WO1987001926A1 - Conduit de fluides rigide et transparent pour irrigation chirurgicale - Google Patents

Conduit de fluides rigide et transparent pour irrigation chirurgicale Download PDF

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Publication number
WO1987001926A1
WO1987001926A1 PCT/US1986/001754 US8601754W WO8701926A1 WO 1987001926 A1 WO1987001926 A1 WO 1987001926A1 US 8601754 W US8601754 W US 8601754W WO 8701926 A1 WO8701926 A1 WO 8701926A1
Authority
WO
WIPO (PCT)
Prior art keywords
fluid conduit
irrigation fluid
sleeve
polypropylene
irrigation
Prior art date
Application number
PCT/US1986/001754
Other languages
English (en)
Inventor
Dennis L. Steppe
Stephen W. Haines
Original Assignee
Coopervision, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Coopervision, Inc. filed Critical Coopervision, Inc.
Priority to JP61504602A priority Critical patent/JPH0659290B2/ja
Priority to KR1019870700453A priority patent/KR940008956B1/ko
Priority to BR8606887A priority patent/BR8606887A/pt
Publication of WO1987001926A1 publication Critical patent/WO1987001926A1/fr
Priority to NO872205A priority patent/NO872205L/no
Priority to DK268087A priority patent/DK268087A/da
Priority to FI872329A priority patent/FI872329A/fi

Links

Classifications

    • 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
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems

