The invention relates to a medical instrument system for creating a surgical operating space in the human or animal body by minimally invasive way in operations on the jaw.
Operations which are performed on the lower jaw, in particular in the area of the jaw joint, and which are necessary, for example, as a result of fractures of the lower jaw, have hitherto often had to be carried out by open surgery. In open surgery, extensive skin incisions are made in the patient's cheek anterior to the ear, in order to expose the lower jaw at the operating site and to be able to perform the necessary surgical measures with visual monitoring by the naked eye.
However, open surgery involves an increased potential for complications. The relatively complex approach from outside may, for example, result in injuries to the facial nerve (nervus facialis), which may cause permanent paralysis of the patient's facial muscles. In addition to these health risks, the extensive skin incisions also result in corresponding scar formations which are esthetically detrimental to the patient's appearance.
To move away from the conventional techniques of open surgery and reduce the surgical trauma, DE 197 17 977 A1 describes an instrument system with which operations on the lower jaw or operations on the jaw joint can be performed by minimally invasive surgery. With this known instrument, a bone plate for osteosynthesis can be fitted on the lower jaw in an endoscopic procedure in order to treat a fracture of the lower jaw or of the jaw joint.
The known instrument system comprises an endoscope and an endoscope supplement which receives the endoscope and also the bone plate. The endoscope supplement with the endoscope is introduced through an artificial opening made in the oral cavity on the jaw. The endoscope then permits visual monitoring through the mouth (transorally).
The known instrument system also comprises a connection tube which is introduced into the operating site from outside through the cheek via a separate incision. This connection tube is securely connected to the endoscope supplement in the area of its distal end.
The disadvantage of this known instrument system is that the bone plate is brought to the operating site via the endoscopic supplemental device, which is coupled directly to the endoscope. By this means, the necessary movements for orienting and fixing the bone plate on the jaw area to be fixed lead to an involuntary and constant changing of the viewing field, which makes visual monitoring of the procedure considerably more difficult. Moreover, securing the endoscopic fixture to the connection tube introduced from outside through the cheek requires that the distal end of the connection tube coincides with the distal part of the endoscopic supplemental device and the bone plate, which, because of the two different accesses, namely the access through the mouth and the access through the cheek, is not guaranteed.
A particular disadvantage of the known instrument system, however, is that said known instrument does not permit the creation, at the operating site, of a preformed operating space allowing work to be carried out with a clear view, which is necessary for safely performing the operation.
It is therefore an object of the invention to make available a medical instrument system of the type mentioned at the outsystem, with which a surgical operating space can be created in the human or animal body by minimally invasive way in operations on the jaw, so that operations on the jaw joint can be performed quickly, simply and safely by minimally invasive way involving the least possible trauma.
According to an aspect of the invention, a medical instrument system for creating a surgical operating space in the human or animal body by minimally invasive way in operations on the jaw is provided, comprising a shaft having a distal end and a proximal end, which can be introduced through an incision in the cheek, a plate-shaped flat element which can be introduced through the mouth, and a connection mechanism provided at the distal end of the shaft and on the plate-shaped element and being designed such that the plate-shaped element can be secured on the shaft.
According to another aspect of the invention, a method for creating a surgical operating space by minimally invasive way in operations on the jaw is provided, comprising making a first incision through the cheek anterior to the ear, making a second incision in the mucous membrane adjacent to a site where the operation is to be carried out, introducing a plate-shaped flat element through the mouth und through the second incision between the lower jaw bone and the cheek in the area of the jaw angle, introducing an elongated shaft through the first incision towards the plate-shaped element, connecting a distal end of the shaft with the plate-shaped element, and drawing back the shaft after having being connected with the plate-shaped element to create the operating space between the lower jaw and a side of the plate-shaped element facing the lower jaw.
The instrument system according to the invention makes it possible to create a surgical operating space in the area of the lower jaw by minimally invasive way in operations on the jaw and on the jaw joint, since the shaft is introduced through a minimal incision or puncture in the cheek, and, on the distal end of the shaft lying opposite the jaw, the plate-shaped flat element is secured which has previously been introduced through the mouth to the operating site between the lower jaw and the cheek. By drawing the shaft back out of the incision, the soft tissue of the cheek can now be held away from the jaw, as a result of which, in respect of the operation to be performed, which can then be performed through the mouth, sufficient free operating space is made available for the tools used in the operation. By virtue of the plate-shaped flat configuration of the element, the creation of this operating space also takes place in an atraumatic manner since the element bears flat on the soft tissue, and injuries to the tissue are thereby avoided. In other words, the plate-shaped flat element represents a retractor element which, via the shaft, can be operated from outside the body through a minimal incision.
