EP2381856A1 - Anti-backup mechanism - Google Patents

Anti-backup mechanism

Info

Publication number
EP2381856A1
EP2381856A1 EP08879305A EP08879305A EP2381856A1 EP 2381856 A1 EP2381856 A1 EP 2381856A1 EP 08879305 A EP08879305 A EP 08879305A EP 08879305 A EP08879305 A EP 08879305A EP 2381856 A1 EP2381856 A1 EP 2381856A1
Authority
EP
European Patent Office
Prior art keywords
translator
spring
backup
reciprocal
backup mechanism
Prior art date
Legal status (The legal status 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 status listed.)
Withdrawn
Application number
EP08879305A
Other languages
German (de)
French (fr)
Other versions
EP2381856A4 (en
Inventor
Joseph Walter Blake, Iii
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP2381856A1 publication Critical patent/EP2381856A1/en
Publication of EP2381856A4 publication Critical patent/EP2381856A4/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston

Abstract

An anti-backup mechanism for constraining operating components in an operating mechanism to complete first and second strokes of reciprocal linear motion.

Description

ANTI-BACKUP MECHANISM BACKGROUND OF THE INVENTION
The present invention relates to surgical clip appliers embodied as an instrument having a supply of clips for rapidly deploying several clips in closing severed blood vessels and other small fluid carrying ducts in surgical procedures. There are many different designs for surgical clip applicators for a variety of surgical procedures including both open surgery and laparoscopy in which a clipping appliance fits through a trocar tube into a body cavity where the clips are applied.
A surgical clip applicator comprises an operating handle and clip applying mechanism having an operating cycle in which operating levers are squeezed together and released. In this operating cycle, a clip is applied in surgery and the clip applicator jaws are reloaded with a single clip from a clip supply channel for clip application in the next cycle. The applicator provides a moveable clip supply channel containing a line of clips that are released seriatim. The supply channel integrates a clip pusher and an escapement or clip stop spring in a single unit.
A well-known hazard with clip appliers is a condition of releasing a partially closed clip in a surgical site. This condition results when operating handles are given a partial pull or closing and then released. The partial pull crimps but does not close a clip located in the instrument jaws. When partially pulled handles of some older instruments are released, the instrument jaws re-open and the partially closed clip falls from the jaws into the surgical site.
This invention provides an anti-backup mechanism for a repeating multi-clip applier to prevent this operating hazard.
The present invention also relates generally to mechanical devices used in applications other than clip appliers, where such devices have reciprocal motion in one or more components, and where it is desirable for proper operation of the devices to ensure that full reciprocal motion of components occurs in operating or using the devices. The invention ensures that reciprocal translators (i.e., that component of the device which undergoes reciprocal motion) forming part of a mechanical device move through the full reciprocal excursion assigned to the translator as a component of a mechanical device. Specifically, the invention prevents reversal of movement of a reciprocal translator at a point intermediate the full excursion assigned to the translator. If a translator comes to rest at a point intermediate full excursion, the anti-backup device of the invention ensures that the translator is restricted to resuming movement only in the same direction as before it came to rest.
SUMMARY OF THE INVENTION
A preferred embodiment of repeating multi-clip applier according to the present invention comprises an instrument having an operating handle housing and a removable, fully rotatable and disposable clip applying cartridge. A full squeeze and release of operating handles applies a clip to a surgical site and reloads another clip into clip applying jaws of the instrument.
The operating handle housing accommodates an anti-backup mechanism to prevent a partial pull and release of the operating handles to prevent the hazard of a partially closed clip falling into the surgical site. The present invention prevents occurrence of this condition by means of an anti-backup mechanism to ensure that when the appliance handles are pulled, the handles must be given a full pull to execute a complete cycle of the clip applier mechanism. If a partial pull of the appliance handles occurs, the anti-backup mechanism retains or holds the clip applier mechanism in fixed position without possibility of backup or reverse. The anti- backup "hold" is released simply by giving the handles a complete pull. When a partial pull occurs and the anti-backup mechanism holds the clip applying mechanism in place, the instrument jaws remain partially closed holding a partially closed clip thereby preventing the clip from falling into a surgical site. The anti- backup mechanism also functions in the opposite, or release, motion of operating handles. That is, the operating handles when being released are constrained by the anti-backup mechanism to undergo a full release motion. The anti-backup mechanism prevents partial release and re-pull of the trigger thereby to prevent double loading of a clip into the crimping jaws, a condition that would jam the instrument.