Definitions

  • This invention relates to molded plastic fluid conduits and more particularly to thin-walled, rigid, transparent fluid conduits suitable for use in surgical irrigation-aspiration apparatus.
  • a particularly common proce ⁇ dure is the removal of a cataract by ultrasonic frag ⁇ mentation and aspiration through a small-diameter ultrasonically vibrated needle having an axial aspir ⁇ ation conduit, which is inserted through an incision just large enough to accomodate the diameter of the tool. Fluid leakage though the incision as well as removal of aqueous humor by aspiration through the ultrasonic needle leads to loss of the aqueous humor from the interior of the eye.
  • the anterior chamber of the eye will collapse, with serious consequences for the health of the eye, particularly for the delicate corneal endo- thelium. Accordingly, in order to prevent this collapse it is conventional to provide a supply of irrigating fluid to the interior of the eye, either through a secondary incision in the eye or by means adapted for both irrigation and aspiration through a single incision.
  • the single incision method is generally preferred, but it requires an irrigation- aspiration apparatus having a double lumen tube with the separate channels for irrigation and aspiration placed either side by side or coaxially.
  • the coaxial configuration has certain advantages, especially for ultrasonic surgical instruments having provision for irrigations and aspiration.
  • Such an instrument which incorporates an ultrasonic fragmenting and aspirating needle and a coaxial irrigation conduit is disclosed, e. g., in Banko and Kelman, U.S. Patent 3,589,363.
  • the performance requirements of a sleeve which defines the irrigating channel in a coaxial surgical irrigator/aspirator place severe demands on the materials and design of the sleeve.
  • the sleeve should have a low heat conductivity to insulate the tissue at the sides of the incision from heat generated by friction with the ultrasonic tool. It should be sufficiently strong to prevent collapse under pressure from the sides of the incision. At the same time it should be as of a small diameter as possible to allow a minimum size incision. It is also helpful if the sleeve is transparent to provide better visibility for the surgeon.
  • the element is small and of rather precise dimensions, it is desirable that it be capable of being formed by molding for economical manufacture.
  • Metal sleeves e.g., stainless steel
  • rigidity which makes them easier to insert through a small incision and less likely to injure the ocular tissues such as the corneal endo- thelial cell layer and Descemet's membrane. Since they cannot be collapsed by pressure from the sides of the incision, they make it easier to assure a constant flow rate of irrigation fluid.
  • they because of their extreme rigidity, they must be very precisely matched to the shape of the interior aspiration conduit, so that many different sleeves are needed to accomodate various aspiration conduits.
  • Synthetic resins in the cross-sections required for irrigation sleeves, tend to be lacking in rigidity and/or strength. This requires a larger incision, either to accommodate a larger wall thickness or to minimize the force from the sides of the incision which tends to collapse the sleeve. Furthermore, some plastics are not transparent, and, like metal sleeves, obscure the surgeon's vision.
  • U. S. Patent 3,589,363 recommends the use of a sleeve of polytetrafluoroethy- lene, which is inert, but difficult to fabricate and is not perfectly transparent, even in thin sections.
  • a commonly used commercial irrigation sleeve is made from silicone rubber and is molded integrally with a cap for fastening the sleeve to the ultrasonic handpiece.
  • Silicone rubber can be conveniently molded by injection molding, but is flexible and tends to collapse under pressure from the incision and to fold back on itself or "telescope" when it is inserted through the incision. Furthermore, it is at best translucent, so that the surgeon's vision is somewhat obscured.
  • an irrigation conduit having a sufficiently rigid wall with a wall thickness sufficiently small to be used as a sleeve in a coaxial surgical irrigation-aspiration instrument and thereby to allow a conveniently small incision can be molded from certain polyolefin synthetic resins, particularly from polypropylene.
  • a further object is to to provide a rigid infusion sleeve which can be used generally with irrigation/as ⁇ piration handpieces with or without ultrasonic frag- mentation.
  • a further object is to provide a rigid infusion sleeve which makes it easier to maintain fluidic balance through a small incision.
  • a further object is to provide a generally trans- parent infusion sleeve, which improves the visibility of the irrigation/aspiration or ultrasonic fragmenting tip and of the ocular structures during use.
  • a further object is to provide a rigid infusion sleeve which reduces the incidence of trauma to ocular tissues.
  • Figure 1 shows an ultrasonic surgical irrigator- aspirator of the type which incorporates a tip cap/sleeve member which acts as an irrigation conduit.
  • Figure 2 shows a longitudinal section of the tip portion of the irrigator-aspirator of Figure 1, showing the attachment of the tip cap and sleeve member to the handpiece.
  • Figure 3 shows a side elevation of a tip cap and sleeve member of this invention.
  • Figure 4 shows a partial longitidinal section of a molded tip cap/sleeve of this invention.
  • Figure 5 shows a preferred embodiment of the fluid conduit of the invention incorporating an overmolded sealing ring.
  • the rigid infusion sleeve of this invention is designed to function as a part of a conventional ophthalmological surgical tool which incorporates coaxial irrigation and aspiration functions.
  • An illustrative surgical instrument of this type wherein an elongated surgical tool or needle is ultrasonically vibrated to fragment tissue is depicted in Figure 1.
  • the surgical tool of this type comprises a handpiece 102 having a barrel 104 and an extension 106 which suppports an ultrasonically vibrated surgical tool or needle 114.
  • the handpiece is provided with a cable 112 containing power and control wires and cooling water tubes.
  • the instrument is also provided with an aspir- ation line 110 which is connected to a source of vacuum and an irrigation line 108 connected to a source of irrigation fluid. Both lines are connected to passages within the handpiece leading to the region of the tip of the handpiece.
  • the distal end of the handpiece is provided with an adaptor 116 and a tip cap and sleeve member 120 which surrounds the ultrasonic tool 114 and provides a coaxial annular passage for supplying irri ⁇ gation fluid to the surgical site.
  • FIG. 2 shows a detailed cross-section of the distal end of the handpiece 102.
