WO2004043274A1 - Method and device for application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum - Google Patents

Method and device for application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum Download PDF

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Publication number
WO2004043274A1
WO2004043274A1 PCT/IL2003/000949 IL0300949W WO2004043274A1 WO 2004043274 A1 WO2004043274 A1 WO 2004043274A1 IL 0300949 W IL0300949 W IL 0300949W WO 2004043274 A1 WO2004043274 A1 WO 2004043274A1
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WO
WIPO (PCT)
Prior art keywords
aerosol
cavity
peritoneum
vessel
medical
Prior art date
Application number
PCT/IL2003/000949
Other languages
French (fr)
Inventor
Viacheslav Gasin
Original Assignee
Freedman, Zeev, (Vladimir)
Taran, David
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 Freedman, Zeev, (Vladimir), Taran, David filed Critical Freedman, Zeev, (Vladimir)
Priority to AU2003279504A priority Critical patent/AU2003279504A1/en
Publication of WO2004043274A1 publication Critical patent/WO2004043274A1/en

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Classifications

    • 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
    • A61M11/00—Sprayers or atomisers specially adapted for therapeutic purposes
    • A61M11/005—Sprayers or atomisers specially adapted for therapeutic purposes using ultrasonics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • 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
    • A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
    • A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating needles, e.g. Veress needles
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/02—Gases
    • A61M2202/0225—Carbon oxides, e.g. Carbon dioxide
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/04—Liquids
    • A61M2202/0468—Liquids non-physiological
    • A61M2202/048—Anaesthetics
    • 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
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/101—Pleural cavity

Definitions

  • the present invention relates to the field of medicine and, more particularly, to application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum.
  • the present invention may chiefly be used in anesthesia to reduce pain intensity during and after endoscopic procedures in visceral and artificial cavities.
  • the object of the present invention is, therefore, the task of developing a method of application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum found in the thoracic or the abdominal cavity, respectively, wherein a medical preparation could be administered in a form ensuring the uniform application of the medical preparation over the whole surface of the pleura or the peritoneum, to increase the efficiency of the method, to prevent general intoxication and to reduce the irritative painful effect of carbon dioxide.
  • the said task is fulfilled by dilation of the respective cavity allowing to expose a clear surface of the pleura or the peritoneum to apply a medical preparation thereto.
  • the medical preparation is applied to the said clear surface by means of insufflation of its aerosol having a range of particle dimensions of 1-10 ⁇ m into the cavity.
  • the device of the present invention for application of medical preparations comprises vessel 2 insulated from the environment, the said vessel having inlet pipe 4 to receive the vehicle gas and outlet pipe 6 to discharge an aerosol.
  • the device also comprises insufflator 8, its outlet 10 connected to inlet pipe 4 of vessel 2.
  • any other known pressure regulator having an outlet expanding gas pressure of 5 to 30 mm Hg may be used.
  • Vessel 2 is equipped with a sealing member - membrane 12 - to pass a medical preparation into the vessel.
  • Other structure, such as an end cap, may be used in the capacity of sealing member.
  • the device of the present invention also comprises means 14 for preparing an aerosol of the medical preparation with a range of particle dimensions of 1 to 10 ⁇ m, the said means placed directly in the vessel and made in the form of an ultrasonic generator.
  • Isufflator 8 is adjusted so as to have an expanding gas pressure of 5 to 30 mm Hg at its outlet 10.
  • the proposed device is built into a l ⁇ iown system for insufflation of a gas into closed cavities. This system comprises carbon dioxide tank 16 connected through valve 18 with inlet 20 of insufflator 8, and connective pipe 22 with insufflation needle 24 or a troacar intended for insertion into abdominal cavity 26.
  • An aqueous solution of a local anesthetic having a preset concentration is injected with a syringe (not shown) through membrane 12 into vessel 2.
  • the amount of the anesthetic is determined by its maximal tolerance dose for the patient.
  • sodium bicarbonate may be administered instead of or together with the anesthetic to prevent the acidic effect of carbon dioxide on the body tissue.
  • ultrasonic generator 14 an aerosol of the anesthetic with a range of particle dimensions of 1 to 10 ⁇ m is created in vessel 2.
  • the said range of particle dimensions is ensured by the shape of the vessel and by the frequency of the generator that are selected by the known design-and-experiment method.
  • valve 18 of carbon dioxide tank 16 is opened and carbon dioxide is fed from tank 16 into insufflator 8 providing for a preset pressure in the range from 5 to 30 mm Hg, a preset gas flow, and for gas purification.
  • the range of pressure values is determined by the possibility of dilation of the cavity to the required dimensions and by the patient's safety criteria.
  • a specific pressure value within the said range is selected with regard to the compliance of the cavity.
  • the gas is fed through inlet pipe 4 into vessel 2 where it is mixed with the anesthetic aerosol.
  • Aerosol of the mixture of expanding gas, playing as well the role of driving gas, and anesthetic is passed to the abdominal cavity through outlet pipe 6, connective pipe 22 and insufflation needle 24 or a troacar.
  • Dilation of abdominal cavity 26 caused by the aerosol exposes a clear peritoneal surface, and the aerosol is uniformly distributed over the whole volume of cavity 26.
  • the said uniform distribution of the aerosol results in the uniform deposition of aerosol particles on the clear peritoneal surface and the formation of a uniform thin layer of anesthetic having a preset effective concentration.
  • the cavity may be dilated by other known methods, for example, by gas-less techniques envisaging the use of mechamcal or vacuum devices.
  • gas-less techniques envisaging the use of mechamcal or vacuum devices.
  • the use of these devices is less advisable since mechanical devices may traumatize the peritoneum and vacuum ones bar the access to the operating field.
  • Other embodiments of the present invention can be used in treatment for inflammatory diseases or in diagnostic procedures with the medical preparation being, respectively, an antibiotic or a diagnostic preparation, for example, a contrast medium intended to increase the contrast of organs' surfaces in X-ray, CT or MRI images or images obtained by other techniques.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgery (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