Another embodiment of anti-backup mechanism has general application in devices having one or more components undergoing reciprocal motion during operation of the device, where it is desirable to ensure full reciprocal excursion occur in each operating use of the device. For this purpose, an anti-backup spring is held stationary along spaced edges within the device housing, with the spring itself having spring blades positioned in confronting relation across an opening in the spring. A reciprocal translator, passes through the spring opening in sliding engagement with operative edges of the spring blades. In this sliding engagement the spring blades deflect slightly in that direction of motion of the translator. An attempt to reverse motion of the translator to travel in the opposite direction is blocked by the spring blades which cooperate by engaging translator surfaces to prevent reverse motion. So, the only motion available to the translator is full excursion in the original direction to a point where the spring blades disengage the translator. Motion may be reversed only after such disengagement of the spring blades. In like manner, the spring blades engage the translator on the return excursion preventing backup motion until full return excursion occurs.
Full excursion of the translator is selected according to the task it performs as part of an operating mechanism and the translator is confined to that full excursion by locating transition points a specified distance apart on the translator body. At each transition point, the spring blades disengage the translator and motion can be reversed.
Specific examples are included in the following description for purposes of clarity, but various details can be changed within the scope of the present invention.
OBJECTS OF THE INVENTION
An object of the invention is to provide a clip applicator having an operating handle that provides anti-backup linear reciprocating motion of a clip applying cartridge. Another object of the invention is to provide a clip applicator having an operating handle with an anti-backup mechanism that permits full forward and reverse strokes of a clip applying cartridge to avoid the hazard of releasing a partially crimped clip at a surgical site.
Another object of the invention is to provide a clip applicator having an operating handle with an anti-backup mechanism that permits full forward and reverse strokes of a clip applying cartridge to prevent double loading of a clip into the crimping jaws, a condition that would jam the instrument.
Another object of the invention is to provide an anti-backup mechanism having general application in devices with components undergoing reciprocal motion where it is desirable or necessary for the component always to complete full motion in one direction before reversal of motion is possible.
Other and further objects of the invention will become apparent with an understanding of the following detailed description of the invention or upon employment of the invention in practice.
BRIEF DESCRIPTION OF THE DRAWING
A preferred embodiment of the invention has been chosen for detailed description to enable those having ordinary skill in the art to which the invention appertains to readily understand how to construct and use the invention and is shown in the accompanying drawing in which:
Figure 1 is a side elevation view of the applicator of Figure 1 with the operating handle housing partially in section and with handles in release position.
Figure 2 is a side elevation view of the applicator of Figure 1 with the operating handle housing partially in section and with handles in pull position. Figure 3 is a side elevation of a rotary translator. Figure 4a is a side elevation view of the rotary drum. Figure 4b is a longitudinal section view of the rotary drum of Figure 4a. Figure 5 is a front elevation of anti-backup disc. Figures 6 a-g are sequential views of anti-backup mechanism with disc in (a) rear groove, (b)&(c) between grooves, (d) in front groove, (e)&(f) between grooves, and (g) again in rear groove, and with arrows indicating directions of permitted and prevented movement of operating handle and cartridge mechanism.
Figure 7 is an exploded view of components of a modified embodiment of anti-backup mechanism according to the invention. Figure 8 is a front elevation view of anti-backup spring of the embodiment of Figure 7.
Figure 9 is a front elevation view of anti-backup spring of the embodiment of Figure 7 showing the position of a reciprocal translator. Figures 10a-e are sequential views of the anti-backup mechanism of Figures undergoing full reciprocal motion in relation to the anti-backup spring.
Figures 11 and 12 are perspective views of the mechanism of Figure 7 showing positions of spring and spring blades and reciprocal translator in travel in opposite directions.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to the drawing, a preferred embodiment of the repeating multi-clip applier 10 comprises operating handle housing 12 and clip applicator cartridge 14.
The operating handle housing 12 shown in Figures 1-2 comprises handle members including a depending grip 12c, a center section defining a central chamber 12e, and a forward cylindrical portion 12f defining a forward chamber 12g.
