KR102178934B1 - Varicose vein surgery kit and surgical method using the same - Google Patents

Abstract

An object of the present invention is to provide a varicose vein surgery kit capable of effectively treating varicose veins by a combination of a catheter injecting a drug and a radiation optical fiber emitting a laser. The present invention comprises: a catheter (10) having a lumen (11) formed therein and having a catheter tip (12) at one end thereof and first and second ports (14, 16) at the other end thereof; a radiation optical fiber (20) having a radial tip (22) inserted into the lumen (11) through the first port (14), connected to a laser generator (21), and outputting a laser in a 360° direction at the end thereof; and a drug passage (30) formed between the outer diameter of the radiation optical fiber (20) and the inner diameter of the lumen (11) and communicated with the second port (16) to supply a vasoocclusion drug through a syringe part (32). When using the varicose vein surgery kit, by the combination of a catheter injecting a drug and a radiation optical fiber emitting a laser in the 360° direction, the use of drugs is minimized, and the treatment area for varicose veins is expanded without side effects by using a low-power laser, and the operation time is shortened. In particular, the kit can be universally applied to blood vessels of various sizes with a simple method of adjusting the laser output.

Description

Varicose vein surgery kit and surgical method using the same}

The present invention relates to a varicose veins surgical kit and a surgical method using the same, and more specifically described, it relates to a varicose veins surgical kit capable of effectively treating varicose veins by a combination of a catheter injecting a drug and a radiation optical fiber that irradiates a laser.

Normally, varicose veins in the lower extremities are visible due to the stretching of the superficial veins in the legs. As the disease progresses, valve insufficiency progresses, so chronic venous insufficiency occurs, and the vicious cycle continues. Chronic venous insufficiency is chronic As complications such as edema, fibrosis of the lower extremity skin, and venous ulcer of the lower extremity are accompanied, rapid treatment is required.

In addition, varicose veins treatment methods include wearing medical compression stockings, vascular sclerosis therapy in which blood vessels are degraded by injecting a vascular sclerosing agent, high-frequency heat occlusion in which a high-frequency device is inserted into a blood vessel and heat is applied to the device to damage blood vessels, There are laser treatments that damage blood vessels with a laser beam by inserting a laser device into the interior, and vein removal surgery to remove veins directly through surgery.

However, the treatment method wearing compression stockings has the disadvantage that the fundamental treatment is difficult and it takes a lot of time to recover, and vascular sclerotherapy cannot be fundamentally treated and is used only as an auxiliary treatment method. , Nerve damage, and other side effects remain, and laser treatment also has a problem with wounds and side effects, and venous extraction requires general anesthesia, large wounds, and high fatigue from surgery.

Accordingly, in Patent Registration No. 10-1995043 disclosed in the prior art, as a handle defining a receptacle into which a cartridge is inserted, the cartridge includes an elongated intraluminal member that advances from an access site into the vein; And a wire contained within the elongate inner tube member having a disturbing member. Including, a handle; Means for imparting movement to the wire; And a source of a vein occluding material in fluid communication with the intraluminal member, wherein the disturbing member is a tip of a wire, and the wire generates backflow of blood in the blood vessel when the tip rotates. A technology including a blade configuration has been previously registered.

However, the prior art is a technology configured to damage the inner vessel wall by contacting the inner vessel wall when the traumatic tip of the wire rotates, but the rotation radius of the traumatic tip is unadjustable, so that the thickness of the vessel that can be operated is reduced. As the limited and damaged inner membrane of blood vessels wraps around, it takes a lot of time for malfunctioning and 1 cm of blood vessels to be operated for more than 8 seconds, so the treatment efficiency is greatly reduced.In particular, the cost of the treatment kit for single use is formed at an expensive price of over 1 million won This great trouble followed.

On the other hand, in order to solve the problem of the prior art, the applicant of the present invention in Patent Registration No. 10-2080330, a catheter consisting of a first lumen through which the expansion fluid is moved and a second lumen through which the drug is moved; A balloon installed at an end of the catheter, connected to the first lumen, and expanded by an inflation fluid injection pressure to damage blood vessels; An inflator unit connected to the first lumen and provided to control supply of the expansion liquid; And a syringe part connected to the second lumen and provided to control the supply of drugs into the blood vessel damaged by the balloon.