The method and device for application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum. Cavities is fulfilled and dilated by gas (mostly carbon dioxide), allowing to expose a clear surface of the pleura or the peritoneum. The medical preparation is applied to the said clear surface by means of insufflation of its aerosol having a range of particle dimensions of 1-10 ?m into the cavity. That ensures the uniform application of the thin, randomized layer of medical preparation over the whole surface of the pleura, peritoneum or artifical cavities (created for the operational needs), increases the efficiency by use of small amount of concentrated preparation whithout exceeding of the safe amount of anesthetic, diagnostic or therapeutic substances, reduce the irritative painful effect of carbon dioxide and will serve as the base of new diagnostic and therapeutic methods.This method may chiefly be used in anesthesia to reduce pain intensity during and after endoscopic procedures in visceral and artificial cavities, to eliminate need for general anesthesia in the part of the cases.

Description

METHOD AND DEVICE FOR APPLICATION
OF MEDICAL PREPARATIONS TO SURFACES
OF THE CLOSED VISCERAL CAVITIES,
FOR EXAMPLE, TO THE PLEURA OR THE PERITONEUM
Background of the Invention
Field of the Invention
The present invention relates to the field of medicine and, more particularly, to application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum. The present invention may chiefly be used in anesthesia to reduce pain intensity during and after endoscopic procedures in visceral and artificial cavities.
State of the Art
A method of application of an anesthetic preparation to the pleura or the peritoneum is known (J Am Assoc Gynecol Laparosc, 9.02.2002, pages 29-34, "The effect of intraperitoneal ropivacaine on pain after laparoscopic excision of endometriosis", Gordon SJ, Maher PJ, Hiscock R), wherein the thoracic or the abdominal cavity is dilated to expose a clear surface with an expanding gas to apply the medical preparation thereto, whereupon the medical preparation is administered into the cavity in the form of a solution and applied to the said clear surface. This method is not efficient enough as it does not ensure the uniform distribution of the medical preparation over the whole surface of the pleura or the peritoneum which results in the lack of anesthesia in certain zones of the surface. Administering an excess of anesthetic may cause general intoxication. Besides, according to the techniques generally adopted over the recent decades, dilation of cavities is usually performed with the help of expanding gases among which carbon dioxide has been recognized as the safest. Nevertheless, it produces an irritative painful effect.
Because of these drawbacks, the above method has not found practical implementation. So, just about all endoscopic operations are performed under the general anesthesia.
Summary of the Invention
The object of the present invention is, therefore, the task of developing a method of application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum found in the thoracic or the abdominal cavity, respectively, wherein a medical preparation could be administered in a form ensuring the uniform application of the medical preparation over the whole surface of the pleura or the peritoneum, to increase the efficiency of the method, to prevent general intoxication and to reduce the irritative painful effect of carbon dioxide.
The said task is fulfilled by dilation of the respective cavity allowing to expose a clear surface of the pleura or the peritoneum to apply a medical preparation thereto. The medical preparation is applied to the said clear surface by means of insufflation of its aerosol having a range of particle dimensions of 1-10 μm into the cavity. The present invention will be understood more fully from the detailed description given herein below and from the accompanying drawing of the preferred embodiment of the invention which, however, should not be construed as exhaustive to the invention but are for explanation and understanding only.
Brief Description of the Drawings
The essence of the invention is illustrated by a drawing representing schematically a system for application of medical preparations to the surface of a closed visceral cavity, the said system comprising the device of the present invention.
Detailed Description of the Preferred Embodiment of the
Invention
Below an embodiment of the present invention will be described intended for an endoscopic procedure in the abdominal cavity wherein a local anesthetic and carbon dioxide in the capacity of expanding gas are used.
