
・「AUTOMATIC ULTRASONIC ENERGY ACTIVATION CIRCUIT DESIGN FOR MODULAR SURGICAL SYSTEMS」と題する米国特許出願整理番号第END9070USNP6/180682-6号、
・「COORDINATED ENERGY OUTPUTS OF SEPARATE BUT CONNECTED MODULES」と題する米国特許出願整理番号第END9070USNP7/180682-7号、
・「MANAGING SIMULTANEOUS MONOPOLAR OUTPUTS USING DUTY CYCLE AND SYNCHRONIZATION」と題する米国特許出願整理番号第END9070USNP8/180682-8号、
・「PORT PRESENCE DETECTION SYSTEM FOR MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9070USNP9/180682-9号、
・「INSTRUMENT TRACKING ARRANGEMENT BASED ON REAL TIME CLOCK INFORMATION」と題する米国特許出願整理番号第END9070USNP10/180682-10号、
・「REGIONAL LOCATION TRACKING OF COMPONENTS OF A MODULAR ENERGY SYSTEM」と題する米国特許出願整理番号第END9070USNP11/180682-11号、
・「ENERGY MODULE」と題する米国特許出願整理番号第END9212USDP1/190370D号、
・「ENERGY MODULE MONOPOLAR PORT WITH FOURTH SOCKET AMONG THREE OTHER SOCKETS」と題する米国特許出願整理番号第END9213USDP1/190371D号、
・「BACKPLANE CONNECTOR FOR ENERGY MODULE」と題する米国特許出願整理番号第END9214USDP1/190372D号、及び
・「ALERT SCREEN FOR ENERGY MODULE」と題する米国特許出願整理番号第END9215USDP1/190373D号。
図1を参照すると、コンピュータ実装インタラクティブ外科システム100は、1つ又は2つ以上の外科システム102と、クラウドベースのシステム(例えば、ストレージ装置105に連結されたリモートサーバ113を含むことができるクラウド104)と、を含む。各外科システム102は、リモートサーバ113を含み得るクラウド104と通信する、少なくとも1つの外科用ハブ106を含む。一実施例では、図1に示すように、外科システム102は、互いに、及び/又はハブ106と通信するように構成された、可視化システム108と、ロボットシステム110と、ハンドヘルド式インテリジェント外科用器具112と、を含む。いくつかの態様では、外科システム102は、M個のハブ106と、N個の可視化システム108と、O個のロボットシステム110と、P個のハンドヘルド式インテリジェント外科用器具112と、を含んでもよく、ここでM、N、O及びPは1以上の整数である。
図12は、本開示の1つ又は2つ以上の態様による、外科用器具又はツールの制御システム470の論理図を示す。システム470は、制御回路を備える。制御回路は、プロセッサ462及びメモリ468を備えるマイクロコントローラ461を含む。例えば、センサ472、474、476のうちの1つ又は2つ以上が、プロセッサ462にリアルタイムなフィードバックを提供する。モータ駆動器492によって駆動されるモータ482は、長手方向に移動可能な変位部材を動作可能に連結して、クランプアーム閉鎖部材を駆動する。追跡システム480は、長手方向に移動可能な変位部材の位置を判定するように構成されている。位置情報は、長手方向に移動可能な駆動部材の位置及び閉鎖部材の位置を判定するようにプログラム又は構成可能なプロセッサ462に提供される。閉鎖管の移動、シャフトの回転、関節運動、若しくはクランプアームの閉鎖、又は上記の組み合わせを制御するために、ツールドライバインターフェースに追加のモータが提供されてもよい。ディスプレイ473は、器具の様々な動作条件を表示し、データ入力のためのタッチスクリーン機能を含んでもよい。ディスプレイ473上に表示された情報は、内視鏡撮像モジュールを介して取得された画像とオーバーレイさせることができる。