However, in the prior art, since the inner diameter of the vein to be operated differs depending on the location, there is a problem in that it is inconvenient to have balloons of various sizes suitable for the diameter of the blood vessel to be operated, and thus the operation time is lengthened.

KR 10-1995043 B1 (2019.06.25) KR 10-2080330 B1 (2020.02.17.)

In the present invention, in order to solve all the problems of the prior art, a new technology was created. Varicose veins in which the concentration and amount of drug can be reduced by a combination of a catheter injecting a drug and a radiation optical fiber that irradiates a laser in the 360° direction. It is an object of the present invention to provide a surgical kit.

In addition, it is an object of the present invention to provide a varicose vein surgery kit that is universally applied to blood vessels of various sizes with a simple method of adjusting laser output.

Along with this, although not described separately, other objects within the range that can be inferred in consideration of the specific content and claims for carrying out the following invention are also included in the entire subject of the present invention.

In order to achieve this object, a feature of the present invention is a catheter 10 having a lumen 11 formed therein, and having a catheter tip 12 at one end and first and second ports 14 and 16 at the other end. ); Radiation optical fiber 20 having a radial tip 22 inserted into the lumen 11 through the first port 14, connected to the laser generator 21, and outputting a laser in a 360° direction at the end thereof ); And a drug passage 30 formed between the outer diameter of the radiating optical fiber 20 and the inner diameter of the lumen 11 and communicated with the second port 16 to supply a blood vessel occlusion drug through the syringe portion 32; And, after inserting the catheter 10 into the blood vessel, a certain amount of the drug is supplied by the syringe unit 32 and the laser generating unit 21 is turned on so that the laser is applied to the radial tip 22. After the output, the catheter 10 and the radiation optical fiber 20 are characterized in that it is provided to be transported at a constant speed at a set speed.

At this time, the catheter tip 12 is inserted into the blood vessel so as to coincide with the vascular treatment start point P, and the radial tip 22 protrudes inward from the vascular treatment start point P, and the radial tip 22 The silver protrudes from the catheter tip 12 by 30 to 70 mm in the blood vessel, and the laser is irradiated with an output of 4 to 12 w after 10 to 25 seconds have elapsed from the time the drug is supplied, and the amount of drug injection is 0.1 to 0.3 cc/ It is set in cm, and the catheter withdrawal speed is set to 1 ~ 5mm/sec, and the withdrawal is operated.

In addition, the catheter 10 is marked with a scale (10a) on the outer circumferential surface, and the scale is displayed in ascending order based on the zero point (10b) from the end side where the first port 14 is formed, and the catheter ( 10) Cut the catheter 10 so that it matches the length of the blood vessel to the starting point (P) of the procedure from the point where the blood vessel is inserted (P1), and the zero point (10b) of the scale (10a) and the point of blood vessel entry (P1) are It characterized in that it is provided to set the treatment position by inserting the catheter 10 into the blood vessel to match.

In addition, an airtight packing 15 is installed in the first port 14, and an airtight hole 15a is formed in the airtight packing 15 so that the radiating optical fiber 20 is inserted through, so that the first port 14 While allowing the movement of the radiation optical fiber 20 through, it is characterized in that it is provided to block outflow of the drug.

In addition, a reference setting portion 14a is formed in the first port 14, a stopper 24 is formed on the outer circumferential surface of the radiating optical fiber 20 corresponding to the reference setting portion 14a, and the radial tip 22 ) Is accommodated in the catheter 10, after moving to the vascular treatment point, the stopper 24 inserts the radiation optical fiber 20 to the position where the movement is stopped by the reference setting unit 14a, and the radial tip 22 ) Characterized in that it is provided to set the protruding length.

In addition, a separate signal module 21a for flashing and outputting the laser through the radial tip 22 is further formed in the laser generating unit 21, so that the laser output by the signal module 21a is transmitted from the outside of the blood vessel. It characterized in that it is configured to detect the catheter tip 12 retracted position in real time by visually identifying it.

In addition, the end of the catheter 10 including the catheter tip 12 is characterized in that it is composed of a soft tube 13 made of a flexible material by a predetermined length.