The device of the present invention for application of medical preparations comprises vessel 2 insulated from the environment, the said vessel having inlet pipe 4 to receive the vehicle gas and outlet pipe 6 to discharge an aerosol. The device also comprises insufflator 8, its outlet 10 connected to inlet pipe 4 of vessel 2. Instead of the insufflator, any other known pressure regulator having an outlet expanding gas pressure of 5 to 30 mm Hg may be used. Vessel 2 is equipped with a sealing member - membrane 12 - to pass a medical preparation into the vessel. Other structure, such as an end cap, may be used in the capacity of sealing member. The device of the present invention also comprises means 14 for preparing an aerosol of the medical preparation with a range of particle dimensions of 1 to 10 μm, the said means placed directly in the vessel and made in the form of an ultrasonic generator. Isufflator 8 is adjusted so as to have an expanding gas pressure of 5 to 30 mm Hg at its outlet 10. The proposed device is built into a lαiown system for insufflation of a gas into closed cavities. This system comprises carbon dioxide tank 16 connected through valve 18 with inlet 20 of insufflator 8, and connective pipe 22 with insufflation needle 24 or a troacar intended for insertion into abdominal cavity 26.
Application of medical preparations to the surface of a closed cavity is performed as follows.
An aqueous solution of a local anesthetic having a preset concentration is injected with a syringe (not shown) through membrane 12 into vessel 2. The amount of the anesthetic is determined by its maximal tolerance dose for the patient. In one of the embodiments of the present invention, sodium bicarbonate may be administered instead of or together with the anesthetic to prevent the acidic effect of carbon dioxide on the body tissue. Then, with the help of ultrasonic generator 14, an aerosol of the anesthetic with a range of particle dimensions of 1 to 10 μm is created in vessel 2. The said range of particle dimensions is ensured by the shape of the vessel and by the frequency of the generator that are selected by the known design-and-experiment method. Then valve 18 of carbon dioxide tank 16 is opened and carbon dioxide is fed from tank 16 into insufflator 8 providing for a preset pressure in the range from 5 to 30 mm Hg, a preset gas flow, and for gas purification. The range of pressure values is determined by the possibility of dilation of the cavity to the required dimensions and by the patient's safety criteria.
A specific pressure value within the said range is selected with regard to the compliance of the cavity. From insufflator 8, the gas is fed through inlet pipe 4 into vessel 2 where it is mixed with the anesthetic aerosol. Aerosol of the mixture of expanding gas, playing as well the role of driving gas, and anesthetic is passed to the abdominal cavity through outlet pipe 6, connective pipe 22 and insufflation needle 24 or a troacar. Dilation of abdominal cavity 26 caused by the aerosol exposes a clear peritoneal surface, and the aerosol is uniformly distributed over the whole volume of cavity 26. The said uniform distribution of the aerosol results in the uniform deposition of aerosol particles on the clear peritoneal surface and the formation of a uniform thin layer of anesthetic having a preset effective concentration. Thus, the block of peripheral sensory receptors in the peritoneum is ensured and anesthesia achieved. Experiments have shown that, particle dimensions exceeding 10 μm, deposition of particles in the connective pipe increases considerably while their distribution over the volume of the cavity and, consequently, their deposition on the clear peritoneal surface, becomes less uniform. Particle dimensions being less than 1 μm, their deposition on the clear peritoneal surface slows down substantially.
In one of the embodiments of the present invention, the cavity may be dilated by other known methods, for example, by gas-less techniques envisaging the use of mechamcal or vacuum devices. However, the use of these devices is less advisable since mechanical devices may traumatize the peritoneum and vacuum ones bar the access to the operating field. Other embodiments of the present invention can be used in treatment for inflammatory diseases or in diagnostic procedures with the medical preparation being, respectively, an antibiotic or a diagnostic preparation, for example, a contrast medium intended to increase the contrast of organs' surfaces in X-ray, CT or MRI images or images obtained by other techniques.
Implementation of the method and the device of the present invention allows to perform operations in closed visceral cavities without the general anesthesia.
Although the invention has been described and illustrated with a certain degree of particularity, it is understood that the present disclosure has only been made by way of example, and that various modifications thereof may be resorted to by those skilled in the art without departing from the spirit and scope of the invention, as hereinafter claimed.

