CN204133601U - 电外科系统 - Google Patents
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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Abstract
电外科系统包括适合于产生用于治疗组织的电外科能量的发生器。发生器包括供应能量给组织的一个或多个有源输出端子。有源输出端子与一个或多个有源引线可操作地连接。发生器还包括从组织返回能量的一个或多个返回输出端子。返回输出端子与至少一个返回引线可操作地连接。该系统还包括与一个或多个有源引线可操作地连接的电外科仪器和与一个或多个返回引线可操作地连接的一个或多个返回电极。该系统还包括电外科线缆,该电外科线缆包括一个或多个有源引线和一个或多个返回引线。一个或多个有源引线和一个或多个返回引线以双螺旋方式缠绕,从而使得沿着线缆的电场沿其长度减缓。
Description
技术领域
本公开涉及用于执行电外科程序的电外科系统和方法。更具体地,本公开涉及用于检测电外科发生器内的直流(DC)特性(例如,电压和电流)并基于测得的DC特性来控制射频治疗能量的输出的系统和方法。
背景技术
电外科手术涉及将高射频电流施加到手术部位,以切割组织、消融组织或使组织凝血。在单极电外科手术中,源或有源电极将射频能量从电外科发生器输送到组织,并且返回电极将电流返回带到发生器。在单极电外科手术中,源电极通常是由外科医生保持的手术仪器的一部分,并且被施加到要治疗的组织。患者返回电极被放置为远离有源电极,以将电流返回带到发生器。
在双极电外科手术中,手持的仪器的电极中的一个电极充当有源电极,另一个电极充当返回电极。返回电极被放置为紧密靠近有源电极,使得在两个电极(例如,电外科钳)之间形成电路。以这样的方式,施加的电流被局限于位于电极之间的身体组织。当这些电极彼此之间充分分离时,电路是开路的,并且因此,身体组织与分离的电极中的任意一个的意外接触防止电流流动。
双极电外科手术通常涉及使用钳。钳是钳子状的仪器,该仪器依赖于它的钳夹之间的机械动作来握持、夹持和约束血管或组织。所谓的“开放式钳(open forceps)”常用于开放式外科程序,而“内窥镜钳”或“腹腔镜钳”,正如其名称所暗示的,用于微创内窥镜外科程序。电外科钳(开放式或内窥镜的)利用机械夹持动作和电能,以在被夹持的组织上实现止血。钳包括对夹持的组织施加电外科能量的电 外科导电表面。通过控制通过导电板施加到组织的电外科能量的强度、频率和持续时间,外科医生可以使组织凝血、烧灼和/或闭合组织。
组织或血管闭合是液化组织中的胶原、弹性蛋白和基质的过程,以便它们改性成在相对的组织结构之间具有显著减小的分界的熔融物。烧灼涉及使用热破坏组织,并且,凝血是使组织脱水的过程,其中,组织细胞被破裂和干燥。
组织闭合程序涉及不仅仅使组织烧灼或凝血以产生有效的闭合;所述程序涉及对各种因素的精确控制。例如,为了影响血管或组织中的合适的闭合,已经确定了两种主导的机械参数必须被精确地控制:施加到组织的压力;以及电极之间的间隙距离(例如,相对的钳夹部件或相对的闭合表面之间的距离)。另外,必须在受控的条件下对组织施加电外科能量,以确保产生有效的血管闭合。
上面概述的电外科程序可以在基于反馈的控制系统中利用各种组织和能量参数。继续需要改进传感器以及用于处理感测信号的系统和方法。
实用新型内容
在一个实施例中,本公开提供一种电外科系统。该系统包括:直流电源,被配置为供应直流电;射频输出级,与直流电源电耦合,该射频输出级被配置为将直流电变换为射频波形;直流电压传感器,与直流电源耦合,并且被配置为测量直流电压;直流电流传感器,与直流电源耦合,并且被配置为测量直流电流;以及控制器,与直流电压传感器和直流电流传感器耦合,该控制器被配置为基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
在另一个实施例中,本公开提供一种用于输送射频能量给组织的方法。该方法包括:在直流电源处产生直流电;在与直流电源电耦合的射频输出级处将直流电变换为射频波形;测量被供应到射频输出级的直流电的电压和电流;以及基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