In a preferred embodiment, the plate-shaped element can be secured on the shaft in such a way that it extends substantially obliquely or transversely with respect to the shaft.
This measure has the advantage that the operating space can in this way be created in an especially efficient manner, because the drawing back of the shaft, in order to draw back the plate-shaped element, can take place substantially perpendicular to the cheek, which makes the handling of the instrument much easier for the physician.
In a further preferred embodiment, the plate-shaped element can be connected to the outer distal end of the shaft from the front.
This measure is of advantage in particular if endoscopic monitoring is also possible through the shaft, as will be described below, since the securing of the plate-shaped element on the shaft can then take place under visual monitoring through the shaft.
In a further preferred embodiment, the shape of the plate-shaped element is adapted to the lower jaw in the area of the jaw angle, the plate-shaped element extending approximately from the jaw base to the jaw joint.
This measure has, on the one hand, the advantage that the plate-shaped element as a whole has a large surface area, as a result of which a larger operating space can be created in the area of the jaw angle because more tissue can be held away from the jaw bone, and, on the other hand, the advantage that if, as is provided for in an embodiment to be described below, a suction and/or irrigation system is present on the plate-shaped element, it is also possible to achieve irrigation and suctioning over a large surface area at the operating site.
In a further preferred embodiment, the connection point between the plate-shaped element and the shaft is located in an edge area of the plate-shaped element, which edge area is adjacent to the jaw joint when the plate-shaped element is in the inserted state.
This measure has the advantage that the incision for introducing the shaft can be made close to the jaw angle, which on the one hand further reduces the risk of injury to the facial nerve. Moreover, this configuration has the advantage that the shaft in the area of the ear does not obstruct the operating steps performed through the mouth.
In a further preferred embodiment, the proximal end of the shaft is provided with a handle which protrudes laterally from the shaft.
The provision of a handle has the advantage that the tensile forces needed to draw back the tissue to create the operating space can be applied by the operator with sufficient manual force. The handle can in this case advantageously be connected to the shaft in such a way that the handle points toward the patient's temple in its intended use.
In a further preferred embodiment, the shaft is designed as the shaft of an endoscope.
The advantage of this is that the shaft not only satisfies the function of creating the operating space, but at the same time also the function of visual monitoring in the sense of endoscopic viewing of the operating site. In the aforementioned case, namely that the shaft is the shaft of an endoscope, the plate-shaped element can correspondingly be secured on the distal end of the endoscope.
In a preferred alternative, however, the shaft is made hollow as an insertion aid for insertion of an endoscope.
This configuration also affords the advantage that viewing is permitted via the shaft, which in particular greatly simplifies the securing of the plate-shaped element on the distal end of the shaft.
The further advantage of this measure is that the plate-shaped element does not have to be secured on the endoscope itself, so that a conventional endoscope can be used as endoscope, without structural changes having to be made to the endoscope in order to secure the plate-shaped element on the endoscope.
Yet another advantage of this design is that a relative movement is permitted between the shaft and the endoscope, for example an axial movement and also a relative rotation between the shaft and the endoscope, without the secured plate-shaped element being moved too. For example, the distal end of the endoscope in this design can also extend closer to the operating site past the distal end of the shaft and also past the plate-shaped element.
In this context, it is preferred if the plate-shaped element is transparent at least in the area of connection to the shaft.
This measure has the advantage that not only can the step of securing the plate-shaped element on the shaft be observed through the endoscope, the lower jaw itself can also be observed through the transparent area by means of the endoscope, and in particular the operating steps, for example fitting a bone plate on the jaw, can then also be viewed.
In a preferred alternative, the plate-shaped element has an opening at least in the area of connection to the shaft.
This embodiment also affords the advantage of permitting viewing not only of the plate-shaped element but also of the operating area lying behind the latter, this embodiment having the further advantage that the distal end of the endoscope can also be brought closer to the lower jaw through the plate-shaped element, while the plate-shaped element in its function as retractor plate for creating an operating space is placed further away from the lower jaw.
