JP2014083237A - Probe position control device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To dispose a probe of a probe unit extending over the substantially whole area of a visual field range of an endoscope without changing the visual field of the endoscope.SOLUTION: A probe position control device 1 includes: a tip part 6 for positioning a probe at a tip of the wire-like probe unit in a radial direction; a tip side curved part 7 and a base end side curved part 8 arranged in a longitudinal direction and curled to be curved opposite to each other on the base end side from the tip part 6 and elastically deformable; and a curving length control part 10 for controlling the curving length of the base end side curved part 8. The probe position control device 1 is provided to be retractable from an opening part of a channel opened to the vicinity of the end of an endoscope insertion part.

Description

  The present invention relates to a probe position adjusting device.

  Conventionally, a US hood with a forceps port for attaching a probe such as an ultrasonic probe to the distal end of an endoscope is known (for example, see Patent Document 1). An endoscope having a moving mechanism for moving the probe of an ultrasonic probe over a predetermined angle range with respect to an observation range is known (for example, see Patent Document 2).

Japanese Patent No. 3671764 JP 2000-5182 A

  However, the US hood of Patent Document 1 fixes the probe of the ultrasonic probe to the distal end of the endoscope, and in order to change the acquisition range of the tomographic image by the ultrasonic probe, It is necessary to change the field of view. For example, when it is desired to obtain a tomographic image of a target site captured at a corner of the endoscope field of view, the entire field of view of the endoscope must be changed, which may cause a problem that the target site may be lost.

  Further, the endoscope of Patent Document 2 only finely adjusts the angle of the probe by swinging the probe swinging means, and spreads on both sides around the longitudinal axis of the insertion portion in front of the insertion portion of the endoscope. There is an inconvenience that the probe of the probe cannot be arranged over the entire field of view. That is, as in Patent Document 1, when it is desired to obtain a tomographic image of the target site captured at the corner of the endoscope field of view, the entire field of view of the endoscope must be changed, and the target site may be lost. There is an inconvenience.

  The present invention has been made in view of the above-described circumstances, and a probe in which a probe of a probe can be arranged over almost the entire field of view of the endoscope without changing the field of view of the endoscope. An object is to provide a position adjusting device.

In order to achieve the above object, the present invention provides the following means.
In one embodiment of the present invention, a distal end portion that positions a probe at a distal end of a wire-like probe in a radial direction and a proximal end side than the distal end portion are arranged in a length direction and are bent in opposite directions. An endoscope insertion portion comprising: a distal-side bending portion and a proximal-side bending portion that can be elastically deformed and a bending-length adjusting portion that adjusts a bending length of the proximal-side bending portion. There is provided a probe position adjusting device provided so as to be able to protrude and retract from an opening portion of a channel opening in the vicinity of the tip of the probe.

  According to this aspect, when projecting in the distal direction from the opening portion of the channel that opens near the distal end of the endoscope, the two curved portions that are restored in elastic deformation and curved in the opposite directions are projected out of the opening portion. It is done. When the bending length of the proximal end side bending portion is adjusted by the operation of the bending length adjusting portion, the distal end position of the proximal end side bending portion moves in one direction, and as a result, the distal end position of the distal end portion moves in one direction.

  By sufficiently securing the bending length of the proximal-side bending portion, it is possible to move the distal end position of the distal end portion in one direction over a sufficiently wide range only by adjusting the bending length. Since the tip portion positions the probe of the wire-like probe in the radial direction, the probe probe also moves as the position of the tip portion moves. As a result, the probe of the probe can be moved over a wide range within the field of view of the endoscope with a simple configuration, and without losing sight of the target site found in the corner of the field of view of the endoscope. By this, detailed observation of the target site can be performed.

In the above aspect, the bending length adjusting portion may be a correction wire that is inserted into a hole extending in the longitudinal direction in the proximal-side bending portion and straightens the proximal-side bending portion.
In this way, when the correction wire is inserted into the hole in the proximal-side bending portion, the proximal-side bending portion of the inserted portion is straightened and the bending length can be easily adjusted.