様々な態様では、スマート超音波エネルギー装置は、超音波ブレードの動作を制御するための適応アルゴリズムを含んでもよい。一態様では、超音波ブレード適応制御アルゴリズムは、組織のタイプを識別し、装置パラメータを調整するように構成される。一態様では、超音波ブレード制御アルゴリズムは、組織のタイプをパラメータ化するように構成される。超音波ブレードの遠位先端の振幅を調整するために組織のコラーゲン/弾性比を検出するためのアルゴリズムが、本開示の以下の項で説明される。スマート超音波エネルギー装置の様々な態様が、例えば図12~図19に関連して本明細書で説明される。したがって、適応型超音波ブレード制御アルゴリズムの以下の説明は、図12~図19及びこれらに関連する説明と併せて読まれるべきである。
感知されたデータに応答する制御アルゴリズムを含む「インテリジェント」装置は、感知されたデータを考慮することなく動作する「データ処理能力のない(dumb)」装置に改善を加えたものであり得るが、いくつかの感知されたデータは、単独で考慮される場合、すなわち、実施される外科処置のタイプ又は手術されている組織のタイプのコンテキストなしには、不完全又は決定的ではない可能性がある。処置コンテキストを知る(例えば、手術される組織のタイプ又は実施されている処置のタイプを知る)ことがなければ、制御アルゴリズムは、特定のコンテキストを含まない感知データが与えられると、モジュール式装置を不正確に又は準最適に制御することがある。例えば、特定の感知されたパラメータに応答して外科用器具を制御するための制御アルゴリズムの最適な方法は、手術されている特定の組織のタイプによって変化する可能性がある。これは、異なる組織のタイプが異なる特性(例えば、引き裂きに対する抵抗)を有し、そのため、外科用器具によってとられた動作に対して異なって応答するという事実に起因する。したがって、特定のパラメータについて同じ測定値が感知された場合であっても、外科用器具が異なる動作をとることが望ましいことがある。1つの具体的な例として、外科用ステープル留め及び切断器具がそのエンドエフェクタを閉鎖するために予想外に高い力を感知することに応答してその器具を制御する最適な方法は、組織のタイプが引き裂きの影響を受けやすいか、又はこれに耐性があるかによって異なる。肺組織など、引き裂きの影響を受けやすい組織の場合、器具の制御アルゴリズムは、組織の引き裂きを回避するために、閉鎖するための予想外に高い力に応答してモータを最適にランプダウンさせる。胃組織など、引き裂きに耐性がある組織の場合、器具の制御アルゴリズムは、エンドエフェクタが組織に適切にクランプされることを確実にするために、閉鎖するための予想外に高い力に応答してモータを最適にランプアップさせる。肺組織がクランプされているのか、胃組織がクランプされているのかを知らなければ、制御アルゴリズムは、準最適な決定を行う可能性がある。
外科処置を実施するために必要な設備の量に起因して、ORは世界中で、コード、装置、及び人の絡まった網になっている。大部分の外科用資本設備が単一の専門的なタスクを実施するため、外科用資本設備は、この問題の主な原因となる傾向がある。それらの専門的な性質に起因して、外科医は、単一の外科処置の過程で複数の異なるタイプの装置を利用する必要があるため、ORはエネルギー発生器などの外科用資本設備の2つ又は更にはより多くの部品を備蓄することを余儀なくされる場合がある。これらの外科用資本設備の各々は、電源に個別にプラグ接続されていなければならず、ORの職員の間で渡されている1つ又は2つ以上の他の装置に接続されて、誘導されなければならないコードの角度を作成することができる。現代のORで直面する別の問題は、これらの専門的な外科用資本設備の各々がその自身のユーザインターフェースを有し、またOR内の他の設備から独立して制御されなければならないことである。これにより、互いに接続して複数の異なる装置を適切に制御することが複雑になり、ユーザは異なるタイプのユーザインターフェースの訓練を受け、これらのユーザインターフェースを記憶しなければならなくなる(これらのユーザインターフェースは、資本設備の各々の間での変更に加え、実施されるタスク又は外科処置に基づいて更に変更されることがある)。