In a further preferred embodiment, a proximal end of the shaft is provided with an attachment piece for securing the endoscope on the shaft, the attachment piece being able to rotate about the longitudinal axis of the shaft, preferably through 360°.
This measure is of advantage in particular if the endoscope has an oblique viewing lens or side viewing lens, so that, by rotating the endoscope about its longitudinal axis, it is possible to view in all directions, without the shaft having to be rotated, with the result that the plate-shaped element, in accordance with its function of creating an operating space, does not have to change position in contact with the soft tissue to be held away.
In preferred embodiments of the connection mechanism for connecting the plate-shaped element to the shaft, the connection mechanism has a catch mechanism and/or a screw mechanism.
These kinds of connection mechanisms have the advantage of rapid and simple handling while at the same time ensuring reliable securing of the plate-shaped element on the shaft, the connection mechanisms preferably being generally designed such that they can be actuated from outside the body, without awkward maneuvers having to be performed in the operating site.
In a first preferred specific embodiment of the connection mechanism, the shaft has, at the distal end, a plug which extends substantially transversely with respect to the longitudinal direction of the shaft, the plate-shaped element having a substantially complementary opening, and the plug being able to be fitted into the opening in a first position of rotation and, by rotating it to a second position of rotation, being secured against withdrawal from the opening.
In this “keyhole” configuration, the plate-shaped element can be locked onto the shaft with positive engagement inside the body by means of a simple plug-in and rotational movement, the positive fit avoiding undesired detachment of the plate-shaped element from the shaft at the necessary tensile load.
In this case, it is preferred if the shaft has an inner shaft, on which the plug is formed, and an outer shaft which is axially displaceable but not rotatable with respect to the inner shaft, and which has, at a distal end, at least one projection which is offsystem by angle with respect to the plug about the longitudinal direction and which, with the plug in the second position of rotation, engages in the opening.
It is of advantage here that the outer shaft secures the positive connection between the plug of the inner shaft and the opening of the plate-shaped element such that the shaft as a whole is connected to the plate-shaped element in a manner fixed against rotation, and the outer shaft ensures that, if a relative torque is exerted between the shaft and the plate-shaped element, the plug does not move back unwanted into the first position of rotation. Only when the outer shaft is drawn back axially can the inner shaft with the plug be moved back from the second position of rotation to the first position of rotation in order to be able to detach the plate-shaped element from the shaft.
It is also preferred if the outer shaft is pretensioned in the distal direction by means of a spring force.
It is of advantage here that, upon connection of the plate-shaped element to the shaft, the outer shaft in the second position of rotation snaps automatically into the opening, as a result of which the handling of the instrument according to the invention when securing the plate-shaped element on the shaft is further simplified.
In a second preferred structural embodiment of the connection mechanism, the shaft has an inner shaft which has a fork at its distal end, the plate-shaped element having at least two thread segments, and the fork being able to be coupled to the thread segments in a cross-over arrangement secure against rotating, and the shaft moreover having an outer shaft whose distal end can be screwed onto the thread segments.
In this embodiment too, the shaft is designed in two parts, the inner shaft according to one embodiment securing against rotation between the plate-shaped element and the shaft, while the outer shaft secures the plate-shaped element on the shaft in the axial direction.
It will be appreciated, however, that the shaft can also advantageously be designed in one piece for the purposes of a simple construction and can simply be screwed onto the plate-shaped element.
In a third preferred structural embodiment, the shaft has an inner shaft and an outer shaft, the outer shaft being able to be screwed onto the plate-shaped element, and the inner shaft being able to be secured on the outer shaft by means of a securing element and being able to be withdrawn from the outer shaft by loosening of the securing element.
In contrast to the embodiments described above, here only the outer shaft is secured on the plate-shaped element, whereas the inner shaft is held in a fixed position with respect to the plate-shaped element indirectly via the securing element and the outer shaft.
In a further preferred embodiment, the plate-shaped element has at least one suction and/or irrigation line with at least one suction and/or irrigation opening.
In this embodiment, the plate-shaped element advantageously also has the function of a suction and/or irrigation instrument, so that it is possible to dispense with introducing a separate suction and/or irrigation instrument into the operating site, with the result that the operating space receives at any one time the smallest possible number of different instruments that could obstruct the operating procedure. By suctioning and irrigation, the visual monitoring in particular through the above-described endoscope can be maintained by means of clear irrigation fluid being flushed through and by tissue and blood residues being suctioned off.