Moreover, in the said aspect, you may provide the curvature adjustment part which adjusts the curvature of the said front end side bending part.
By doing in this way, the curvature of a front end side curved part can be adjusted with a curvature adjustment part, and the position of a front-end | tip part can be finely moved within the range of the curvature change. Therefore, the position of the probe of the probe can be finely adjusted. Further, by moving the probe in the longitudinal direction of the probe with respect to the tip portion, the position of the probe can be finely adjusted in a two-dimensional range.

Further, in the above aspect, the curvature adjusting portion is inserted into a hole extending in the longitudinal direction in the proximal end side bending portion and the distal end side bending portion, and is fixed near the distal end of the distal end side bending portion. A tension wire capable of transmitting tension may be used.
In this way, by applying tension to the tension wire, the tension is transmitted to the vicinity of the distal end of the distal-side curved portion through the holes in the proximal-side curved portion and the distal-side curved portion, and the distal-side curved portion The curvature can be easily adjusted.

Further, in the above aspect, the distal end side bending portion and the distal end side bending portion are inserted into a hole extending in the longitudinal direction, and the tension is transmitted by being fixed near the distal end portion of the distal end side bending portion. The curvature adjustment part which consists of a tension | pulling wire is provided, and the rigidity of a correction wire, a base end side curved part, a front end curved part, a tension wire, and a probe may have the following relationships.
Straightening wire> Base end side bend> Tip side bend and tension wire> Probe

  By doing so, the probe can be bent without changing the brazed state of the proximal-side bending portion and the distal-side bending portion, and when the pulling wire is pulled, The curvature of the distal side bending portion can be changed without changing the bending state of the bending portion.

Moreover, in the said aspect, you may form in the tube shape which has the inner hole which penetrates the said probe.
By doing so, the endoscope is inserted through the forceps channel of the endoscope insertion portion or the endoscope insertion portion via an external channel with the probe inserted into the inner bore. The probe can be guided into the field of view.

Moreover, in the said aspect, you may equip the said front-end | tip part with the fixing | fixed part fixed to the front-end | tip of the said probe.
In this way, the fixed part is attached to the distal end of the probe guided into the field of view of the endoscope through the forceps channel of the endoscope insertion part or through an external channel to the endoscope insertion part. By fixing and adjusting the position of the fixed portion, the probe can be guided to a desired position within the scope of the endoscope visual field.

Moreover, in the said aspect, the said fixing | fixed part may be attached to the said front-end | tip part so that rocking | fluctuation is possible.
In this way, the position of the probe can be adjusted without applying an excessive force to the probe even by pushing and pulling the probe in the longitudinal direction.

  According to the present invention, there is an effect that the probe of the probe can be arranged over almost the entire field of view of the endoscope without changing the field of view of the endoscope.

It is a longitudinal cross-sectional view which shows the probe position adjustment apparatus which concerns on the 1st Embodiment of this invention. It is a longitudinal cross-sectional view which shows the state by which the probe is arrange | positioned at the left end of the visual field range by the probe position adjustment apparatus of FIG. It is a longitudinal cross-sectional view which shows the state by which the probe is arrange | positioned in the center of the visual field range by the probe position adjustment apparatus of FIG. It is a longitudinal cross-sectional view which shows the state by which the probe is arrange | positioned at the right end of the visual field range by the probe position adjustment apparatus of FIG. FIG. 7 is a longitudinal sectional view showing a state in which a probe is arranged at the left end of the visual field range in a modification of the probe position adjusting device of FIG. 1. It is a longitudinal cross-sectional view which shows the state by which the probe is arrange | positioned at the right end of the visual field range by the probe position adjustment apparatus of FIG. It is a probe position adjusting device concerning the 2nd embodiment of the present invention, Comprising: It is a longitudinal section of a probe position adjusting device provided with the fixed part which consists of snares. It is a modification of the probe position adjustment apparatus of FIG. 7, Comprising: It is a longitudinal cross-sectional view of a probe position adjustment apparatus provided with the fixing | fixed part containing a balloon. FIG. 8 is a vertical cross-sectional view of a probe position adjusting device that is another modification of the probe position adjusting device of FIG. 7 and includes a fixing portion including soft rubber. FIG. 8 is a vertical cross-sectional view of a probe position adjusting device having another guide portion to a fixed portion, which is another modification of the probe position adjusting device of FIG. 7.