In the surgical method using the varicose veins surgery kit according to the present invention, the catheter tip 12 is inserted into the blood vessel so that the catheter tip 12 coincides with the vascular procedure starting point (P) with the radiation optical fiber 20 inserted into the catheter 10. In the catheter insertion step (S1), the radial tip protrusion step (S2) of further protruding the radial tip 22 from the catheter tip 12 by a certain length, and a certain amount of the drug by the syringe part 32 A drug supply and laser output step (S3) of supplying the catheter tip 12 through the flow path 30 and outputting a laser to the radial tip 22 by operating the laser generator 21 on and supplying the drug. It characterized in that it consists of a blood vessel occlusion step (S4) in which the catheter 10 and the radiation optical fiber 20 on which the laser is output are simultaneously drawn out and transported at a constant speed to occlude the blood vessel.

According to a specific means for solving the above-described problem, in an environment where the concentration and dosage of drugs that can be used in one surgery for the safety of the patient are limited, the present invention irradiates a catheter injecting drugs and a laser in a 360° direction. Since a low-concentration drug can be used by the combination of the radiating optical fiber, as many blood vessels as possible can be operated with a single procedure.

In addition, as a low-powered laser is used while using a drug with a low concentration, side effects such as scars and pigmentation of varicose veins treatment methods and pain of the patient can be minimized.

In addition, the simple method of adjusting the laser output allows the operation of various sizes of vessels regardless of the size of the vessel to be treated, so it has excellent versatility, the operator's convenience is high, and the operation time is significantly shortened. It is a great invention.

1 is a block diagram showing the overall varicose veins surgical kit according to an embodiment of the present invention.
Figure 2 is a configuration diagram showing the operating state of the varicose veins surgery kit according to an embodiment of the present invention.
Figure 3 is a configuration diagram showing the scale of the varicose veins surgery kit according to an embodiment of the present invention.
Figure 4 is a block diagram showing a stopper of the varicose veins surgical kit according to an embodiment of the present invention.
5 is a block diagram showing a structure for detecting a catheter retraction position using a signal module of a varicose vein surgery kit according to an embodiment of the present invention.
Figure 6 is a block diagram schematically showing a surgical method using a varicose vein surgery kit according to the present invention.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the description of the present invention, when it is determined that the subject matter of the present invention may be unnecessarily obscured as matters that are obvious to those skilled in the art with respect to known functions related to the present invention, a detailed description thereof will be omitted.

1 is an overall configuration diagram showing a preferred embodiment of the varicose veins surgical kit provided by the present invention. The varicose veins surgical kit of the present invention is a combination of a catheter injecting a drug and a radiation optical fiber that irradiates a laser in a 360° direction. By minimizing the use of drugs and using a low-power laser, the treatment area for varicose veins is expanded without side effects, and the operation time is shortened. In particular, the catheter 10, so that it can be universally applied to blood vessels of various sizes with a simple method of adjusting the laser output, It is characterized by including the main components of the radiation optical fiber 20 and the drug passage 30.

First, in the catheter 10 according to the present invention, a radiation optical fiber 20 to be described later and a lumen 11 to which a drug is supplied are formed therein, and a catheter tip 12 is formed at one end, and the first and second sides thereof are opposite. Ports 14 and 16 are provided. The catheter 10 is formed as a 3-way tube as shown in FIG. 1, and the radiating optical fiber 20 to be described later is inserted into the first port 14 to penetrate the catheter 10 to insert the catheter tip 12. It is provided to protrude through.

In addition, the second port 16 is formed at the end of the branched tube so as to share the lumen 11 between the gartheter tip 12 and the first port 14, and is connected to the syringe portion 32, It is provided to communicate with the space between the radiation optical fiber 20 and the lumen 11 so that the drug is supplied through the syringe part 32.

On the other hand, the end of the catheter 10 including the catheter tip 12 may be coupled to a flexible tube 13 made of a flexible material for a predetermined length. In this case, due to the flexibility of the catheter tip 12, the catheter 10 can easily move in the blood vessel along its own curved line, thereby reducing the time to reach the vascular procedure starting point P, and reducing the blood vessel during movement. It is possible to prevent accidents that are damaged or penetrated to the outside.

The radiation optical fiber 20 according to the present invention is inserted into the lumen 11 through the first port 14, is connected to the laser generator 21, and outputs a laser in the direction of 360° of the outer peripheral surface of the optical fiber at the end. A radial tip 22 is provided.