  • the ultrasonic tool 114 is fastened to the ultrasonically vibrating connecting member 124 by a threaded connection.
  • An axial bore 126 in the ultrasonic tool communicates through conventinal drilled passages in the ultrasonic connecting member 124 and the handpiece (not shown) with the aspiration line 110.
  • the region between the ultrasonic connecting member 124 and the extension 106 provides a conduit 128 for irrigation fluid. This conduit is connected by conventional channels (not shown) in the handpiece 102 to the irrigation fluid line 108.
  • the tip cap and sleeve member 120 fits on the end of the adapter 116, and is made up of a body member 130 and a sleeve member 132.
  • the body member and sleeve member are preferably molded homogeneously from one synthetic resin material.
  • the tip cap and sleeve member 120 surrounds the ultrasonic tool 114 to provide a coaxial fluid channel 133 which receives fluid from the fluid channel 128 and conducts it to the surgical site.
  • the tip cap/sleeve 132 of this invention has a body portion 130 which is hollow and has means for engaging the front end of the surgical instrument so as to be in fluid communication with the passage or passages in the handpiece which supply irrigation fluid.
  • the body portion of the tip cap and sleeve surrounds the ultrasonically vibrated needle and has an axis which is coincident with the axis of the ultra ⁇ sonically vibrated needle.
  • the body portion is cylindrical in shape and has a relatively thick wall provided with fastening means at one end of the body for engaging the end of the handpiece to be retained thereon.
  • the means for engaging the end of the handpiece is simply the internal bore of the body member 130 which is press fit for the end of the adapter 116.
  • the fastening means are internal threads 140 on the wall of the body portion 130 (as shown in Figure 4) which threadably engage external threads on the end of the handpiece to fasten the tip cap and sleeve thereto.
  • the sleeve portion of the tip cap and sleeve of the invention is molded homogeneously with the body portion and is a tubular member having an axis coaxial with the axis of the body member and a wall thickness not greater than 0.006 inches.
  • the cap and sleeve should be molded of a synthetic resin material which provides sufficient rigidity to prevent collapse under the pressure of the sides of the ocular incision, with accompanying decrease in irrigation and danger of excessive heating of the adjacent tissue.
  • the synthetic resin used in the tip cap and sleeve should also be transparent so as not to obscure the surgeon's view of ocular structures, and preferably has a refrac ⁇ tive index close to that of water, so that it becomes practically invisible when immersed in the aqueous humor of the eye, a property which enhances the surgeon's view of the surgical site.
  • Polyolefin resins having sufficient rigidity to resist collapse are suitable materials for forming the fluid conduit of this invention. Such materials are obtainable in grades which are substantially transparent in thin wall sections and have a refractive index close to that of the aqueous humor and the irrigation fluid whereby they are substantially invisible in use and do not obstruct the surgeon's vision.
  • FIG. 3 A preferred embodiment of the fluid conduit of this invention is shown in Figure 3.
  • the body member 130 and sleeve member 132 are molded homogeneously of one synthetic resin material.
  • the radiused annulus distal tip 136 of the fluid conduit is sized to fit closely over the aspiration member of a surgical irri ⁇ gator-aspirator and is provided with a tapered section 134 for easy insertion into the incision.
  • Side infusion holes 138 are also formed in the sleeve member 132 to provide free flow of irrigation fluid to the surgical site.
  • Figure 4 shows a partial section of the embodiment of Figure 3 showing the internal threads in the wall of the body member 130 which provide means for attaching the fluid conduit of the invention to the surgical irrigator-aspirator.
  • Figure 5 shows a preferred embodiment of the fluid conduit of the invention having a sealing ring 142 attached to the end of the body member 130.
  • the sealing ring is made of a synthetic resin material selected for its sealing ability and is over olded to form an integral part of the body member 130.
  • a pre ⁇ ferred material for the sealing ring is an elastomer, e.g., polyvinyl chloride.
  • a preferred material for the tip cap and sleeve of this invention is polypropylene. This material has the capability of being molded by injection molding in the thin wall sections which are required in the tip cap sleeve of this invention. It also has sufficient rigidity to prevent collapse of the sleeve under the normal compressive stress induced by contact with the sides of the incision. The material is also transparent and has a refractive index relatively close to that of the aqueous humor of the eye. Consequently, in use the sleeve is substantially invisible, and does not obstruct the surgeon's view.
  • the tip cap and sleeve of this invention is preferably made from polypropylene having a melt flow rate by ASTM D1238 of 9.0-12.0 grams/10 minutes, preferably 10.0-11.0 grams/10 min.
  • the polypropylene preferably has a weight-average molecular weight, as measured by gel permeation chromatography, of about 220,000 to about 280,000, more preferably about 250,000.
  • the molding procedure for manufacturing the tip cap and sleeve of the invention is generally conven- tional but requires the usual care needed for molding thin sections in polypropylene.
  • the mold is designed to be vented at the distal end of the irrigation sleeve core pin by means of a small vent machined into the mold to allow complete filling of the mold during injection of the molten resin.
  • the mold is designed to provide for molding the ports at the distal end of the sleeve to eliminate a punching operation on the finished product.
  • the completed molded unit is preferably flame treated on the distal end of the sleeve to remove any molding flash.
  • the tip cap and sleeve of the invention may be molded in an injection molding machine of either the toggle clamp or hydraulic clamp type. In either case the mold-fill injection time should be about 8.0 seconds at a pressure of about 7000 psi. The injection time is somewhat critical in order to prevent material shearing and consequent burning of the material during mold-fill. After the injection phase, a part cooling cycle of about 11.0 seconds takes place, and the mold is then opened and the finished part is ejected.
  • the nozzle temperature of the injection molding machine should be about 520° ⁇ 20°F for a toggle-clamp molding machine and about 500° ⁇ 20°F for a hydraulic clamp machine.
  • the clamp setting or clamp pressure should be backed off before the mold is filled to provide about 0.0008 inch parting line venting to assure complete filling of the mold during the material fill cycle.

