WO2015129395A1 - Dispositif d'exclusion et système de robot - Google Patents
Dispositif d'exclusion et système de robot Download PDFInfo
- Publication number
- WO2015129395A1 WO2015129395A1 PCT/JP2015/052877 JP2015052877W WO2015129395A1 WO 2015129395 A1 WO2015129395 A1 WO 2015129395A1 JP 2015052877 W JP2015052877 W JP 2015052877W WO 2015129395 A1 WO2015129395 A1 WO 2015129395A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- exclusion
- suction
- smoke
- body cavity
- organ
- 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.)
- Ceased
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00314—Separate linked members
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2906—Multiple forceps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/007—Aspiration
- A61B2218/008—Aspiration for smoke evacuation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
Definitions
- the present invention relates to an exclusion device and a robot system, and more particularly to an exclusion device and a robot system for excluding an organ in a body cavity.
- an exclusion device that excludes organs around a treatment site is known (for example, (See Patent Document 1).
- a suction port used for adsorption of an exclusion surface to an organ and suction of liquid accumulated in the abdominal cavity is provided on the exclusion surface.
- the present invention has been made in view of the above-described circumstances, and an object thereof is to provide an exclusion device and a robot system capable of simultaneously securing a treatment space by organ exclusion and discharging smoke.
- an elongated insertion portion that can be inserted into a body cavity of a living body, an exclusion surface that is provided at the distal end of the insertion portion and is in contact with the surface of an organ within the body cavity, and suction
- a pressure relief portion having a suction surface with an opening, a suction passage having the suction port at a distal end, extending to a proximal end side of the insertion portion, and disposed on a proximal end side of the insertion portion;
- a suction part that sucks the suction surface, and the suction surface and the suction surface face each other in different directions.
- the insertion part is inserted into the body cavity, the exclusion part is arranged in the vicinity of the treatment site, the exclusion surface of the exclusion part is brought into contact with an organ around the treatment part, and the exclusion part
- a treatment space for observing and treating the treatment site can be secured around the treatment site.
- the suction surface facing in a direction different from the exclusion surface is exposed to the treatment space without contacting the organ. Therefore, the smoke in the treatment space can be discharged to the outside of the living body through the suction port and the suction passage by sucking the inside of the suction passage with the suction portion while excluding the organ and securing the treatment space.
- the smoke detection part which detects the smoke in the said body cavity, and the attraction
- produced in the body cavity can be automatically detected by the smoke detection part, and the exhaust_gas
- the smoke detection unit may receive an endoscope image from an endoscope that images the inside of the body cavity, and may detect the smoke based on a luminance value of the endoscope image. .
- the smoke detection unit may receive an endoscope image from an endoscope that images the inside of the body cavity, and may detect the smoke based on a luminance value of the endoscope image.
- the said smoke detection part may detect a smoke based on the action
- an exclusion device according to any one of the above, a medical instrument inserted into the body cavity, and an electric arm that holds the exclusion device and the medical instrument, respectively, outside the living body.
- a robot system including an operation input unit operated by an operator and an arm control unit that operates the electric arm based on an operation input to the operation input unit.
- the arm control unit may control the electric arm holding the exclusion device based on the position and posture of the electric arm holding the medical instrument.
- FIG. 1 is an overall configuration diagram of an exclusion device according to a first embodiment of the present invention. It is a figure explaining the usage method in the laparoscopic surgery of the exclusion apparatus of FIG. It is a whole block diagram of the exclusion apparatus which concerns on the 2nd Embodiment of this invention. It is a block diagram of the exclusion part with which the exclusion apparatus which concerns on the 3rd Embodiment of this invention is provided. It is a whole block diagram which shows the modification of an exclusion apparatus provided with the exclusion part of FIG. It is a block diagram which shows the collapsed state of the exclusion part with which the exclusion apparatus which concerns on the 4th Embodiment of this invention is provided. It is a block diagram which shows the state which the exclusion part of FIG. 6A spread.
- FIG. 10 is a diagram showing the exclusion part of FIG. 9 supporting an organ. It is a whole block diagram of the robot system which concerns on the 7th Embodiment of this invention.
- the exclusion apparatus 10 which concerns on the 1st Embodiment of this invention is demonstrated with reference to FIG. 1 and FIG.
- the exclusion device 10 includes an exclusion device 1 and a suction device (suction unit) 2.
- FIG. 2 is a diagram illustrating a method of using the retraction tool 1.