A probe position adjusting device 1 according to a first embodiment of the present invention will be described below with reference to the drawings.
The probe position adjusting device 1 according to the present embodiment passes through the forceps channel 3A (see FIG. 2) provided through the endoscope insertion portion 2 (see FIG. 2) in the longitudinal direction, or the endoscope. The probe 5 (see FIG. 2) at the tip of the probe 4 (see FIG. 2) passes through a channel 3B (see FIG. 7) externally attached to the tip of the mirror insertion section 2 and into the visual field range A in front of the endoscope. A guide sheath (hereinafter also referred to as a guide sheath 1) that moves the position within the field-of-view range A of the endoscope. The probe 4 is, for example, an ultrasonic probe.

The guide sheath 1 is a tube made of an elastic material that can be elastically deformed as a whole. As shown in FIG. 1, the distal end portion 6, the distal end side bending portion 7, the proximal end side bending portion 8, An end portion 9, a bending length adjusting means 10 that adjusts the bending length of the proximal end side bending portion 8, and a curvature adjusting means 11 that adjusts the curvature of the distal end side bending portion 7 are provided.
The inner hole 1a at the center of the guide sheath 1 has an inner diameter that is slightly larger than the outer diameter of the wire-like probe 4, and accommodates the probe 4 so as to be movable in the longitudinal direction.

  The distal end portion 6 has an opening 6 a that opens at the distal end of the guide sheath 1 and allows the probe 4 to appear and disappear. Since the inner hole 1a of the guide sheath 1 has an inner diameter that is slightly larger than the outer diameter of the probe 4, the probe 5 of the probe 4 projected from the opening 6a of the distal end 6 of the guide sheath 1 is It will be in the state positioned in the radial direction.

The distal end side bending portion 7 is connected to the proximal end side of the distal end portion 6 and is brazed so as to be curved over an angular range of about 125 ° in one direction by being placed in one plane.
The proximal-side bending portion 8 is connected to the proximal-end side of the distal-end-side bending portion 7 and is bent in an opposite direction within the same plane as the distal-end-side bending portion 7 over an angle range of about 150 °. It is attached. The curvatures of the distal end side bending portion 7 and the proximal end side bending portion 8 in the free state are set to be equal to or less than the allowable maximum curvature of the probe 4 that penetrates the inner hole 1a.
In the example shown in FIG. 1, the curvature of the distal-side bending portion 7 in the free state is set smaller than the curvature of the proximal-side bending portion 8, and the curvature of the proximal-side bending portion 8 is set to the allowable maximum curvature of the probe 4. ing.

By these curved portions 7 and 8, a portion bent in a substantially S shape in a free state is provided in the vicinity of the distal end of the guide sheath 1. Further, when the curved portions 7 and 8 are accommodated in a channel such as the forceps channel 3A of the endoscope, the curved portions 7 and 8 are elastically deformed into a substantially straight shape that can be accommodated in the channel 3A. It has become.
The base end portion 9 is a substantially straight tubular portion in a free state, and is connected to the base end side of the base end side bending portion 8.

  The bending length adjusting means 10 includes a hole 12 that is formed through the tube wall in the longitudinal direction over almost the entire length from the proximal end portion 9 to the proximal end side bending portion 8, and a correction wire 13 that is inserted into the hole 12. It has. The correction wire 13 has a sufficiently high rigidity with respect to the proximal-side curved portion 8. As a result, when the correction wire 13 passes through the base end portion 9 from the base end side and is inserted into the hole 12 of the base end side bending portion 8, the base end side bending portion is inserted into the portion where the correction wire 13 is inserted. 8 is corrected almost straight, and the bending length of the proximal end side bending portion 8 is shortened.

  The curvature adjusting means 11 is inserted into the hole 14 through a hole 14 formed in the longitudinal direction in the tube wall over almost the entire length of the proximal end portion 9, the proximal end side bending portion 8 to the distal end side bending portion 7, And a tension wire 15 having a distal end fixed to the distal end portion 6. The tension wire 15 has lower rigidity than any of the distal end side bending portion 7, the proximal end side bending portion 8, and the proximal end portion 9, and when tension is applied on the proximal end side of the proximal end portion 9, the applied tension is reduced. It can transmit to the front-end | tip part 6. FIG.