在又一实施例中,公开一种电外科系统。该系统包括:电外科发生器,具有被配置为供应直流电的直流电源;直流电压传感器,与直流电源耦合,并且被配置为测量直流电压;直流电流传感器,与直流电源耦合,并且被配置为测量直流电流;以及控制器,与直流电压传感器和直流电流传感器耦合。该系统还包括与电外科发生器耦合的电外科仪器,电外科仪器包括与直流电源电耦合的射频输出级,射频输出级被配置为将直流电变换为射频波形;其中,控制器被配置为基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
附图说明
这里参照附图描述本公开的各种实施例,在附图中:
图1是根据本公开的电外科系统的实施例的示意性框图;
图2是根据本公开的电外科发生器的前视图;
图3是根据本公开的图2的电外科发生器的示意性框图;
图4是根据本公开的方法的流程图;以及
图5是根据本公开的电外科系统的实施例的示意性框图。
具体实施方式
在下文中将参照附图描述本公开的特定实施例。在下面的描述中,为了避免在不必要的细节中使本公开模糊,不详细地描述公知的功能和结构。
根据本公开的发生器可以执行单极和/或双极电外科程序,包括血管闭合程序。发生器可以包括用于与各种电外科仪器(例如,单极仪器、返回电极、双极电外科钳、脚踏开关等)通过接口连接的多个输出端。此外,发生器包括被配置为产生特别适合于多种电外科模式(例如,切割、混合、分割等)和程序(例如,单极、双极、血管闭合)的射频能量的电路系统。在实施例中,发生器可以被嵌入、集成或以另外的方式耦合到电外科仪器,提供全合一(all-in-one)电外科设备。
图1是根据本公开的双极和单极电外科系统1的示意图。该系统1可以包括具有用于治疗患者的组织的一个或多个电极(例如,电外科切割探头、(一个或多个)消融电极等)的一个或多个单极电外科仪器2。经由与发生器200的有源端子230(图3)连接的供应线4由发生器200供应电外科能量给仪器2,从而允许仪器2使组织凝血、消融和/或以另外的方式治疗组织。经由在发生器200的返回端子32(图3)处的返回线8,通过返回电极6将能量返回到发生器200。系统1可以包括多个返回电极6,其被设置在患者上,以通过使与患者的总接触面积最大来使组织损伤的机会最少。另外,发生器200和返回电极6可以被配置为用于监测所谓的“组织与患者”接触,以确保在其间存在充分的接触,以进一步使组织损伤的机会最少。
系统1还可以包括具有用于治疗患者的组织的一个或多个电极的双极电外科钳10。电外科钳10包括壳体11和设置在轴12的远端处的相对的钳夹部件13和15。钳夹部件13和15分别具有设置在其中的一个或多个有源电极14和返回电极16。有源电极14和返回电极16经由线缆18与发生器200连接,线缆18包括分别与有源端子和返回端子230、232(图3)耦合的供应线和返回线4、8。电外科钳10经由设置在线缆18的端部处的插头在具有到有源端子和返回端子230、232(例如,引脚)的连接的连接器处与发生器200耦合,其中,插头包括来自供应线和返回线4、8的触点,如下面更加详细地描述的。
参照图2,示出发生器200的前面240。发生器200可以是任何合适的类型(例如,电外科、微波等),并且可以包括多个连接器250-262,以适应各种类型的电外科仪器(例如,电外科钳10等)。连接器250-262可以包括各种检测装置,所述检测装置可以读取(例如,扫描、解码等)被编码或者以另外的方式被记录在仪器的插头或线缆上或内的识别信息。连接器250-262被配置为对在与特定仪器的操作参数相对应的插头上编码的信息进行解码,从而允许发生器200基于连接的仪器来预设能量输送设置。在实施例中,数据可被编码在条形码、电部件(例如,电阻器、电容器等)、RFID芯片、磁体、非暂态存储装置 (例如,非易失性存储器、EEPROM等)中,然后,可以将它们耦合或集成到插头中。对应的检测装置可以包括,但不限于,条形码读取器、电传感器、RFID读取器、霍尔效应传感器、存储器读取器等,以及被配置为对数据解码的任何其他合适的解码器。
发生器200包括用于向用户提供各种输出信息(例如,强度设置、治疗完成指示器等)的一个或多个显示屏幕242、244、246。屏幕242、244、246中的每一个与对应的连接器250-262相关联。发生器200包括用于控制发生器200的合适的输入控制器(例如,按钮、激活器、开关、触摸屏等)。显示屏幕242、244、246也被配置为显示用于电外科仪器(例如,电外科钳10等)的对应的菜单的触摸屏。然后,用户通过简单地触摸对应的菜单选项来进行输入。