Claims

Claims:
1. A method of application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum found, respectively, in the thoracic or the abdominal cavity, the said method comprising: dilation of the said cavity to expose a clear pleural or peritoneal surface to apply a medical preparation thereto, application of the medical preparation to the said clear surface by administering its aerosol having a range of particle dimensions of 1 to
10 μm into the cavity.
2. The method according to Claim 1, wherein the dilation of the cavity is performed with the help of an aerosol of the medical preparation in an expanding gas known by itself, the said expanding gas being the driving gas of the aerosol.
3. The method according to Claim 2, wherein carbon dioxide is used in the capacity of driving gas, and a neutralizer of the irritative effect of carbon dioxide is used in the capacity of medical preparation.
4. The method according to Claim 2 intended for analgesia during endoscopic procedures, wherein an aerosol of a local anesthetic is used in the capacity of aerosol.
5. The method according to Claim 4, wherein the dilation of the cavity is performed with the help of an aerosol of a local anesthetic in carbon dioxide.
6. A device for application of medical preparations according to Claims 1 to 5, said device comprising: a vessel for the medical preparation, the said vessel being isolated from the environment and having an inlet pipe to receive the pressurized expanding gas, and an outlet pipe, a means for preparing an aerosol of the medical preparation, having a range of particle dimensions of 1 to 10 μm, directly in the vessel, the said outlet pipe intended for passing the aerosol from the vessel into a closed visceral cavity, the said device providing for preparing an aerosol with a preset range of particle dimensions under a pressure of 5 to 30 mm Hg in the vessel.
7. The device according to Claim 6, comprising an insufflator of a known design having an inlet to receive the expanding gas and an outlet connected to the inlet pipe of the vessel.
8. The method and the device according to any of Claims 1 to 7 as described above, with reference to the attached specification.
PCT/IL2003/000949 2002-11-13 2003-11-12 Method and device for application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum WO2004043274A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003279504A AU2003279504A1 (en) 2002-11-13 2003-11-12 Method and device for application of medical preparations to surfaces of the closed visceral cavities, for example, to the pleura or the peritoneum

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL15281302A IL152813A0 (en) 2002-11-13 2002-11-13 Method and device for application of medical preparations to surfaces of the closed visceral cavities for example, to the pleura or the peritoneum
IL152813 2002-11-13

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WO2004043274A1 true WO2004043274A1 (en) 2004-05-27