In a further preferred embodiment, the shaft has at least one suction and/or irrigation channel.
It is of advantage here that the shaft also acquires a further function, namely that of delivering irrigation fluid and/or suctioning off liquids, blood and tissue parts from the operating site.
Irrigation is preferably performed through the cheek via the shaft, whereas material is suctioned off through the mouth via the plate-shaped element.
In connection with one of the aforementioned embodiments according to which the shaft comprises an inner shaft and an outer shaft, the inner shaft being able to be secured on the outer shaft by means of a securing element, provision is made, in a further preferred embodiment, for the securing element to be a suction and/or irrigation attachment piece for attachment of a suction and/or irrigation line.
It is of advantage here that it is possible to dispense with a separate securing element for securing the inner shaft on the outer shaft, because the suction and/or irrigation attachment piece takes over this function, thus keeping down the structural outlay of the shaft.
In a further preferred embodiment, the plate-shaped element has at least one position sensor for detecting the position and/or the area of connection of the plate-shaped element to the shaft.
The at least one position sensor can be used, instead of or in addition to visual monitoring, to observe the position of the plate-shaped element in the operating site and/or to make it easier to secure the plate-shaped element on the shaft.
In this case it is preferred if the at least one position sensor is an electromagnetic sensor.
An electromagnetic sensor has the advantage that, in contrast to light, the signal transmission can also take place unimpeded by tissue.
In a further preferred embodiment, the plate-shaped element has at least one light-emitting element for radiating light through the cheek.
This embodiment too has the advantage that detection can be effected through the cheek by radiation of light from the plate-shaped element.
Further advantages and features are system out in the description below and in the attached drawing.
It will be appreciated that the features mentioned above and the features still to be explained below can be used not only in the respectively cited combination, but also in other combinations or singly, without departing from the scope of the present invention.
Illustrative embodiments of the invention are shown in the drawing and are described in more detail below with reference to said drawing, in which:
a)-6d) show perspective partial views of the connection mechanism between the plate-shaped element according to
a) and 9b) show representations of the connection mechanism for connecting the plate-shaped element to the shaft, partially in longitudinal section,
In
The instrument 10 generally comprises a shaft 26 and a plate-shaped flat element 28. The plate-shaped flat element 28 can be secured on a distal end 30 of the shaft 26 by means of a connection mechanism to be described below, specifically after the element 28 has been introduced through the mouth and the shaft 26 has been introduced through the cheek, the element 28 being able to be secured on the shaft 26 from outside the body.
The plate-shaped element 28 is secured on the shaft 26 such that it extends substantially obliquely or transversely with respect to the latter, as is shown in
In terms of its shape, the plate-shaped element 28 is adapted to the lower jaw 12 in the area of the jaw angle 14 and extends approximately from the jaw base 16 to the jaw joint 18. Adapted “to the shape of the lower jaw 12” means here that the plate-shaped element 28 is slightly curved in accordance with the natural curvature of the surface of the lower jaw 12 in the area from the jaw base 16 to the jaw joint 18.
As will further be seen from
In an operation on the jaw joint, the shaft 26 is introduced through the cheek via a small incision anterior to the ear. In the oral cavity, an incision is made in the mucous membrane adjacent to the operating site. The plate-shaped element 28 is then introduced through the mouth and via the incision in the mucous membrane between the lower jaw bone 12 in the area of the jaw angle 14 and the (muscle) tissue of the cheek. The plate-shaped element 28 is then connected from the front to the distal tip of the shaft 26, as will be described later. By drawing back the shaft 26 from the incision in the cheek, the plate-shaped element 28 is then drawn back against the outerlying tissue, as a result of which an operating space between the lower jaw 12 and that side of the plate-shaped element 28 facing the lower jaw 12 is created in which the bone plate 22 can then be securely and quickly fitted with suitable tools.
To make it easier to draw the plate-shaped element 28 back by means of the shaft 26, a proximal end 32 of the shaft 26 is provided with a handle 34 which protrudes laterally from the shaft 26 and has approximately at least the length of the width of a hand. When the instrument system 10 is in the state of use, the handle 34 points approximately in the direction of the patient's temple.