Here, the radiation optical fiber 20 is a fiber forming a radial tip 22 processed so that the laser is refracted in a vertical direction at the end of the optical fiber and irradiated toward the blood vessel wall, and the laser is refracted in the direction of 360° without being concentrated in one place. , It is evenly irradiated to the blood vessel wall to damage the entire blood vessel wall.

On the other hand, the first port 14 is provided with an airtight packing 15 made of silicon material to prevent external leakage of the drug introduced through the second port, and at this time, the airtight packing 15 is a radiating optical fiber 20 An airtight hole 15a may be formed to be inserted through.

Accordingly, the radiation optical fiber 20 is confined to the airtight packing 15 in a compressed state to allow movement of the radiation optical fiber 20 through the first port 14, but the outflow of the drug is blocked.

The drug flow path 30 according to the present invention is formed between the outer diameter of the radiation optical fiber 20 and the inner diameter of the lumen 11, communicates with the second port 16, and supplies the blood vessel occlusion drug through the syringe portion 32. It is equipped.

That is, the drug flow path 30 is a tubular flow path formed by using a size difference between the outer diameter of the radiation optical fiber 20 and the inner diameter of the lumen 11, and a separate isolated compartment inside the catheter 10 is unnecessary, so the catheter 10 In addition to the possible miniaturization of ), there is an advantage in that the surgical cost is greatly reduced because the surgical kit is configured in a simple manner to replace the catheter 10.

Figure 2 is a configuration diagram showing the operating state of the varicose veins surgery kit according to an embodiment of the present invention. Looking at the method of using the surgical kit of the present application through this, as shown in Figure 2 (a), the blood vessel to operate the catheter 10 After being inserted into the inside, a certain amount of drug is supplied by the syringe part 32 as shown in FIG. 2 (b), and the laser generator 21 is turned on to output a laser to the radial tip 22, and then 2 As shown in (c), the catheter 10 and the radiation optical fiber 20 are brought out at a constant speed at a set speed.

Here, the syringe part 32 is formed in the form of a syringe and can be supplied manually or controlled to automatically supply quantitatively by using a pump, and the withdrawal speed of the catheter 10 and the radiation optical fiber 20 is a scale 10a indicated on the outer circumferential surface. ) Based on manual control or automatic control using a feeding machine.

3 shows an example in which a scale is formed on the catheter, the catheter 10 has a scale 10a displayed on the outer circumferential surface, and the scale is based on the zero point 10b from the end side where the first port 14 is formed. Length unit dimensions are displayed in ascending order.

And cut the catheter 10 so that the catheter 10 is matched with the blood vessel length up to the treatment start point P based on the blood vessel entrance point P1 into which the catheter 10 is inserted, and the zero point 10b and the blood vessel entrance point of the scale 10a It is provided so that the catheter 10 is inserted into the blood vessel so that (P1) is aligned to accurately set the treatment position.

In this way, when the scales 10a are displayed on the outside of the catheter in ascending order, the length of the catheter 10 into the blood vessel to be treated can be precisely controlled, and the catheter 10 is adjusted to correspond to the length corresponding to the length of the blood vessel surgery. Since it is cut to the minimum length (L) and used, the length of the drug passage 30 is reduced in proportion to the length of the catheter 10, thereby reducing the amount of unused drug remaining in the drug passage 30, thereby reducing unnecessary drug loss. There is an advantage to be able to.

Figure 4 is a block diagram showing a stopper of the varicose veins surgical kit of the present invention, a reference setting portion (14a) is formed in the first port 14, the outer peripheral surface of the radiation optical fiber 20 corresponding to the reference setting portion (14a) A stopper 24 is provided. The stopper 24 is installed to be movable along the outer peripheral surface of the radiation optical fiber 20.

In addition, the catheter tip 12 may be formed of a soft tube 13 made of a flexible material as described above, and due to the flexibility of the tube 13, it is deformed along the curved line in the blood vessel of the catheter 10, (10) Guides the movement, and the radial tip 22 is moved to the vascular treatment start point P while being accommodated in the catheter 10.

Then, as shown in Fig. 4 (b), the stopper 24 is inserted by the reference setting part 14a to the position where the movement is stopped, so that the radial tip 22 protruding length is accurately set. As provided, the protruding length of the radial tip 22, which cannot be visually identified in the blood vessel, is accurately positioned by the stopper 24 and the reference setting part 14a, so that even unskilled persons can stably operate, thus the stability of the operation And precision is improved.