A trigger 18 for actuating applier mechanisms is mounted on the housing for pivotal movement about axis A-A1, normal to Figure 1. The trigger includes a depending grip portion 18. The trigger when pulled transmits motion to the clip cartridge mechanism (not shown) through the intermediation of fixed translator slide 20 and a rotary translator 22. The trigger acts against the forward bias of bar spring 16 with its end 16a held by translator slide recess 20a.
The rotary translator 22 (Figs 1 , 2, and 3) forms a subassembly with an anti- backup mechanism 24, a rotatable drum 26, and a thumb wheel hub 28 which subassembly interconnects the fixed translator 20 and the clip cartridge 14 for performing the functions of transmitting reciprocating rectilinear motion with a fixed excursion, accommodating rotary motion of the clip cartridge, enabling mounting and disconnecting of the clip cartridge from the operating handle, and providing an anti- backup capability for the operating handle and cartridge mechanism.
The rotary drum subassembly 22, 24, 26 comprises the rotary translator 22 positioned axially within the drum 26. An anti-backup disc 24 (Figs 2, 3 and 5), defined by an open center 24a and extending radially from the center to define a plurality of inwardly directed spring fingers 24c, fits onto the rotary translator 22 and is assembled to the enlarged rear end flange 26h of the rotary drum by means of a drum cap 26i (Figs. 1 and 2). In normal position of the clip applicator with the trigger released, the anti-backup spring fingers 24c are located in the rear anti-backup groove as shown in Fig. 1.
The rotary drum subassembly is assembled into the forward chamber 12g of the operating handle housing. The center section 22c (Fig 3) of the rotary translator shaft has spaced anti-backup grooves 22d, 22e with the distance between the grooves being approximately equal to the distance of reciprocating rectilinear motion of the fixed translator and equal to the rectilinear excursion of the clip applicator mechanism. The operation of the anti-backup mechanism is illustrated in Figures 6a-g.
In the mechanism position of Figs 1 and 6a, the handle trigger 18 is in released position with the anti-backup disc 24 in registry with the rear anti-backup groove 22d of the rotary translator 22. When the trigger is pulled (Fig 2) (for crimping and applying a clip at a surgical site), the rotary translator moves in the direction of arrow 6a. As the rotary translator continues movement, the spring fingers 24c of the disc engage the outer surface 22c of the rotary translator in the manner shown in Figures 6b-c. The anti-backup mechanism applied by the canted spring fingers 24c (Figs 6b-c) to the outer surface 22c of the rotary translator permits continued movement in the direction of arrow 6a and prevents movement in the opposite direction of arrow 6b. If a surgeon releases the trigger with less than a full pull stroke leaving anti-backup components in the position of Fig 6c, for example, the anti- backup mechanism holds the rotary translator in position against the bias of bar spring 16 which tends to return the trigger to release position. In this Fig 6c hold position, the applicator jaws retain the partially crimped clip preventing it from falling into a surgical site. A continuing pull of the trigger (in direction of arrow 6a) moves the rotary translator through the position of Figure 6c to the position of Figure 6d in which the spring fingers 24c enter the forward groove 22e.
In this position (Fig 6d), the rotary translator may now be moved forward (by releasing the trigger and by force of return spring 16) in the direction of arrow 6c. In this forward movement, the spring fingers 24c are effective to allow continued forward movement while preventing movement in the direction of arrow 6e. If the handle trigger is held by a surgeon with components as in Fig 6f, the anti- backup mechanism will prevent the surgeon from pulling the trigger in the direction of arrow 6e. The surgeon must allow full release of the trigger to component position of Figure 6g. Direction of movement can be changed again when the spring fingers 24c enter the rear groove 22e as in Figure 6g.
A pull on the trigger against the force of bar spring produces unitary rearward rectilinear movement of the fixed translator, the rotary translator passing through the stationary spring fingers of the anti-backup disc, and the puller bar emerging from within the cartridge casing until the trigger and fixed translator reach the end of travel and with the anti-backup disc spring fingers positioned at the front groove. The rearward excursion is now complete, and when the trigger is released, the bar spring urges the fixed translator forward until all components reach normal position.