屏幕242控制单极输出端和与连接器250和252连接的装置。连接器250被配置为与单极电外科仪器(例如,电外科笔)耦合,并且,连接器252被配置为与脚踏开关(未示出)耦合。脚踏开关提供另外的输入(例如,发生器200的复制输入)。屏幕244控制单极和双极输出端以及与连接器256和258连接的装置。连接器256被配置为与其他的单极仪器耦合。连接器258被配置为与双极仪器(未示出)耦合。
屏幕246控制由可以插入到连接器260和262中的钳10执行的双极闭合程序。发生器200通过适合于闭合由钳10握持的组织的连接器260和262输出能量。特别地,屏幕246输出允许用户输入用户定义的强度设置的用户界面。用户定义的设置可以是允许用户调整一个或多个能量输送参数(例如,功率、电流、电压、能量等)或者闭合参数(例如,压力,闭合持续时间等)的任何设置。用户定义的设置被发送到控制器224,在控制器224中,设置可以被保存在存储器226中。在实施例中,强度设置可以是数字标度,例如,从1到10或者1到5。在实施例中,强度设置可以与发生器200的输出曲线相关联。强度设置可以是对于使用的每一个钳10特定的,从而各种仪器向用户提供对应于钳10的特定的强度标度。
图3示出被配置为输出电外科能量的发生器200的示意框图。发生器200包括控制器224、电源227和输出级228。电源227可以是直流高压电源,并且与AC源(例如,线电压)连接,并且提供高压DC功率给输出级228,然后,输出级228将高压DC功率转换为治疗能量(例如,超声、电外科或微波),并且,将该能量输送到有源端子230。能量经由返回端子232被返回到此。输出级228被配置为在多种模式中操作,在所述模式期间,发生器220输出具有特定的占空比、峰值电压、波峰因数等的对应的波形。在另一个实施例中,发生器200可以基于其他类型的合适的电源拓扑。
控制器224包括与存储器226可操作地连接的微处理器225,该存储器226可以包括暂态型存储器(例如,RAM)和/或非暂态型存储器(例如,闪存介质,盘介质等)。微处理器225包括与电源227和/或输出级228连接的输出端口,从而允许微处理器225根据开和/或闭控制环路方案中的任意一种控制发生器200的输出。本领域的技术人员将会认识到,微处理器225可以由适合于执行本文讨论的计算的任何逻辑处理器(例如,控制电路)来替代。
闭环控制方案是反馈控制环路,其中,多个传感器测量多种组织和能量特性(例如,组织阻抗、组织温度、输出功率、电流和/或电压等),并且提供反馈给控制器224。控制器224然后发送信号给电源227和/或输出级228,然后,电源227和/或输出级228分别调整DC和/或电源。控制器224也从发生器200、仪器2和/或钳10的输入控制接收输入信号。控制器224利用输入信号来调整由发生器200输出的功率,并且/或者对其执行其他的控制功能。
根据本公开的发生器200包括RF电压传感器300和RF电流传感器302。RF电压传感器300与有源端子230和返回端子232耦合,并且提供对由输出级228供应的RF电压的测量。RF电流传感器302与有源端子230耦合,并且提供对由输出级228供应的RF电流的测量。RF电压传感器230和RF电流传感器232可以是任何合适的RF电压/电流传感器,其包括,但不限于,传感变压器、传感电阻器、传 感电容器和其组合。RF电压传感器300和RF电流传感器302分别提供感测到的RF电压和电流信号给控制器224,然后,控制器224可以响应于感测到的RF电压和电流信号来调整电源227和/或输出级228的输出。
根据本公开的发生器200还包括DC电压传感器304和DC电流传感器306。为了简单起见,电源227被示意性地示出为经由连接301与输出级228耦合。本领域的技术人员将会认识到,电源227通过其正和负端子(未示出)与输出级228连接。DC电压传感器304和DC电流传感器306与连接301耦合,并且提供对通过电源227供应到输出级228的DC电压和电流的测量。DC电压传感器304和DC电流传感器306可以是任何合适的DC电压/电流传感器,其包括,但不限于,霍尔效应传感器、传感电阻器和其组合。DC电压传感器304和DC电流传感器306分别提供感测到的DC电压和电流信号给控制器224,然后,控制器224可以响应于感测到的DC电压和电流信号来调整电源227和/或输出级228的输出。