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • External Artificial Organs (AREA)
  • Materials For Medical Uses (AREA)

Abstract

Conduit (120) amélioré pour fluides d'irrigation destiné à être utilisé avec un appareil chirurgical coaxial d'irrigation-aspiration (102) pour les opérations chirurgicales ophtalmiques, comportant un corps creux (130) conçu pour s'adapter sur l'appareil chirurgical d'irrigation-aspiration (102) et un manchon (132) tubulaire à parois minces qui s'étend depuis le corps creux pour entourer le conduit d'aspiration (126) de l'instrument. Le corps (130) et le manchon (132) sont constitués de moulages homogènes en polypropylène, ce qui permet d'obtenir un manchon (132) rigide à parois minces dont l'épaisseur de paroi ne dépasse pas 0,006 pouce et qui est transparent pour permettre une meilleure visibilité des tissus adjacents.
PCT/US1986/001754 1985-09-27 1986-08-27 Conduit de fluides rigide et transparent pour irrigation chirurgicale WO1987001926A1 (fr)

Priority Applications (6)

Application Number Priority Date Filing Date Title
JP61504602A JPH0659290B2 (ja) 1985-09-27 1986-08-27 洗浄及び吸引作用を行う眼科用手術器具用洗浄液導管
KR1019870700453A KR940008956B1 (ko) 1985-09-27 1986-08-27 관주용 강성 투명 유체 도관
BR8606887A BR8606887A (pt) 1985-09-27 1986-08-27 Conduto de fluido de irrigacao
NO872205A NO872205L (no) 1985-09-27 1987-05-26 Stivt, gjennomsiktig fluidroer for kirurgisk irrigering.
DK268087A DK268087A (da) 1985-09-27 1987-05-26 Stift transparent vaeskeledningsorgan til kirurgisk udskylning
FI872329A FI872329A (fi) 1985-09-27 1987-05-26 Styvt, transparent foer vaetska vid kirurgisk irrigation.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US78081385A 1985-09-27 1985-09-27
US780,813 1985-09-27

Publications (1)

Publication Number Publication Date
WO1987001926A1 true WO1987001926A1 (fr) 1987-04-09

Family

ID=25120784

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1986/001754 WO1987001926A1 (fr) 1985-09-27 1986-08-27 Conduit de fluides rigide et transparent pour irrigation chirurgicale

Country Status (12)

Country Link
EP (1) EP0240515A4 (fr)
JP (1) JPH0659290B2 (fr)
KR (1) KR940008956B1 (fr)
AU (1) AU6228186A (fr)
BR (1) BR8606887A (fr)
CA (1) CA1259237A (fr)
DK (1) DK268087A (fr)
FI (1) FI872329A (fr)
GR (1) GR862374B (fr)
IE (1) IE862187L (fr)
PT (1) PT83387B (fr)
WO (1) WO1987001926A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2211422A (en) * 1987-12-17 1989-07-05 Anderson Mark Leroy Trocar assembly for draining fluids from a body.
EP0352984A1 (fr) * 1988-07-22 1990-01-31 Allergan, Inc Manchon synthétique pour instruments de chirurgie
EP0625037A1 (fr) * 1992-02-05 1994-11-23 Inventive Systems, Inc Porte-outil ameliore de phacoemulsification
CN107530193A (zh) * 2015-04-20 2018-01-02 博士伦公司 由非金属材料或材料组合制造的超声针和换能器组件
EP3512574B1 (fr) * 2016-09-15 2023-01-11 Integra LifeSciences Enterprises, LLLP Pièce de connexion pour manche chirurgical.

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8282594B2 (en) * 2004-12-20 2012-10-09 Bausch & Lomb Incorporated Non-circular ported phacoemulsification irrigation sleeve