In the event a pull on the trigger, is released without reaching the full extent of rectilinear motion, the anti-back up spring fingers will not have reached their front groove remaining instead in contact with the outer surface of the rotary translator. The spring fingers in contact with outer surface function as a brake against the action of the bar spring tending to force the released components to return to normal position. In this partial pull condition of the trigger a clip has been crimped in the instrument jaws which clip will fall out of the jaws into a surgical site if the jaws reopen by return of the mechanism to normal position. So the anti-backup mechanism retains the instrument in "partial pull position" against the normalizing force of the bar spring and most importantly prevents fallout from the jaws of a partially crimped clip. The anti-backup device retaining action is removed simply by means of a full pull on the trigger causing the spring fingers to enter the forward groove where they can go "over center" thereafter permitting the rotary translator to pass through the spring fingers. It is to be noted that the anti-backup mechanism is effective in both directions. The anti-backup mechanism has effect when the trigger is released after a full pull so that if there is a "partial release" of the trigger, the trigger must nonetheless return to normal position with full release of the trigger before allowing the trigger to be pulled. The design requirement for full release achieved by the anti-backup mechanism prevents double loading of clips into cartridge jaws.
It is a further aspect of the anti-backup mechanism that the cartridge may be rotated on the B-B1 axis as the anti-backup mechanism holds the instrument in partial pull position enabling a surgeon to adjust cartridge or jaw position even after a partial pull has occurred.
A modified embodiment of the invention is shown in Figures 7-12 wherein the anti-backup mechanism 30 assembly comprises a reciprocal translator 32, an anti- backup spring 34 and a stationary mounting pocket 36.
The reciprocal translator 32 is an active component of an operating mechanism (not shown) and is assigned a task in the mechanism which is accomplished by back and forth movement or excursion over a fixed distance. Motion is imparted to the reciprocal translator either directly or indirectly by means forming part of the operating mechanism, usually a manually operated component whose action may be stopped in mid-stroke by its operator. A typical operating mechanism of this sort is a surgical instrument in the hands of a surgeon performing a medical procedure.
The translator has a block body with rectangular cross-section and generally planar parallel opposite sides 32a-b, and 32c-d (Figs 11-12). Opposite sides (e.g., 32c and 32d) have transition points 32e defined by first and second sets of recesses 32f in their surfaces. A recess may be aligned grooves 32h (one set) or shoulders 32i (another set) on opposites sides of the translator. The transition points on the translator are spaced apart a distance equal to the excursion assigned to the translator as a component of the operating mechanism. As will be fully understood with description of the anti-backup spring next below, the transition points allow for spring action on the translator to be neutralized as the spring registers with the transition points.
The anti-backup spring 34 preferably comprises a rectangular sheet of spring steel with its interior portion removed as by metal stamping to define an interior opening 34f leaving a unitary body with side struts 34a-b and end struts 34c-d. Spring blades 34e integral with the end struts project inwardly of the spring interior opening 34f with spring blade edges 34g in generally parallel, confronting relation. As shown in Fig 9, the spring interior 34f accommodates a cross-section of the body of the reciprocal translator for both reciprocal movement as well reversal of movement. In Fig 9 the spring blades are shown in position at translator transition points 32e. The spring may be fabricated of any suitable material that can be formed into the spring shape shown in Figures 8, 11 and 12 and perform the spring action required of blades 34e. The translator and spring are assembled with a support housing preferably in the form of stationary mounting pocket 36 situated within a host operating mechanism. The mounting pocket is a U-shape housing 36a defining a pocket or chamber 36b between confronting arms 36c for receiving the reciprocal translator body. Each arm has a recess in the form of a V-shape channel 36d with opposed channels being aligned for receiving and holding anti-backup spring 34 by their side struts 34a-b as shown in Figure 10. Referring to Fig 7, the mechanism is assembled by inserting spring 34 into channels 36d and by passing the translator through the spring interior 34f until spring blades 34e register with transition grooves 32h.
Figures 10a-e illustrate operation of the anti-backup spring mechanism from: stop (Fig 10) with spring blades 34e in registry with transition shoulder
32i; motion to the right (Figs 10b and 12) where blade edges 34e engage the sides 32c-d of the translator and deflect in the direction of motion allowing the translator to continue moving right and preventing by digging-in engagement with sides 32c-d any reverse movement of the translator; registry (Fig 10c) of spring blade edges 34e with transition groove 32h where the restraining effect of the blade edges is neutralized and rightward movement of the translator stops; reversal of movement (Figs 10d and 11 ) where the spring blades now bow in the direction of travel of the translator; and stop (Fig 10e) where the blades again register with transition shoulders 32i.
Various changes may be made to the structure embodying the principles of the invention. The foregoing embodiments are set forth in an illustrative and not in a limiting sense. The scope of the invention is defined by the claims appended hereto.