5 is a block diagram showing a structure of detecting a catheter retraction position using a signal module of a varicose vein surgery kit. A separate signal module 21a for outputting a laser through the radial tip 22 may be further formed in the laser generator 21.

At this time, the signal module 21a controls the laser through the radial tip 22 to be output as a blinking signal, while preventing damage to the blood vessel during the in/out transfer.

Therefore, while the catheter 10 is inserted into the blood vessel, the laser light source output from the radial tip 22 is visually identified to detect and confirm the catheter 10 inlet position in real time, so even the unskilled person can easily start the vascular procedure (P) Will be set.

The varicose vein surgery kit of the present invention configured as described above is a combination of a catheter 10 for injecting a drug and a radiation optical fiber 20 for irradiating a laser in the 360° direction, and side effects (scars, scars, etc.) using a low-concentration drug and a low-power laser There is no patient pain), and due to the use of low-concentration drugs, it is possible to operate as many blood vessels as possible with one operation, and in particular, there is an advantage that it is universally applied to blood vessels of various sizes with a simple method of adjusting laser output.

6 is a block diagram schematically showing a surgical method using the varicose veins surgical kit according to the present invention.

The surgical method using the varicose vein surgery kit according to the present invention includes an intravascular catheter insertion step (S1), a radial tip protrusion step (S2), a drug supply and laser output step (S3), and a blood vessel occlusion step (S4). ).

1. Intravascular catheter insertion step (S1)

With the radiation optical fiber 20 inserted into the catheter 10, the catheter tip 12 is inserted into the blood vessel so that it coincides with the vascular treatment start point P. At this time, by outputting a blinking signal to the radial tip 22 by the signal module 21a, it can be accurately positioned at the starting point P for vascular treatment.

2. Radial tip protrusion step (S2)

In the above step, if the catheter is positioned at the vascular treatment start point (P), only the radiation optical fiber 20 is further inserted to irradiate the laser to the blood vessel to be occluded, so that the radial tip 22 protrudes from the catheter tip 12 by a certain length. Let it.

The protruding length of the catheter tip 12 is an important factor in determining the time until exposure to the laser after the drug is applied, and preferably, the radial tip 22 is 30 to 30 from the catheter tip 12 in the blood vessel. Make it protrude 70mm.

3. Drug supply and laser output step (S3)

A certain amount of the drug is supplied to the catheter tip 12 through the drug flow path 30 by the syringe unit 32, and then the laser generator 21 is turned on to output a laser to the radial tip 22.

At this time, the laser is irradiated to the blood vessel to be occluded after 10 to 25 seconds have elapsed from the time the drug is supplied. The blood vessel supplied with the drug is constricted, and thus the blood is thinned (the effect of reducing the thickness of the blood layer to which the laser light must be transmitted) because the vessel and the outer diameter of the catheter are close together, and the radial tip to which the laser is irradiated ( 22) Because it is close to the inner wall of the blood vessel, it can easily damage the inner wall of the blood vessel even with low-power laser light, thereby increasing the occluding effect of the blood vessel.

In addition, the laser is output at 4 to 12 w, and the amount of drug injection is set at 0.1 to 0.3 cc/cm, where the drug uses a low concentration of 1% or less. This is because the higher the concentration of the drug (curing agent), the greater the risk of side effects (liver damage, scar, pain), and the occurrence of pigmentation increases in proportion to the concentration.

It has the advantage that effective blood vessel occlusion is possible even if a low concentration of drugs is used by irradiating a laser to contracted blood vessels after supplying the drug, and causing physical damage to the blood vessels that are contracted after the drug is supplied.

4. Blood vessel occlusion step (S4)

The catheter 10 being supplied with the drug and the radiation optical fiber 20 which is outputting the laser are simultaneously drawn out and transported at a set speed to block the blood vessel.

The catheter withdrawal speed is set to 1 ~ 5mm/sec, and the catheter 10 withdrawal speed and laser power are set to be directly proportional.