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3306291A (en) * 1964-04-14 1967-02-28 Burron Medical Prod Inc Disposable sterile syringes, needle containers and the like having prestressed frangible portions therein
US3589363A (en) * 1967-07-25 1971-06-29 Cavitron Corp Material removal apparatus and method employing high frequency vibrations
US3865113A (en) * 1972-10-17 1975-02-11 Laser Ind Ltd Laser device particularly useful as surgical scalpel
US4316465A (en) * 1979-03-30 1982-02-23 Dotson Robert S Jun Ophthalmic handpiece with pneumatically operated cutter
US4386927A (en) * 1979-10-12 1983-06-07 Ocular Associates Device to be utilized in extracapsular cataract surgery
US4465470A (en) * 1982-06-04 1984-08-14 Kelman Charles D Apparatus for and method of irrigating and aspirating an eye
US4515583A (en) * 1983-10-17 1985-05-07 Coopervision, Inc. Operative elliptical probe for ultrasonic surgical instrument and method of its use
US4516398A (en) * 1980-10-08 1985-05-14 Cooper Lasersonics, Inc. Method of use of an ultrasonic surgical pre-aspirator having a orifice by-pass
US4526571A (en) * 1982-10-15 1985-07-02 Cooper Lasersonics, Inc. Curved ultrasonic surgical aspirator

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS587296A (ja) * 1981-07-07 1983-01-17 松下電器産業株式会社 衣類乾燥機の制御回路

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3306291A (en) * 1964-04-14 1967-02-28 Burron Medical Prod Inc Disposable sterile syringes, needle containers and the like having prestressed frangible portions therein
US3589363A (en) * 1967-07-25 1971-06-29 Cavitron Corp Material removal apparatus and method employing high frequency vibrations
US3865113A (en) * 1972-10-17 1975-02-11 Laser Ind Ltd Laser device particularly useful as surgical scalpel
US4316465A (en) * 1979-03-30 1982-02-23 Dotson Robert S Jun Ophthalmic handpiece with pneumatically operated cutter
US4386927A (en) * 1979-10-12 1983-06-07 Ocular Associates Device to be utilized in extracapsular cataract surgery
US4516398A (en) * 1980-10-08 1985-05-14 Cooper Lasersonics, Inc. Method of use of an ultrasonic surgical pre-aspirator having a orifice by-pass
US4465470A (en) * 1982-06-04 1984-08-14 Kelman Charles D Apparatus for and method of irrigating and aspirating an eye
US4526571A (en) * 1982-10-15 1985-07-02 Cooper Lasersonics, Inc. Curved ultrasonic surgical aspirator
US4515583A (en) * 1983-10-17 1985-05-07 Coopervision, Inc. Operative elliptical probe for ultrasonic surgical instrument and method of its use

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP0240515A4 *

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2211422A (en) * 1987-12-17 1989-07-05 Anderson Mark Leroy Trocar assembly for draining fluids from a body.
EP0352984A1 (fr) * 1988-07-22 1990-01-31 Allergan, Inc Manchon synthétique pour instruments de chirurgie
EP0625037A1 (fr) * 1992-02-05 1994-11-23 Inventive Systems, Inc Porte-outil ameliore de phacoemulsification
EP0625037A4 (fr) * 1992-02-05 1995-06-14 Inventive Systems Inc Porte-outil ameliore de phacoemulsification.
CN107530193A (zh) * 2015-04-20 2018-01-02 博士伦公司 由非金属材料或材料组合制造的超声针和换能器组件
EP3291778A4 (fr) * 2015-04-20 2019-01-23 Bausch & Lomb Incorporated Ensembles transducteur et aiguilles à ultrasons formés de matériaux non métalliques ou d'une combinaison de matériaux
US10932948B2 (en) 2015-04-20 2021-03-02 Bausch & Lomb Incorporated Ultrasonic needles and transducer assemblies formed of non-metal materials or a combination of materials
US11752035B2 (en) 2015-04-20 2023-09-12 Bausch & Lomb Incorporated Ultrasonic needles and transducer assemblies formed of non-metal materials or a combination of materials
EP3512574B1 (fr) * 2016-09-15 2023-01-11 Integra LifeSciences Enterprises, LLLP Pièce de connexion pour manche chirurgical.

Also Published As

Publication number Publication date
CA1259237A (fr) 1989-09-12
GR862374B (en) 1986-10-10
AU6228186A (en) 1987-04-24
KR940008956B1 (ko) 1994-09-28
JPH0659290B2 (ja) 1994-08-10
IE862187L (en) 1987-03-27
KR870700335A (ko) 1987-12-28
DK268087D0 (da) 1987-05-26
FI872329A0 (fi) 1987-05-26
FI872329A (fi) 1987-05-26
DK268087A (da) 1987-05-26
PT83387A (en) 1986-10-01
EP0240515A1 (fr) 1987-10-14
JPS63501266A (ja) 1988-05-19
PT83387B (pt) 1992-10-30
BR8606887A (pt) 1987-11-03
EP0240515A4 (fr) 1988-12-08

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