- the exclusion device 10 according to the present embodiment is used together with an endoscope 21 for observing the abdominal cavity A and an energy treatment tool 22 such as an electric knife or an ultrasonic treatment tool in laparoscopic surgery.
- the exclusion tool 1 includes an elongated insertion portion 3 that can be inserted into the abdominal cavity (body cavity), an exclusion portion 4 provided at the distal end of the insertion portion 3, a gripping portion 5 provided at the proximal end of the insertion portion 3, A suction passage 7 provided through the inside of the exclusion part 4, the insertion part 3, and the grip part 5 is provided.
- the exclusion part 4 is provided with a rectangular thin plate-like single exclusion member 6 extending from the distal end of the insertion part 3 in the longitudinal direction of the insertion part 3.
- the exclusion member 6 has an exclusion surface 6A and a suction surface 6B that face each other in the thickness direction. A plurality of suction ports 6b are open on the suction surface 6B.
- the grip part 5 includes a suction operation part 5a such as a switch for turning on and off the suction operation of the suction device 2.
- the suction operation unit 5a transmits an ON signal to the suction device 2 when operated by the surgeon.
- the suction passage 7 is formed along the longitudinal direction of the insertion portion 3 and connects the suction port 6 b and the suction device 2. The suction device 2 sucks the inside of the suction passage 7 when receiving an ON signal from the suction operation unit 5a.
- the insertion part 3 is inserted into the abdominal cavity A, the exclusion surface 6A is brought into contact with the surface of the organ B located in the treatment space by the energy treatment tool 22, and the organ B is excluded by the exclusion part 4. That is, the organ B is moved away from the treatment space by pressing the organ B with the exclusion part 4. Thereby, a treatment space for operating the energy treatment tool 22 is secured, and a visual field of the treatment space by the endoscope 21 is secured.
- the surgeon operates the suction operation unit 5a at hand to start suction by operating the suction operation unit 5a.
- the inside of the suction passage 7 is sucked, the smoke is sucked into the suction port 6b of the suction surface 6B facing the treatment space, and the smoke is removed from the treatment space.
- the suction surface 6B facing in the direction opposite to the exclusion surface 6A in the state in which the organ B is excluded by the exclusion unit 4 is in the vicinity of the treatment site where smoke is generated. It is exposed to the treatment space without contacting the organ B. Therefore, there is an advantage that the smoke can be efficiently discharged from the suction port 6b of the suction surface 6B while the organ B is excluded by the exclusion unit 4. Further, since it is possible to simultaneously perform the exclusion and the exhaust using the single exclusion device 1, it is possible to continuously observe the treatment space by the endoscope 21 and to operate with the exclusion and the exhaust. Therefore, there is an advantage that the efficiency of the operation can be improved.
- the exclusion device 20 according to the present embodiment operates the suction device 2 that detects smoke in the abdominal cavity A, and when the smoke is detected by the smoke detection unit 8. It differs from 1st Embodiment in the point further provided with the suction control part 9 to be made. Therefore, in the present embodiment, the smoke detection unit 8 and the suction control unit 9 will be mainly described, and the components common to the first embodiment will be denoted by the same reference numerals and description thereof will be omitted.
- the smoke detector 8 receives an endoscopic image from the endoscopic system 100 that processes an endoscopic image in the abdominal cavity A photographed by the endoscope 21, and analyzes the received endoscopic image. Detect the occurrence of fumes. Specifically, when smoke occurs in the abdominal cavity A, the illumination light emitted from the distal end of the endoscope 21 is irregularly reflected by the smoke, thereby increasing the luminance value of the endoscope image. Therefore, the smoke detection unit 8 sequentially calculates the average value of the luminance values of the received endoscopic image, calculates the time change rate of the average value of the luminance values, and when the time change rate is equal to or greater than a predetermined threshold value. That is, smoke is detected when the rate of increase in the average value of the luminance values is large. The smoke detection unit 8 transmits a smoke detection signal to the suction control unit 9 when the smoke is detected. The suction control unit 9 operates the suction device 2 when receiving the smoke detection signal.
- the exclusion device 20 when smoke is generated in association with the treatment by the energy treatment tool 22, the brightness value of the endoscope image is increased by the smoke. From the increase in the luminance value of the endoscopic image, the generation of smoke is detected by the smoke detection unit 8, and the body cavity is exhausted by the suction device 2 automatically. In this way, the detection of the occurrence of fumes in the abdominal cavity A and the execution of exhaust are automatically performed without the operator operating the suction operation unit 5a, so that the operator's effort is saved and the efficiency of the operation is reduced. There is an advantage that it can be further improved.