この煩雑で複雑なプロセスは、更により多くの個人がOR内に存在する必要性を必要とする場合があり、複数の装置が互いに適切に制御されていない場合に危険を生じさせる可能性がある。したがって、OR内での外科用資本設備の設置面積を減少させるために、外科医のニーズに柔軟に対応できる単一のシステムに外科用資本設備技術を統合することは、ユーザ体験を単純化し、OR内の乱雑さを減少させ、複数の資本設備を同時に制御することに関連付けられた困難及び危険を防止することになる。更に、このようなシステムを拡張可能又はカスタマイズ可能にすることにより、新しい技術を既存の外科システムに便利に組み込むことが可能になり、外科システム全体を交換する必要性がなくなり、又はORの職員が各新技術で新しいユーザインターフェース若しくは設備制御を学習する必要がなくなる。
外科用装置及び発生器の様々な態様を詳細に説明する前に、例示の実施例は、適用又は用途において、添付の図面及び説明で示される部品の構造及び配置の詳細に限定されないことに注意を喚起しておく。例示の実施例は、他の態様、変形形態、及び修正形態で実装されるか、又はそれらに組み込まれてもよく、様々な方法で実施又は実行されてもよい。更に、特に明記しない限り、本明細書で用いられる用語及び表現は、読者の便宜のために例示の実施例を説明する目的で選択されたものであり、それらを限定するためのものではない。更に、以下に記述される態様、態様の表現、及び/又は実施例のうち1つ以上を、以下に記述される他の態様、態様の表現、及び/又は実施例のうち任意の1つ以上と組み合わせることができるものと理解されたい。
実施例1.リアルタイムクロックと、リアルタイムクロックに結合された制御回路とを備え、制御回路が、エネルギーモジュールに連結された外科用器具の存在を検出し、リアルタイムクロックに基づいてリアルタイムで外科用器具の使用を追跡し、リアルタイムクロックに基づいて所定の合計経過時間に基づいて外科用器具を停止させる、ように構成されている、エネルギーモジュール。
実施例2.超音波変換器駆動回路を備える、実施例1に記載のエネルギーモジュール。
実施例3.無線周波数駆動回路を備える、実施例1から2のいずれか1つに記載のエネルギーモジュール。
実施例4.超音波変換器駆動回路と無線周波数駆動回路との組み合わせを含む、実施例1から3のいずれか1つに記載のエネルギーモジュール。
実施例5.エネルギーモジュールが治療エネルギーを送達するように構成されている、実施例1から4のいずれか1つに記載のエネルギーモジュール。
実施例6.発生器が、治療量未満のエネルギーを送達するように構成されている、実施例1から5のいずれか1つに記載のエネルギーモジュール。
実施例7.制御回路が、外科用器具がエネルギーモジュールのオン/実行時間の長さに基づいて操作され得る時間の長さを制御するように構成されている、実施例1から6のいずれか1つに記載のエネルギーモジュール。
実施例8.制御回路が、リアルタイムクロックに基づいて外科用器具に適用された電力サイクル間の周期を検出し、周期中に外科用器具が同じ患者に使用されているかどうかを決定するように構成されている、実施例1から7のいずれか1つに記載のエネルギーモジュール。
実施例9.制御回路が、単回使用の外科用器具の使用履歴を決定し、使用済み単一の外科用器具の失効を決定するように構成されている、実施例1から8のいずれか1つに記載のエネルギーモジュール。
実施例10.リアルタイムクロックと、リアルタイムクロックに結合された制御回路と、外科用器具の電気コネクタに係合するように構成されたポートであって、ポートが電気コネクタの係合を検出し、検出信号を制御回路に送信するように構成されたセンサを備える、ポートとを備え、制御回路が、ポートに連結された外科用器具の存在を検出し、リアルタイムクロックからリアルタイムを読み取り、リアルタイムを外科用器具のメモリに記憶するように構成されている、エネルギーモジュール。
実施例11.制御回路が、外科用器具のメモリからリアルタイムを読み取り、合計経過時間を決定し、合計経過時間を外科用器具のリアルタイム限界と比較するように更に構成されている、実施例10に記載のエネルギーモジュール。