The rigidity of each part has the following relationship.
Straightening wire 13> base end side bending portion 8> distal end side bending portion 7, tension wire 15> probe 4
As a result, when tension is applied to the pulling wire 15, the distal end portion 6 is pulled, so that only the curvature of the distal end side bending portion 7 can be changed as shown by a chain line in FIG. 1. .

The operation of the guide sheath 1 according to this embodiment configured as described above will be described below.
In order to adjust the position of the probe 5 of the probe 4 using the guide sheath 1 according to this embodiment, the guide sheath 1 in a state where the probe 4 is accommodated in the inner hole 1a is attached to the endoscope insertion portion 2. It is inserted into the forceps channel 3 </ b> A from the proximal end side and protrudes from the distal end opening of the insertion portion 2.

  FIG. 2 shows a state in which the entire length of the proximal-side curved portion 8 is projected forward from the insertion portion 2 from the distal end opening of the forceps channel 3A. In this state, as shown in FIG. 2, the guide sheath 1 exposes the substantially S-shaped distal side bending portion 7 and proximal end bending portion 8 to the outside of the forceps channel 3A. Then, by applying tension to the pulling wire 15 of the curvature adjusting means 11 on the proximal end side of the endoscope, the curvature of the distal end side bending portion 7 is increased, for example, set to be equal to the allowable maximum curvature of the probe 4. deep.

  That is, the guide sheath 1 is curved by drawing a 150 ° arc on the left side by the proximal-side curved portion 8 exposed from the forceps channel 3A, and then the proximal-side curved portion of 180 ° on the right side by the distal-side curved portion 7. By curving while drawing an arc having the same radius as 8, the opening of the distal end portion 6 is disposed obliquely rightward at the left end of the endoscope visual field. At this position, when the tip of the probe 4 having the probe 5 in the circumferential direction is exposed from the opening 6a, a tomographic image in a direction toward the left front side can be acquired as indicated by an arrow B1. .

  In this state, the bending length of the proximal-side bending portion 8 is shortened by pushing the correction wire 13 into the hole 12 of the proximal-side bending portion 8 while pulling the guide sheath 1 itself into the forceps channel 3A. . At the same time, by slightly relaxing the tension applied to the pulling wire 15 of the curvature adjusting means 11, the curvature of the distal side bending portion 7 is slightly reduced.

  As a result, the distal end portion 6 at the distal end of the distal-side bending portion 7 moves rightward in the visual field range A of the endoscope, and as shown in FIG. Will come to place. At this position, the probe 5 of the probe 4 exposed to the right from the opening 6a obtains a tomographic image in a substantially forward direction as indicated by an arrow B2 at the approximate center of the visual field range A. be able to.

  Further, while pulling the guide sheath 1 itself into the forceps channel 3 </ b> A, the correction wire 13 is completely pushed into the hole of the proximal side bending portion 7 to further relax the tension applied to the tension wire 15 of the curvature adjusting means 11. As a result, the bending length of the proximal-side bending portion 8 is minimized, and the distal end portion 6 of the distal end-side bending portion 7 is positioned on the right side of the visual field range A of the endoscope as shown in FIG. Be placed. Therefore, a tomographic image in a direction toward the right front side is obtained by the probe 5 of the probe 4 protruding from the opening 6a that opens to the right rear side at this position, as indicated by an arrow B3. be able to.

  Further, by applying tension to the pulling wire 15 constituting the curvature adjusting means 11 from the state in which the proximal-side curved portion 8 is completely straightened as shown in FIG. Only the curvature of the side curved portion 7 can be changed to finely move the probe 5 of the probe 4. Adjustment of the curvature of the distal-side bending portion 7 by the curvature adjusting means 11 can be performed at any position regardless of the position of the distal end portion 6 only by adjusting the tension applied to the pulling wire 15.