- the smoke detection unit 8 detects the generation of the smoke based on the increase in the luminance value of the endoscopic image, but instead of this, or in addition to this, the energy treatment device 22.
- the generation of smoke may be detected based on the operation of For example, when the smoke detection unit 8 acquires a signal indicating the operating state of the energy treatment tool 22 from the energy treatment tool 22 and detects the start of operation of the energy treatment tool 22, that is, the tissue of the tissue by the energy treatment tool 22.
- the occurrence of fumes is detected when the treatment starts and a situation occurs where fumes are generated.
- the exclusion device 30 according to the present embodiment is different from the first and second embodiments in that a suction port 6 a is formed in the exclusion surface 6 ⁇ / b> A in addition to the suction surface 6 ⁇ / b> B. ing.
- the same reference numerals are assigned to configurations common to the first and second embodiments, and the description thereof is omitted.
- the exclusion device 30 is provided in parallel with the suction passage 7 (hereinafter referred to as the first suction passage 7), passes through the inside of the exclusion portion 4, the insertion portion 3, and the grip portion 5, and the suction port 6a of the exclusion surface 6A.
- Another suction passage 72 (hereinafter referred to as the second suction passage 72) for connecting the suction device 2 is provided.
- the suction device 2 includes, for example, a first switch corresponding to the first suction passage 7 and a second switch corresponding to the second suction passage 72 as the suction operation unit 5a.
- the suction operation in one suction passage 7 and the suction operation in the second suction passage 72 can be turned on and off separately.
- the exclusion device 30 configured in this manner, the inside of the second suction passage 72 is aspirated by the aspiration device 2 by operating the aspiration operation unit 5a while the exclusion surface 6A is in contact with the surface of the organ B.
- the exclusion surface 6A is fixed to the surface of the organ B by the suction force into the suction port 6a.
- the suction surface 6A on the exclusion surface 6A the exclusion surface 6A can be strongly fixed to the surface of the organ B, and there is an advantage that the exclusion operation of the organ B can be performed stably.
- Other effects are the same as those of the second embodiment, and thus the description thereof is omitted.
- either the front surface or the back surface of the exclusion member 6 may be used as the exclusion surface 6A and the suction surface 6B.
- the suction device 2 includes a suction pressure detection unit 11 that detects the suction pressure of the suction passages 7 and 72, and is based on the suction pressure detected by the suction pressure detection unit 11. Thus, it is determined which of the front surface and the back surface is used as the exclusion surface 6A.
- the suction control unit 9 causes the suction device 2 to suck both suction passages 7 and 72 and compares the suction pressures of the two suction passages 7 and 72 after a predetermined time from the start of suction. Then, the suction controller 9 determines that the surface to which the suction passage 7 or 72 having the higher suction pressure is connected is the exclusion surface 6A, and continues the suction in the suction passage 7 or 72.
- the suction control unit 9 determines that the surface to which the suction passage 72 or 7 with the lower suction pressure is connected is the suction surface 6B, stops the suction in the suction passage 72 or 7, and thereafter The suction passage 72 or 7 is sucked based on the detection of the smoke by the smoke detection unit 8 or the operation of the suction operation unit 5a.
- usability can be improved by making it possible to use the front surface and the back surface of the exclusion member 6 as both the exclusion surface 6A and the suction surface 6B.
- the exclusion surface 6A is fixed to the surface of the organ B by suction, but instead of or in addition to this, other fixing means may be adopted.
- the suction surface 6A may be provided with a suction cup, or the relief surface 6A may be subjected to uneven processing for increasing friction with the surface of the organ B.
- an exclusion apparatus according to a fourth embodiment of the present invention will be described with reference to FIGS. 6A and 6B.
- the exclusion device according to the present embodiment is different from the first to third embodiments in the structure of the exclusion portion 4. Therefore, in this embodiment, the exclusion part 4 is mainly demonstrated, about the structure which is common in the 1st to 3rd embodiment, the same code
- the exclusion part 4 includes a plurality (three in this example) of the exclusion members 6 described in the third embodiment.
- the plurality of exclusion members 6 are stacked in the thickness direction, and base end portions are connected to each other so as to be rotatable around a rotation axis in the stacking direction.