The shaft 26 of the instrument system 10 is also used for visual monitoring of the operating site. While for this purpose the shaft 26 can itself be designed as the shaft of an endoscope, for example with an endoscope optical system arranged in the shaft 26 or with the shaft 26 possibly designed as the shaft of a video endoscope, the shaft 26 in the present illustrative embodiment is hollow and thus serves as an insertion aid for insertion of an endoscope 36.
By comparison with the outline representation of the instrument system 10, FIGS. 2 to 9 show a detailed illustrative embodiment of an instrument system 40 (cf.
The instrument system 40 has a shaft 42 which corresponds to the shaft 26 of the instrument system 10 and which is formed by an outer shaft 44 and an inner shaft 46. The outer shaft 44 can be detached from the inner shaft 46 according to
The attachment piece 50 is in this case arranged on the inner shaft 46, i.e. the inner shaft 46 receives the endoscope 36 and is correspondingly hollow throughout.
Arranged at the proximal end 48 of the shaft 42 there is also a handle 52 corresponding to the handle 34 of the instrument system 10 in
The instrument system 40 also has a plate-shaped flat element 54 which corresponds to the plate-shaped element 28 of the instrument system 10 in
The plate-shaped element 54 has a suction line 58 arranged on one side of the plate-shaped element 54 which, in the intended use of the instrument system 40 according to
Starting from
At the distal end 56 of the shaft 42, more precisely at the distal end of the inner shaft 46, there is a plug 68 which extends transversely with respect to the inner shaft 46 and, with the latter, forms approximately the shape of a T. At its proximal end, the outer shaft 44 has a sleeve-like projection 68 which has an opening 70 substantially complementing the plug 66. Before the start of the operation, the outer shaft 44 is pushed onto the inner shaft 46 from the distal end thereof, and, because of the configuration of the opening 70, the outer shaft 44 can be pushed onto the inner shaft 46, via the plug 66, only in a defined rotation position relative to the inner shaft 46. A sleeve nut 72 is then pushed onto the outer shaft 44 and, according to
At its distal end, the outer shaft 44 has two projections 76, 78 which are offsystem by 180° relative to one another and which, when the outer shaft 44 is mounted on the inner shaft 46, are offsystem by an angle to the plug 66 of the inner shaft 46, specifically by 90°.
After the preliminary assembly of the shaft 42 as described above, the shaft 42 can now be introduced through the cheek via a small incision anterior to the ear, as has been described in connection with
The plate-shaped element 54, which is introduced through the mouth and through the incision in the mucous membrane as described in connection with
The securing of the plate-shaped element 54 on the shaft 42 is now described with reference to
In
Starting from
By pushing the shaft 42 farther forward according to
To release the plate-shaped element 54 from the shaft 42 on completion of the operation, the reverse procedure is carried out. First, the outer shaft 44 is drawn back relative to the inner shaft 46 counter to the spring force, for which purpose a grip element 86 is arranged at the proximal end of the outer shaft 44. After the outer shaft 44 has been drawn back, the entire shaft 42 can then be turned through 90° via the handle 52, after which the shaft 42 can be removed from the plate-shaped element 54.
Before the plate-shaped element 54 is secured on the shaft 42, the endoscope 36 in
As an alternative to the opening 88, or in addition to the opening 88, the plate-shaped element 54 can also be made transparent at least in the area of connection to the shaft 44.
While the connection mechanism described above in relation to FIGS. 2 to 9 is a catch mechanism in which the shaft 42 can be locked to the plate-shaped element 54, a further illustrative embodiment of an instrument system 90 with reference to FIGS. 10 to 13 is described in which the connection mechanism for securing a plate-shaped element 92 on a shaft 94 is based principally on a screw mechanism.
Unless otherwise indicated below with reference to the instrument system 90, the configuration of the instrument system 90 otherwise corresponds to the instrument system 10 or instrument system 30.
As in the previous illustrative embodiment, the shaft 94 comprises an outer shaft 96 and an inner shaft 98, and also a handle 100 which is connected to the inner shaft 98, and an attachment piece 102 for insertion and securing of the endoscope 36 from
At its distal end, the inner shaft 98 has a fork 104, i.e. the inner shaft 98 has a slotted configuration at its distal end. The plate-shaped element 92 has a sleeve-shaped projection 106 in whose interior two thread segments 108 and 110 are arranged offsystem from one another by 180°. The thread segments 108 and 110 have a thread on their outside 112, as is shown for the thread segment 110 in
At its distal end, the outer shaft 96 has an internal thread 114.