実施例12.制御回路が、合計経過時間が外科用器具のリアルタイム限界未満であるという決定に基づいて、外科用器具に通電するように更に構成されている、実施例10から11のいずれか1つに記載のエネルギーモジュール。
実施例13.制御回路が、合計経過時間が外科用器具のリアルタイム限界以上であるという決定に基づいて、外科用器具を停止するように更に構成されている、実施例10から12のいずれか1つに記載のエネルギーモジュール。
実施例14.リアルタイムクロックと、リアルタイムクロックに結合された制御回路と、外科用器具の電気コネクタに係合するように構成されたポートであって、ポートが電気コネクタの係合を検出し、検出信号を制御回路に送信するように構成されたセンサを備える、ポートとを備え、制御回路が、ポートに連結された外科用器具の存在を検出し、リアルタイムクロックからリアルタイムを読み取り、リアルタイムを外科用器具のメモリに記憶し、外科用器具のメモリからリアルタイムを読み取り、合計経過時間を決定する、ように構成されている、エネルギーモジュール。
実施例15.制御回路が、器具のエネルギーモジュールへの初期プラグ差し込みからの合計経過時間を決定するように更に構成されている、実施例14に記載のエネルギーモジュール。
実施例16.制御回路が、エネルギーモジュールの実際の経過時間対実行時間を検出するように更に構成されている、実施例14から15のいずれか1つに記載のエネルギーモジュール。
実施例17.制御回路が、エネルギーモジュールへの外科用器具の接続間の経過時間を決定するように更に構成されている、実施例14から16のいずれか1つに記載のエネルギーモジュール。
実施例18.接続間の所定の期間が、患者及び処置を交換することを示す、実施例17に記載のエネルギーモジュール。
実施例19.制御回路が、エネルギーモジュール電力サイクル間の経過時間を決定するように更に構成されている、実施例14から18のいずれか1つに記載のエネルギーモジュール。
(1) エネルギーモジュールであって、
リアルタイムクロックと、
前記リアルタイムクロックに結合された制御回路と、を備え、前記制御回路は、
前記エネルギーモジュールに連結された外科用器具の存在を検出し、
前記リアルタイムクロックに基づいてリアルタイムで前記外科用器具の使用を追跡し、
前記リアルタイムクロックに基づいて所定の合計経過時間に基づいて前記外科用器具を停止させるように構成されている、エネルギーモジュール。
(2) 超音波変換器駆動回路を備える、実施態様1に記載のエネルギーモジュール。
(3) 無線周波数駆動回路を備える、実施態様1に記載のエネルギーモジュール。
(4) 超音波変換器駆動回路と無線周波数駆動回路との組み合わせを含む、実施態様1に記載のエネルギーモジュール。
(5) 前記エネルギーモジュールが治療エネルギーを送達するように構成されている、実施態様1に記載のエネルギーモジュール。
(7) 前記制御回路が、前記エネルギーモジュールのオン/実行時間の長さに基づいて前記外科用器具が操作され得る時間の長さを制御するように構成されている、実施態様1に記載のエネルギーモジュール。
(8) 前記制御回路が、
前記リアルタイムクロックに基づいて、前記外科用器具に適用された電力サイクル間の周期を検出し、
前記外科用器具が前記周期中に同じ患者に使用されているかどうかを判定するように構成されている、実施態様1に記載のエネルギーモジュール。
(9) 前記制御回路が、
単回使用の外科用器具の使用履歴を決定し、
前記単回使用の外科用器具の失効を判定するように構成されている、実施態様1に記載のエネルギーモジュール。
(10) エネルギーモジュールであって、
リアルタイムクロックと、
前記リアルタイムクロックに結合された制御回路と、
外科用器具の電気コネクタに係合するように構成されたポートであって、前記電気コネクタの前記係合を検出し、検出信号を前記制御回路に送信するように構成されたセンサを備える、ポートと、を備え、
前記制御回路は、
前記ポートに連結された外科用器具の存在を検出し、
前記リアルタイムクロックからリアルタイムを読み取り、
前記リアルタイムを前記外科用器具のメモリに記憶させるように構成されている、エネルギーモジュール。
前記外科用器具の前記メモリから前記リアルタイムを読み取り、
合計経過時間を決定し、
前記合計経過時間を、前記外科用器具のリアルタイム限界と比較するように更に構成されている、実施態様10に記載のエネルギーモジュール。