- the exclusion portion 4 is fan-shaped by the state where the exclusion members 6 are overlapped with each other, and as shown in FIG. 6B, the exclusion members 6 are displaced from each other in the rotational direction. It is designed to deform between the expanded state.
- the rotation operation of the exclusion member 6 around the rotation axis is performed by a motor (not shown) in accordance with an input to an extension operation unit (not shown) provided in the grip 5.
- the insertion portion 3 is inserted into the abdominal cavity A in the same manner as in the first embodiment with the exclusion portion 4 folded, and the expansion portion is operated by operating the expansion operation portion. 4 is spread, the surface 6A is brought into contact with the surface of the organ B, and the surface of the organ B is supported by the three surfaces 6A.
- the expansion portion is operated by operating the expansion operation portion. 4 is spread, the surface 6A is brought into contact with the surface of the organ B, and the surface of the organ B is supported by the three surfaces 6A.
- an exclusion apparatus 50 according to a fifth embodiment of the present invention will be described with reference to FIGS.
- the exclusion device 50 according to the present embodiment is different from the first to fourth embodiments in that the exclusion member 6 has a joint structure. Therefore, in this embodiment, the retraction tool 1 is mainly demonstrated and about the structure which is common in the 1st-4th embodiment, the same code
- the exclusion member 6 has an elongated shape like a finger and has a plurality of joints arranged in the longitudinal direction. Each joint is provided so as to be swingable about a swing axis that intersects the longitudinal direction. The exclusion member 6 is bent at an intermediate position in the longitudinal direction as each joint swings, and can be deformed from a linear shape to a curved shape.
- the suction ports 6a are provided on the cylindrical side surface of the exclusion member 6 in a line in the longitudinal direction.
- the suction port 6b is arranged in a line in the longitudinal direction at a position on the side surface of the exclusion member 6 that is 180 ° different from the suction port 6a in the circumferential direction.
- which position of the exclusion member 6 becomes the exclusion surface 6A and which position becomes the suction surface 6B differs according to the bending direction of the exclusion member 6, which position of the exclusion member 6 becomes the exclusion surface 6A and which position becomes the suction surface 6B differs. That is, the side surface located inside the curved shape of the exclusion member 6 is the exclusion surface 6A, and the side surface located outside is the suction surface 6B.
- the grip portion 5 is provided with a bending operation portion (not shown) such as a switch for operating the deformation of the exclusion member 6.
- a bending operation portion such as a switch for operating the deformation of the exclusion member 6.
- the linear exclusion member 6 brought into contact with the surface of the organ B is bent along the curved shape of the organ B by operating the bending operation unit. Accordingly, as shown in FIG. 8, there is an advantage that the organ B can be supported by the exclusion surface 6A along the curved shape of the organ B and the organ B can be more gently excluded.
- an exclusion apparatus 60 according to a sixth embodiment of the present invention will be described with reference to FIGS. 9 and 10.
- An exclusion device 60 according to the present embodiment is a modification of the fifth embodiment, and as shown in FIG. 9, a plurality of (three in this example) exclusion members 6 provided in parallel with each other. I have. Therefore, in this embodiment, the retraction tool 1 is mainly demonstrated and about the structure which is common in 1st to 5th embodiment, the same code
- the three exclusion members 6 are arranged at equal intervals in the circumferential direction around the central axis of the insertion portion 3. When the bending operation part is operated to be in the on state, the three exclusion members 6 are curved outwardly convex with respect to the central axis, so that the exclusion part 4 expands in the radial direction. Yes.
- the suction port 6 a for adsorbing the organ B is provided on the central axis side of the side surface of each exclusion member 6.
- the suction port 6 b for sucking the smoke is provided on the side of each of the extruding members 6 on the side opposite to the central axis.
- the exclusion member 6 by operating the bending operation unit, the exclusion member 6 is moved so that the exclusion member 6 follows the three-dimensional curved shape of the organ B as shown in FIG.
- the organ B is three-dimensionally supported inside the three exclusion members 6 by bending the three exclusion members 6.
- the organ B can be more gently and stably removed by supporting the organ B three-dimensionally with the exclusion surface 6A along the curved surface shape of the organ B.
- stable exclusion is possible even when the organ B is removed with a stronger force.
- the exclusion device 70 according to the present embodiment includes a plurality of electric arms 12, 13, and 14 each holding a medical instrument, and remotely operating the electric arms 12, 13, and 14. This is different from the first to sixth embodiments in that it is applied to a robot system 200 that moves a medical instrument in a body cavity. Therefore, in the present embodiment, the configuration of the robot system 200 will be mainly described, and the configurations common to the first to sixth embodiments will be denoted by the same reference numerals and description thereof will be omitted.