  As described above, according to the guide sheath 1 according to this embodiment, the guide sheath 1 itself is drawn into the forceps channel 3A and the correction wire 13 is pushed into the hole 14 of the proximal-side curved portion 8, thereby By adjusting the bending length of the bending portion 8, the position of the probe 5 of the probe 4 protruding from the distal end portion 6 and the opening 6 a of the distal end portion 6 is changed to each bending portion 7, in the visual field range A of the endoscope. There is an advantage that it can be moved over a wide range in the direction along the eight curved planes.

  As a result, when a target site such as a lesion is found in the corner of the visual field range A of the endoscope insertion unit 2, the probe 4 is moved in the visual field range A while the endoscope visual field range A is fixed. The tomographic image of the target site can be acquired. Since it is not necessary to change the visual field range A of the endoscope that moves greatly, there is an advantage that it is not necessary to lose sight of the target site captured at the corner.

  Further, the position of the probe 5 of the probe 4 can be finely adjusted by changing only the curvature of the distal-side bending portion 7 by the operation of the curvature adjusting means 11. As a result, the position of the tomographic image to be acquired can be finely adjusted.

  Furthermore, in this embodiment, the probe 5 of the probe 4 can be moved over a wide range in the same plane. That is, when the probe is swung only on one side with respect to the longitudinal axis of the insertion portion in the visual field range A of the endoscope as in the prior art, the probe is arranged in the visual field range A on the other side. Therefore, it is necessary to rotate the insertion portion itself of the endoscope by 180 ° around the longitudinal axis. However, for example, in a flat gap like in the pericardium, there is no space for rotating the insertion portion 2, and it is necessary to perform a complicated operation of rotating the probe once accommodated in the forceps channel and projecting the probe again. .

  On the other hand, like the guide sheath 1 according to the present embodiment, the probe 4 is placed in a wide range extending on both sides across the longitudinal axis of the endoscope in one plane arranged in the visual field range A of the endoscope. There is an advantage that a tomographic image at a desired position can be acquired with a simple operation even if there is no space for rotating the insertion portion 2.

The guide sheath 1 according to the present embodiment is a case where the probe 4 having the probe 5 in the circumferential direction is used, and the distal end side bending portion 7 is set to an angular range of about 180 °. The tip of the probe 4 is arranged toward the tangential direction of the trajectory that makes a circular motion in the field of view range A of the endoscope, and a tomographic image along the radial direction of the circular arc trajectory is acquired.
Instead, when the probe 4A having the probe 5 toward the tip is used, as shown in FIGS. 5 and 6, the angle range of the tip side bending portion 7 is set to about 90 °. The tip of the probe 4 may be arranged in the radial direction of the arc motion locus. Even in this case, a tomographic image along the radial direction of the arc locus can be acquired.

  Moreover, in this embodiment, although the guide sheath 1 which accommodates the probe 4 introduce | transduced via the forceps channel 3A with which the insertion part 2 of the endoscope was equipped was illustrated as the probe position adjustment apparatus 1, it replaced with this Thus, the present invention may be applied to a guide sheath that accommodates the probe 4 introduced through the channel 3B that is externally attached to the distal end of the insertion portion 2 of the endoscope.

  Moreover, in this embodiment, although the angle range of the front end side bending part 7 and the base end side bending part 8 was prescribed | regulated, it is not limited to this. In addition, although the distal end side bending portion 7 and the proximal end side bending portion 8 are adjacent to each other and configured in an S shape, three or more bending portions may be provided instead.

Next, a probe position adjusting apparatus 20 according to a second embodiment of the present invention will be described below with reference to the drawings.
In the description of the present embodiment, parts having the same configuration as those of the probe position adjusting device 1 according to the first embodiment described above are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 7, the probe position adjusting device 20 according to the present embodiment has a field of view of the endoscope via a channel 3 </ b> B provided in an attachment member 23 attached to the distal end of the insertion portion 2 of the endoscope. The distal end portion 6 is arranged in the range A, but the probe 4 is not housed in the inner hole 20a of the probe position adjusting device 20, but the probe 4 alone is viewed through the forceps channel 3A of the endoscope. It is different from the first embodiment in that it is introduced within the range A.