(12) 前記制御回路が、前記合計経過時間が前記外科用器具の前記リアルタイム限界未満であるという判定に基づいて、前記外科用器具に通電するように更に構成されている、実施態様11に記載のエネルギーモジュール。
(13) 前記制御回路が、前記合計経過時間が前記外科用器具の前記リアルタイム限界以上であるという判定に基づいて、前記外科用器具を停止するように更に構成されている、実施態様11に記載のエネルギーモジュール。
(14) エネルギーモジュールであって、
リアルタイムクロックと、
前記リアルタイムクロックに結合された制御回路と、
外科用器具の電気コネクタに係合するように構成されたポートであって、前記電気コネクタの前記係合を検出し、検出信号を前記制御回路に送信するように構成されたセンサを備える、ポートと、を備え、
前記制御回路が、
前記ポートに連結された外科用器具の存在を検出し、
前記リアルタイムクロックからリアルタイムを読み取り、
前記リアルタイムを前記外科用器具のメモリに記憶させ、
前記外科用器具の前記メモリから前記リアルタイムを読み取り、
合計経過時間を決定するように構成されている、エネルギーモジュール。
(15) 前記制御回路が、前記エネルギーモジュール内への前記器具の初期差込みからの、合計経過時間を決定するように更に構成されている、実施態様14に記載のエネルギーモジュール。
(17) 前記制御回路が、前記外科用器具の前記エネルギーモジュールへの接続間の経過時間を決定するように更に構成されている、実施態様14に記載のエネルギーモジュール。
(18) 接続間の所定の期間が、患者及び処置を交換することを示す、実施態様17に記載のエネルギーモジュール。
(19) 前記制御回路が、エネルギーモジュール電力サイクル間の経過時間を決定するように更に構成されている、実施態様14に記載のエネルギーモジュール。
Claims (8)
- エネルギーモジュールであって、
リアルタイムクロックと、
前記リアルタイムクロックに結合された制御回路と、を備え、前記制御回路は、
前記エネルギーモジュールに連結された外科用器具の存在を検出し、
前記リアルタイムクロックに基づいてリアルタイムで前記外科用器具の使用を追跡し、
前記リアルタイムクロックに基づいて所定の合計経過時間に基づいて前記外科用器具を停止させるように構成されており、
前記制御回路が、
前記リアルタイムクロックに基づいて、前記外科用器具に適用された電力サイクル間の周期を検出し、
前記外科用器具が前記周期中に同じ患者に使用されているかどうかを判定するように構成されている、エネルギーモジュール。 - 超音波変換器駆動回路を備える、請求項1に記載のエネルギーモジュール。
- 無線周波数駆動回路を備える、請求項1に記載のエネルギーモジュール。
- 超音波変換器駆動回路と無線周波数駆動回路との組み合わせを含む、請求項1に記載のエネルギーモジュール。
- 前記エネルギーモジュールが治療エネルギーを送達するように構成されている、請求項1に記載のエネルギーモジュール。
- 前記エネルギーモジュールが、治療量未満のエネルギーを送達するように構成されている、請求項1に記載のエネルギーモジュール。
- 前記制御回路が、前記エネルギーモジュールのオン/実行時間の長さに基づいて前記外科用器具が操作され得る時間の長さを制御するように構成されている、請求項1に記載のエネルギーモジュール。
- 前記制御回路が、
単回使用の外科用器具の使用履歴を決定し、
前記単回使用の外科用器具の失効を判定するように構成されている、請求項1に記載のエネルギーモジュール。
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CN112689480B (zh) | 2024-05-24 |
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US11696789B2 (en) | 2023-07-11 |
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BR112021002970A2 (pt) | 2021-05-11 |
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