Claims

1. An anti-backup mechanism for a device having linear reciprocating motion through forward and reverse strokes over a distance defining a fixed excursion, the anti-backup mechanism comprising a reciprocal translator having opposite generally parallel sides, the opposite sides having first and second spaced transition points formed into the sides at a distance substantially equal to the fixed excursion, an anti- backup spring having an interior opening, the spring further having opposed blades projecting into the opening with blade edges in confronting relation, a support housing having aligned recesses for receiving and holding the spring in operative position to receive the reciprocal translator in the interior opening whereby movement of the translator is confined to full fixed excursion between first and second transition points.
2. An anti-backup mechanism for a device having linear reciprocating motion through forward and reverse strokes over a distance defining a fixed excursion, the anti-backup mechanism comprising a reciprocal translator having opposite generally parallel sides, the opposite sides having first and second spaced transition points formed into the sides at a distance substantially equal to the fixed excursion, an anti- backup spring having an interior opening, the spring further having opposed blades projecting into the opening with blade edges in confronting relation, a U-shape support housing defining a pocket for accommodation the translator in reciprocal motion through said fixed excursion, the support housing having aligned recesses for receiving and holding the spring in operative position to receive the reciprocal translator in the interior opening of the spring whereby movement of the translator is confined to full fixed excursion between first and second transition points.
3. An anti-backup mechanism for a device having linear reciprocating motion through forward and reverse strokes over a distance defining a fixed excursion, the anti-backup mechanism comprising a reciprocal translator having opposite generally parallel sides, the opposite sides having first and second spaced transition points formed into the sides at a distance substantially equal to the fixed excursion, an anti- backup spring having an interior opening, the spring further having opposed blades projecting into the opening with blade edges in confronting relation, a U-shape support housing defining a pocket for accommodation the translator in reciprocal motion through said fixed excursion, the support housing having V-shape recesses aligned on opposite sides of the pocket for receiving and holding the spring in operative position to receive the reciprocal translator in the interior opening of the spring whereby movement of the translator is confined to full fixed excursion between first and second transition points.
4. An anti-backup mechanism as defined in claim 3 in which first and second spaced transition points are recesses in the sides of the translator.
5. An anti-backup mechanism as defined in claim 4 in which first one of the recesses is a shoulder, and the other recess is a channel formed by adjacent shoulders.
6. An anti-backup mechanism as defined in claim 4 in which the shoulder recess is at an end of the translator first inserted into the pocket.
EP08879305.4A 2008-12-30 2008-12-30 Anti-backup mechanism Withdrawn EP2381856A4 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2008/014118 WO2010077228A1 (en) 2008-12-30 2008-12-30 Anti-backup mechanism

Publications (2)

Publication Number Publication Date
EP2381856A1 true EP2381856A1 (en) 2011-11-02
EP2381856A4 EP2381856A4 (en) 2014-09-03

Family

ID=42310019

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08879305.4A Withdrawn EP2381856A4 (en) 2008-12-30 2008-12-30 Anti-backup mechanism

Country Status (6)

Country Link
EP (1) EP2381856A4 (en)
JP (1) JP5480289B2 (en)
KR (1) KR20110132321A (en)
CN (1) CN102271594B (en)
CA (1) CA2750168A1 (en)
WO (1) WO2010077228A1 (en)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9707005B2 (en) 2014-02-14 2017-07-18 Ethicon Llc Lockout mechanisms for surgical devices
CN112869818B (en) * 2021-02-26 2022-01-28 苏州法兰克曼医疗器械有限公司 Anastomat with anti-error triggering safety mechanism

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5271527A (en) * 1992-04-02 1993-12-21 Habley Medical Technology Corporation Reusable pharmaceutical dispenser with full stroke indicator
WO1995023557A1 (en) * 1994-03-01 1995-09-08 United States Surgical Corporation Surgical stapler with anvil sensor and lockout
US20030135224A1 (en) * 2002-01-17 2003-07-17 Blake Joseph W. Repeating multi-clip applier

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2750943A (en) * 1954-12-21 1956-06-19 American Home Prod One-hand veterinary syringe
US2914792A (en) * 1957-04-19 1959-12-01 Jr Donald K Campbell Door check
US5289963A (en) * 1991-10-18 1994-03-01 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5271527A (en) * 1992-04-02 1993-12-21 Habley Medical Technology Corporation Reusable pharmaceutical dispenser with full stroke indicator
WO1995023557A1 (en) * 1994-03-01 1995-09-08 United States Surgical Corporation Surgical stapler with anvil sensor and lockout
US20030135224A1 (en) * 2002-01-17 2003-07-17 Blake Joseph W. Repeating multi-clip applier

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO2010077228A1 *

Also Published As

Publication number Publication date
EP2381856A4 (en) 2014-09-03
CN102271594B (en) 2014-07-09
CA2750168A1 (en) 2010-07-08
JP2012513820A (en) 2012-06-21
JP5480289B2 (en) 2014-04-23
KR20110132321A (en) 2011-12-07
WO2010077228A1 (en) 2010-07-08
CN102271594A (en) 2011-12-07

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