If the catheter withdrawal speed is maintained at less than 1 mm/sec, surgery time is delayed, and if the catheter withdrawal rate exceeds 5 mm/sec, the efficiency of blood vessel occlusion by drugs and lasers decreases, as well as areas where the laser is not sufficiently irradiated, requiring reoperation. Is done. Accordingly, the catheter withdrawal speed is set to 1 to 5 mm/sec, and the laser output is preferably adjusted to 4 to 12 w according to the diameter of the blood vessel according to the size of the blood vessel.

As described above, the most preferred embodiments of the present invention have been described in the detailed description of the present invention, but various modifications may be made within the scope of the technical scope of the present invention. Therefore, the scope of protection of the present invention is not limited to the above embodiments, but the scope of protection should be recognized from the techniques of the claims to be described later and equivalent technical means from these techniques.

10: catheter 10a: scale 10b: zero point
11: lumen 12: catheter tip 13: soft tube
14: first port 14a: standard setting part
15: airtight packing 15a: airtight hole 16: second port
20: radiation optical fiber 21: laser generator 21a: signal module
22: radial tip 24: stopper
30: drug flow 32: syringe
P: vascular procedure starting point P1: vascular entry point

Claims (8)

A catheter 10 having a lumen 11 formed therein, and having first and second ports 14 and 16 on opposite sides of the catheter tip 12 and the catheter tip 12 at one end;
Radiation optical fiber having a radial tip 22 inserted into the lumen 11 through the first port 14, connected to the laser generator 21, and outputting a laser in the 360° direction of the outer circumferential surface at the end (20); And
A drug channel 30 formed between the outer diameter of the radiating optical fiber 20 and the inner diameter of the lumen 11 and communicated with the second port 16 to supply a blood vessel occlusion drug through the syringe part 32; Is done by
After inserting the catheter 10 into the blood vessel, a certain amount of drug is supplied by the syringe unit 32 and the laser generating unit 21 is turned on to output the laser to the radial tip 22, and then the catheter ( 10) and the radiation optical fiber 20 are drawn out and transported at a constant speed at a set speed
The catheter tip 12 is inserted into the blood vessel so as to coincide with the vascular treatment start point P, the radial tip 22 protrudes from the catheter tip 12 in the blood vessel by 30 to 70 mm, and the laser supplies the drug. The lower limb, characterized by the fact that it is irradiated with an output of 4 to 12 w after 10 to 25 seconds elapse from the time point, and the drug injection amount is set to 0.1 to 0.3 cc/cm, and the catheter withdrawal speed is set to 1 to 5 mm/sec. Varicose vein surgery kit.
delete The method of claim 1,
The catheter 10 is marked with a scale (10a) on the outer circumferential surface, and the scale is displayed in ascending order based on the zero point (10b) from the end side where the first port 14 is formed, and the catheter 10 Cut the catheter 10 so that it matches the length of the blood vessel to the start point of the procedure (P) based on the blood vessel entry point (P1), and the zero point (10b) of the scale (10a) and the blood vessel entry point (P1) coincide. Varicose veins surgery kit, characterized in that provided to set the operation position by inserting the catheter 10 into the blood vessel.
The method of claim 1,
An airtight packing 15 is installed in the first port 14, and an airtight hole 15a is formed so that the radiation optical fiber 20 is inserted through the airtight packing 15, and radiation through the first port 14 Although the movement of the optical fiber 20 is allowed, varicose veins surgical kit, characterized in that provided to block outflow of the drug.
The method of claim 1,
A reference setting portion 14a is formed in the first port 14, a stopper 24 is formed on the outer peripheral surface of the radiation optical fiber 20 corresponding to the reference setting portion 14a, and the radial tip 22 After moving to the vascular treatment point while being accommodated in the catheter 10, the stopper 24 draws the radiating optical fiber 20 to the position where the movement is stopped by the reference setting part 14a, and the radial tip 22 protrudes. Varicose veins surgery kit, characterized in that provided to set the length.
The method of claim 1,
A separate signal module 21a for flashing and outputting the laser through the radial tip 22 is further formed in the laser generating unit 21, so that the laser output by the signal module 21a is visually transmitted from the outside of the blood vessel. Varicose veins surgery kit, characterized in that configured to identify and detect the catheter tip 12 inlet position in real time.
The method of claim 1,
An end of the catheter (10) including the catheter tip (12) is a varicose veins surgery kit, characterized in that consisting of a soft tube (13) made of a flexible material for a predetermined length.
delete

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