Starting from
The handle 100 is oriented with respect to the fork 104 in such a way that, when the plate-shaped element 92 is secured on the shaft 94, the handle 100 is pointing toward the patient's temple when the instrument system 90 is in its intended use according to
Referring to FIGS. 14 to 17, a further illustrative embodiment of an instrument system 130 is described which can be used similarly to the instrument system 10 according to
Unless otherwise stated below, features of the instrument system 130 which are not described below are identical to the features of the instrument systems 10, 40 and 90 or at least correspond to these features.
The instrument system 130 has a shaft 132 and a plate-shaped element 134 which can be secured on a distal end 136 of the shaft 132 by means of a connection mechanism still to be described below.
At its proximal end, the shaft 132 has a handle 138 protruding laterally from the shaft 132. At the outermost proximal end, the shaft 132 has an attachment piece 140 for securing for example the endoscope 36 from
The shaft 132 comprises an outer shaft 142 and an inner shaft 144. The outer shaft 142 can be pushed onto the inner shaft 144, as is shown in
The inner shaft 144, which has the attachment piece 140 at its proximal end, serves not only as an insertion aid for an endoscope, for example the endoscope 36 in
Arranged at the proximal end of the shaft 132 there is accordingly an irrigation attachment piece 146 which, in addition to the function of an attachment piece for an irrigation line (not shown), has a further function, namely that of securing the inner shaft 144 on the outer shaft 142, as will be described below. Seals 148 and 150 seal off the inner shaft 144 from the outer shaft 142. Between the seals 148 and 150, the inner shaft 144 has openings 152, into one of which the attachment piece 146 can be screwed, in which case the corresponding opening 152 then serves as an inlet opening for irrigation fluid into the inner shaft 144.
The handle 138 can be detached from the shaft 132. The handle 138 is pushed onto the outer shaft 142 by way of an opening 152. The opening 154 is substantially rectangular, and a complementary square 156 is provided on the outer shaft 142, and the opening 154 can be fitted with positive locking onto the square 156 in four different positions of rotation. To secure the handle 138 on the outer shaft 142, a sleeve nut 158 is provided.
The plate-shaped element 134 has a sleeve-like projection 160 having a substantially cylindrical opening 162.
Before the operation, the shaft 132 is assembled by pushing the inner shaft 144 into the outer shaft 142. The attachment piece 146 is then screwed through an opening 164 in the proximal end of the outer shaft 142 and into one of the openings 152, as a result of which the inner shaft 144 is secured on the outer shaft 142 in a manner in which it is fixed in terms of rotation and is also axially non-displaceable. The handle 138 is pushed onto the outer shaft 142 and secured by means of the sleeve nut 158.
As has been described with reference to
At its distal end, the outer shaft 142 has an external thread 166, while the opening 162 of the projection 160 of the plate-shaped element 134 has a corresponding internal thread.
Before the shaft 132 is introduced into the incision, a cap 168 according to
The cap 168 can then be unscrewed from the direction of the inside of the oral cavity, after which the shaft 132, or more precisely the outer shaft 142, can then be screwed into the thread of the opening 162 of the projection 160 of the plate-shaped element 134 which has been introduced beforehand through the mouth, after which the plate-shaped element 134 is secured on the shaft 132.
As has already been described above, the handle 138 can be brought to a desired position by appropriate loosening of the sleeve nut 158, preferably in such a way that the handle 138, as shown in
It will be appreciated that the illustrative embodiments cited above can also be combined with one another in terms of their structural configuration. In other embodiments not shown, the respective plate-shaped element 28, 54, 92 or 134 can further be provided with at least one position sensor for detecting the position and/or the area of connection of the respective plate-shaped element to the respective shaft 26, 42, 94 or 132. Such a position sensor is preferably an electromagnetic sensor.
It is also possible to provide, on the aforementioned plate-shaped elements, at least one light-emitting element for radiating light through the patient's cheek.
Number | Date | Country | Kind |
---|---|---|---|
103 10 978.1 | Mar 2003 | DE | national |
The present application is a continuation of pending International patent application PCT/EP2004/002139 filed on Mar. 3, 2004 which designates the United States and claims priority of German patent application 103 10 978.1 filed on Mar. 6, 2003.
Number | Date | Country | |
---|---|---|---|
Parent | PCT/EP04/02139 | Mar 2004 | US |
Child | 11220247 | Sep 2005 | US |