- FIG. 11 shows an example of the exclusion device 70 including the exclusion device 1 described in the sixth embodiment, but any of the exclusion devices described in other embodiments may be adopted. Good.
- the robot system 200 includes a retraction tool 1, an endoscope (medical instrument) 21 and an energy treatment tool (medical instrument) 22, and a retraction tool 1, an endoscope 21, and an energy treatment tool 22.
- a retraction tool 1 Based on the articulated electric arms 12, 13, and 14 that hold the respective base end portions outside the body, the operation input unit 15 operated by the operator (operator), and the operation input to the operation input unit 15 And an arm control unit 16 that drives and controls the joints of the electric arms 12, 13, and 14.
- the arm control unit 16 receives detection values from an encoder (not shown) provided on the electric arms 12, 13, and 14 that detects the rotation angle of each joint, and based on the received detection values of the encoder, The positions and postures of the retraction tool 1, the endoscope 21, and the energy treatment tool 22 are calculated. Then, the arm control unit 16 moves the joint of the electric arm 12 holding the relieving tool 1 so as to move the relieving tool 1 based on the calculated position and posture of the endoscope 21 and the energy treatment tool 22. Control.
- the retraction device when the endoscope 21 and the energy treatment device 22 approach the retraction device 1 and the distance between the arm control unit 16 and the retraction device 1 becomes less than a predetermined threshold, the retraction device The joint of the electric arm 12 is controlled so that 1 is moved away from the endoscope 21 or the energy treatment tool 22.
- the robot system 200 configured as described above, when the energy treatment tool 22 approaches the retraction tool 1 while performing the treatment by operating the endoscope 21 and the energy treatment tool 22 in the abdominal cavity A, By automatically moving the retraction device 1 away from the energy treatment device 22, the organ B located near the energy treatment device 22 is further relieved, and a treatment space for the energy treatment device 22 is newly secured. .
- the retraction tool 1 automatically moves so as to move away from the endoscope 21, and the visual field of the endoscope 21 is ensured.
- Exclusion device 1, 20, 30, 50, 60, 70 Exclusion device 1 Exclusion tool 2 Suction device (suction part) DESCRIPTION OF SYMBOLS 3 Insertion part 4 Exclusion part 5 Grasp part 5a Suction operation part 6 Exclusion member 6A Exclusion surface 6B Suction surface 6a, 6b Suction port 7 Suction passage 8 Smoke detection part 9 Suction control part 11 Suction pressure detection part 12, 13, 14 Electric arm 15 Operation Input Unit 16 Arm Control Unit 21 Endoscope (Medical Instrument) 22 Energy treatment device (medical device) 100 Endoscopic system 200 Robot system A Abdominal cavity (body cavity) B organ
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Abstract
L'invention concerne un dispositif d'exclusion (10) comportant : une zone d'insertion effilée (3) à insérer dans la cavité corporelle d'un sujet ; une zone d'exclusion (4) située à l'extrémité distale de la zone d'insertion (3) et dotée d'une face d'exclusion (6A) en contact avec la surface d'un organe dans la cavité corporelle, et une face d'aspiration (6B) dans laquelle un orifice d'aspiration (6b) est formé ; un passage d'aspiration (7) comportant l'orifice d'aspiration (6b) au niveau de son extrémité distale et s'étendant vers le côté proximal de la zone d'insertion (3) ; et une zone d'aspiration (2) permettant d'aspirer l'intérieur du passage d'aspiration (7), la partie d'aspiration (2) étant disposée sur le côté proximal de la zone d'insertion (3) ; la face d'exclusion (6A) et la face d'aspiration (6B) se font face mutuellement dans des directions différentes.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2014039814A JP2015163172A (ja) | 2014-02-28 | 2014-02-28 | 圧排装置およびロボットシステム |
| JP2014-039814 | 2014-02-28 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2015129395A1 true WO2015129395A1 (fr) | 2015-09-03 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/JP2015/052877 Ceased WO2015129395A1 (fr) | 2014-02-28 | 2015-02-02 | Dispositif d'exclusion et système de robot |
Country Status (2)
| Country | Link |
|---|---|
| JP (1) | JP2015163172A (fr) |
| WO (1) | WO2015129395A1 (fr) |
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