输出级228可以被实现为任何合适的RF逆变电源拓扑结构,其包括,但不限于,半桥、全桥、推挽(push pull)以及它们的组合。在实施例中,输出级228的输出可以是通过改变电源227的DC电压而产生的任何振幅调制的RF波形。发生器200基于通过DC电压传感器304和DC电流传感器306以及/或者RF电压传感器300和RF电流传感器302中的任意一个测得的感测信号来调整输出级228的RF输出。
控制器224包括将感测到的DC电压和电流信号与感测到的RF电压和电流信号相关的传递函数。特别地,输出级228的操作参数可以被表达为传递函数,可以使用该传递函数来基于感测到的DC电压和电流信号来计算输出的RF电压和电流。可以使用传递函数来补偿在输出级228和负载之间引入的损耗和/或失真。这些不理想的行为可能受多种不同因素的影响,这些因素包括输入电压、输入电流、输出电压、输出电流和负载阻抗。表征这些行为的一种方式可以包括在不 同的开环操作点处分析发生器200,同时监测输入和/或输出特征,即,DC电压和电流以及RF输出电压和电流。然后,可以使用该数据来产生多项式曲线拟合和/或分段线性曲线。然后,将这些曲线转换到传递函数,该传递函数描述DC电压和电流与输出RF电压和电流之间的关系,从而提供传递函数。可以在发生器200的初始设置期间逐个单元地或者对于任何特定的块(lot)执行获得传递函数的过程,然后,该过程被预编程并存储在存储器226中。
因此,控制器224基于感测到的DC电压和电流信号来确定输出RF电压和电流。然后,可以将计算出的输出RF电压和电流与实际感测到的RF电压和电流进行比较作为冗余测量(例如,以检验传感器300、302、304和306的功能)。
图4示出根据本公开的方法。在步骤400中,由电源227输出的DC电压和电流分别由DC电压传感器304和DC电流传感器306测量。测得的传感器信号被发送到控制器224。在步骤402中,控制器224基于感测到的DC电压和电流值来计算输出RF电压和电流。特别地,控制器224(例如,微处理器225)利用将感测的输出DC值与输出RF值相关的传递函数。
在步骤401中,由输出级228输出的RF电压和电流分别由RF电压传感器300和RF电流传感器302测量。测得的传感器信号被发送到控制器224。在步骤403中,控制器224基于感测到的DC电压和电流值来将测得的RF输出值与计算出的RF电压和电流进行比较。可以使用计算出的RF值与测得的RF值之间的差来确定发生器200的功能性,从而,如果测得的和计算出的RF值之间的差改变预定的量,则发出导致停止和/或调整功率输出的错误。触发错误条件的计算出的RF值与测得的RF值之间的差可以为约10%及以上,在实施例中,为约20%及以上。
在步骤405中,控制器224可以利用该比较来确定在输送输出功率时的剂量误差。如本文中使用的术语“剂量误差”表示预设的输出功率(例如,用户或发生器选择的)和输送的输出功率之间的差。该 差可能是由于各种因素(例如,故障发电部件,传感器等)引起的。剂量误差,例如基于测得的DC值和/或实际测得的RF值的预设的功率和计算出的RF值之间的差,可以为约10%及以上,在实施例中,为约20%及以上。剂量误差计算确定传感器300、302、304和306的功能性(或者故障)。因此,如果剂量误差在期望的限值以外,则在步骤405中,控制器224可以发出警报并且/或终止发生器200的输出。
在步骤404中,控制器224发送信号给电源227和/或输出级228,以响应于用于控制发生器200的输出的算法或其他指令(包括在步骤403和405中计算出的差)来调整其输出。
图5示出电外科系统500的另一个实施例。系统500包括与上面关于图2和3描述的发生器200相似的发生器502。发生器502与钳10耦合,仅仅出于图示的目的而示出该钳10,并且,可以利用任何其他的电外科仪器。系统500将输出级228与发生器502去耦合。输出级228反而被设置在钳10的壳体11中。发生器502也不包括RF电压传感器300和RF电流传感器302,从而允许使输出级228显著地小型化并将其重新定位到壳体11中。这显著地简化了用于电外科系统500的硬件设计。
基于测得的DC信号计算输出RF值也简化了电外科发生器的硬件和软件要求,其通常执行密集的均方根计算。此外,该配置避免了在发生器的高电压侧处包括传感器的需要,从而允许以较低的额定电压来使用各部件。