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006060301A2 (en) 2004-11-30 2006-06-08 Tissue Technologies, Llc Starch derivatives and other derivatives, production processes therefor, and wound healing applications therefor
WO2008117264A1 (en) * 2007-03-28 2008-10-02 Stamford Devices Limited Insufflation of body cavities
WO2011018777A1 (en) * 2009-08-10 2011-02-17 Aerosurgical Limited An insufflation system
WO2012163346A1 (en) * 2011-05-27 2012-12-06 Alexander Hetzel Operating device for use in laparoscopy
US8551036B2 (en) 2009-08-10 2013-10-08 Aerosurgical Limited Insufflation system
US9572596B2 (en) 2011-06-30 2017-02-21 Covidien Lp Applicators for controlled in situ delivery of therapeutic compositions and implants, methods of fabrication and use
WO2021092666A1 (en) * 2019-11-12 2021-05-20 Bhio Supply Indústria E Comércio De Equipamentos Médicos Ltda. Ultrasonic aerosolization platform for the application of therapeutic substances to body cavities
RU2794246C1 (en) * 2022-11-22 2023-04-13 Федеральное государственное бюджетное образовательное учреждение высшего образования "Курский государственный медицинский университет" Министерства здравоохранения Российской Федерации Reusable trocar

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US5558668A (en) * 1994-10-11 1996-09-24 Plc Medical Systems, Inc. Medical laser treatment system and method
US5964223A (en) * 1994-06-17 1999-10-12 Trudell Medical Limited Nebulizing catheter system and methods of use and manufacture
WO2001008573A2 (en) * 1999-07-30 2001-02-08 Ott Douglas E Perforated trocar sleeve and method of use
WO2002085444A1 (en) * 2001-04-24 2002-10-31 Northgate Technologies Inc. Laparoscopic insertion device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5964223A (en) * 1994-06-17 1999-10-12 Trudell Medical Limited Nebulizing catheter system and methods of use and manufacture
US5558668A (en) * 1994-10-11 1996-09-24 Plc Medical Systems, Inc. Medical laser treatment system and method
WO2001008573A2 (en) * 1999-07-30 2001-02-08 Ott Douglas E Perforated trocar sleeve and method of use
WO2002085444A1 (en) * 2001-04-24 2002-10-31 Northgate Technologies Inc. Laparoscopic insertion device

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006060301A2 (en) 2004-11-30 2006-06-08 Tissue Technologies, Llc Starch derivatives and other derivatives, production processes therefor, and wound healing applications therefor
WO2008117264A1 (en) * 2007-03-28 2008-10-02 Stamford Devices Limited Insufflation of body cavities
US10166348B2 (en) 2009-08-10 2019-01-01 Aerosurgical Limited Insufflation system
WO2011018777A1 (en) * 2009-08-10 2011-02-17 Aerosurgical Limited An insufflation system
US8551036B2 (en) 2009-08-10 2013-10-08 Aerosurgical Limited Insufflation system
US11738159B2 (en) 2009-08-10 2023-08-29 Aerosurgical Limited Insufflation system
US10888674B2 (en) 2009-08-10 2021-01-12 Aerosurgical Limited Insufflation system
US9629967B2 (en) 2009-08-10 2017-04-25 Aerosurgical Limited Insufflation system
WO2012163346A1 (en) * 2011-05-27 2012-12-06 Alexander Hetzel Operating device for use in laparoscopy
US9511197B2 (en) 2011-05-27 2016-12-06 Alexander Hetzel Surgical device for use in laparoscopy
US9572596B2 (en) 2011-06-30 2017-02-21 Covidien Lp Applicators for controlled in situ delivery of therapeutic compositions and implants, methods of fabrication and use
WO2021092666A1 (en) * 2019-11-12 2021-05-20 Bhio Supply Indústria E Comércio De Equipamentos Médicos Ltda. Ultrasonic aerosolization platform for the application of therapeutic substances to body cavities
RU2794246C1 (en) * 2022-11-22 2023-04-13 Федеральное государственное бюджетное образовательное учреждение высшего образования "Курский государственный медицинский университет" Министерства здравоохранения Российской Федерации Reusable trocar

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AU2003279504A8 (en) 2004-06-03
AU2003279504A1 (en) 2004-06-03
IL152813A0 (en) 2003-06-24

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