根据本实用新型的一个方面,提供一种用于输送射频能量给组织的方法,该方法包括:在直流电源处产生直流电;在与直流电源电耦合的射频输出级处将直流电变换为射频波形;测量被供应到射频输出级的直流电的电压和电流;以及基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
在一种实施方式中,所述方法还包括:测量射频波形的电压和电流。
在一种实施方式中,所述方法还包括:将基于直流电的测得的电 压和电流计算出的射频波形的电压和电流与射频波形的测得的电压和电流进行比较。
在一种实施方式中,所述方法还包括:基于所述比较来计算剂量误差,其中,剂量误差分别是射频波形的计算出的电压和电流与射频波形的测得的电压和电流之间的差。
在一种实施方式中,所述方法还包括:基于剂量误差执行发出警报、调整或终止电源和射频输出级中的至少一个的输出中的至少一个。
在一种实施方式中,所述确定包括使用传递函数基于直流电的测得的电压和电流来计算射频波形的电压和电流中的至少一个,所述传递函数将直流电压和直流电流与射频波形的电压和电流中的至少一个相关。
虽然在附图中示出了和/或在本文中讨论了本公开的几个实施例,但是本公开不应当局限于此,因为本公开应当为如本领域将允许的范围那样宽,并且应当以同样的方式来阅读本说明书。因此,上面的描述不应当被解释为限制性的,而仅仅作为特定实施例的示例。本领域的技术人员将在所附权利要求的范围和精神内设想到其他的修改。
Claims (14)
1.一种电外科系统,包括:
被配置为供应直流电的直流电源;
与直流电源电耦合的射频输出级,该射频输出级被配置为将直流电变换为射频波形;
与直流电源耦合并且被配置为测量直流电压的直流电压传感器;
与直流电源耦合并且被配置为测量直流电流的直流电流传感器;以及
与直流电压传感器和直流电流传感器耦合的控制器,该控制器被配置为基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
2.根据权利要求1所述的电外科系统,其中,射频输出级包括至少一个有源输出端子和至少一个返回输出端子。
3.根据权利要求2所述的电外科系统,还包括:
射频电压传感器,与所述至少一个有源输出端子和所述至少一个返回输出端子耦合,并且被配置为测量所述至少一个有源输出端子和所述至少一个返回输出端子之间的射频电压;以及
射频电流传感器,与所述至少一个有源输出端子耦合,并且被配置为测量通过所述至少一个有源输出端子的射频电流。
4.根据权利要求3所述的电外科系统,其中,控制器被配置为将射频波形的计算出的电压和计算出的电流中的至少一个与射频波形的测得的电压和测得的电流中的至少一个进行比较。
5.根据权利要求4所述的电外科系统,其中,控制器被配置为基于所述比较来确定剂量误差。
6.根据权利要求1所述的电外科系统,其中,射频输出级被设置在手持电外科仪器的壳体内。
7.根据权利要求1所述的电外科系统,其中,所述手持电外科仪器是电外科钳,该电外科钳包括具有设置在其远端处的端部执行器组件的至少一个轴部件,该端部执行器组件包括能从相对于彼此处于分开关系的第一位置移动到至少一个后续位置的两个钳夹部件,其中,所述钳夹部件协作来握持其间的组织,所述钳夹部件中的每一个包括导电闭合表面。
8.根据权利要求1所述的电外科系统,其中,控制器使用传递函数基于直流电压和直流电流来确定射频波形的电压和电流中的至少一个,所述传递函数将直流电压和直流电流与射频波形的电压和电流中的至少一个相关。
9.一种电外科系统,包括:
电外科发生器,该电外科发生器包括:
被配置为供应直流电的直流电源;
与直流电源耦合并且被配置为测量直流电压的直流电压传感器;
与直流电源耦合并且被配置为测量直流电流的直流电流传感器;以及
与直流电压传感器和直流电流传感器耦合的控制器;以及
与电外科发生器耦合的电外科仪器,该电外科仪器包括与直流电源电耦合的射频输出级,该射频输出级被配置为将直流电变换为射频波形,其中,控制器被配置为基于直流电的测得的电压和电流来确定射频波形的电压和电流中的至少一个。
10.根据权利要求9所述的电外科系统,其中,电外科仪器是电外科钳,该电外科钳包括具有设置在其远端处的端部执行器组件的至少一个轴部件,该端部执行器组件包括能从相对于彼此处于分开关系的第一位置移动到至少一个后续位置的两个钳夹部件,其中,所述钳夹部件协作来握持其间的组织,所述钳夹部件中的每一个包括导电闭合表面。
11.根据权利要求10所述的电外科系统,其中,射频输出级包括至少一个有源输出端子和至少一个返回输出端子,所述至少一个有源输出端子和至少一个返回输出端子中的每一个与导电闭合表面中的一个耦合。
12.根据权利要求11所述的电外科系统,还包括:
射频电压传感器,与所述至少一个有源输出端子和所述至少一个返回输出端子耦合,并且被配置为测量所述至少一个有源输出端子和所述至少一个返回输出端子之间的射频电压;以及
射频电流传感器,与所述至少一个有源输出端子耦合,并且被配置为测量通过所述至少一个有源输出端子的射频电流。
13.根据权利要求12所述的电外科系统,其中,控制器被配置为将射频波形的计算出的电压和计算出的电流中的至少一个分别与射频波形的测得的电压和测得的电流中的至少一个进行比较。
14.根据权利要求13所述的电外科系统,其中,控制器被配置为基于所述比较来确定剂量误差。
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2011
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2012
- 2012-08-22 CN CN201290000738.2U patent/CN204133601U/zh not_active Expired - Lifetime
- 2012-08-22 AU AU2012300446A patent/AU2012300446A1/en not_active Abandoned
- 2012-08-22 WO PCT/US2012/051796 patent/WO2013032799A1/en active Application Filing
- 2012-08-22 EP EP12827271.3A patent/EP2750618B1/en active Active
- 2012-08-22 JP JP2014528452A patent/JP2014529465A/ja active Pending
- 2012-08-22 CA CA2845345A patent/CA2845345A1/en not_active Abandoned
- 2012-08-22 CN CN201420854417.XU patent/CN204734544U/zh not_active Expired - Lifetime
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Cited By (3)
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CN112998840A (zh) * | 2015-09-25 | 2021-06-22 | 捷锐士阿希迈公司(以奥林巴斯美国外科技术名义) | 医疗装置 |
CN111712206A (zh) * | 2017-12-28 | 2020-09-25 | 爱惜康有限责任公司 | 利用单极返回垫电极感测患者的位置和接触以向集线器提供态势感知 |
CN113473935A (zh) * | 2019-03-05 | 2021-10-01 | 直观外科手术操作公司 | 用于医疗设备的辅助功能控制装置以及相关的系统和方法 |
Also Published As
Publication number | Publication date |
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EP2750618A4 (en) | 2015-04-01 |
CN204734544U (zh) | 2015-11-04 |
JP2014529465A (ja) | 2014-11-13 |
US9033973B2 (en) | 2015-05-19 |
AU2012300446A1 (en) | 2014-01-16 |
US20150223865A1 (en) | 2015-08-13 |
CA2845345A1 (en) | 2013-03-07 |
EP2750618B1 (en) | 2017-05-17 |
EP2750618A1 (en) | 2014-07-09 |
US20130053840A1 (en) | 2013-02-28 |
WO2013032799A1 (en) | 2013-03-07 |
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