  The probe position adjusting device 20 according to this embodiment includes a fixing portion 21 that fixes the tip of the probe 4 to the tip 6. As shown in FIG. 7, the fixing portion 21 may be a snare 21 a introduced from the proximal end side through the inner hole 20 a of the tube constituting the probe position adjusting device 20. As shown, the tubular portion 21b through which the probe 4 is inserted and the fluid introduced from the proximal end side through the inner hole 20a of the tube constituting the probe position adjusting device 20 are radially inner on the inner surface of the tubular portion 21b. It may be provided with a balloon 21c that is inflated in the direction. According to the fixing portion 21 using the snare 21a or the balloon 21c, an arbitrary position of the probe 4 can be grasped or released. In the figure, reference numeral 21e denotes a tube for supplying fluid.

  Further, as the fixing portion 21, a structure in which the probe 4 is gripped by the snare 21a or the balloon 21c is illustrated, but instead, as shown in FIG. 9, the inner surface of the tubular portion 21b constituting the fixing portion 21 Alternatively, a material coated with a soft rubber 21d such as silicone rubber may be used. In this case, the probe 4 can be fixed in the tubular portion 21b by friction by inserting the probe 4 into the soft rubber 21d and elastically deforming the soft rubber 21d.

Then, by fixing the probe 4 to the fixing portion 21, the probe 4 can be supported at least in the radial direction at the distal end portion 6 of the probe position adjusting device 20.
Since the operation of the probe position adjusting device 20 is the same as that of the first embodiment, the description thereof is omitted.

Also with the probe position adjusting device 20 according to the present embodiment, the probe 5 of the probe 4 held by the fixing portion 21 provided at the distal end portion 6 can be arranged at a desired site in the visual field range A of the endoscope. .
As shown in FIG. 10, the fixing portion 21 may include a guide portion 22 for guiding the probe 4 introduced through the forceps channel 3A into the fixing portion 21 from the opening of the forceps channel 3A. Good. The guide portion 22 is preferably joined to the opening of the forceps channel 3 </ b> A, and has a structure that is detached from the opening after the probe 4 is fixed to the fixing portion 21.

  Moreover, the tubular part 21b which comprises the fixing | fixed part 21 may be attached to the front-end | tip part 6 so that rocking is possible around the axis line orthogonal to the longitudinal direction. By doing in this way, when the probe 4 is greatly bent and a load is applied, the tubular portion 21b is swung to release the load and prevent the probe 4 from being damaged.

DESCRIPTION OF SYMBOLS 1,20 Probe position adjustment apparatus 1a Inner hole 2 Endoscope insertion part 3A Forceps channel (channel)
3B channel 4 probe 5 probe 6 distal end portion 7 distal end side bending portion 8 proximal end side bending portion 10 bending length adjusting means (curving length adjusting portion)
11 Curvature adjusting means (curvature adjusting part)
12, 14 hole 13 straightening wire 15 tension wire 21 fixing part

Claims (8)

A tip for positioning the probe at the tip of the wire-shaped probe in the radial direction;
A proximal end side and a proximal end side curved portion that are elastically deformable and are brazed so as to be bent in the length direction and curved in the opposite direction to the proximal side from the distal end portion,
A bending length adjusting part for adjusting the bending length of the proximal end side bending part,
A probe position adjusting device provided so as to be able to protrude and retract from an opening of a channel that opens near the distal end of an endoscope insertion portion.   2. The probe position adjustment according to claim 1, wherein the bending length adjusting portion is a correction wire that is inserted into a hole extending in a longitudinal direction in the proximal-side bending portion and straightens the proximal-side bending portion. apparatus.   The probe position adjusting device according to claim 1, further comprising a curvature adjusting unit that adjusts a curvature of the distal-end-side bending unit.   A tension wire in which the curvature adjusting portion is inserted into a hole extending in the longitudinal direction in the proximal-side bending portion and the distal-side bending portion, and is fixed in the vicinity of the distal end of the distal-side bending portion and can transmit tension. The probe position adjusting device according to claim 3. A curvature adjusting unit made of a tensile wire that is inserted into a hole extending in the longitudinal direction in the proximal-side bending portion and the distal-side bending portion and is fixed in the vicinity of the distal end portion of the distal-side bending portion and capable of transmitting tension. With
The probe position adjusting device according to claim 2, wherein the straightening wire, the proximal-side bending portion, the distal-end bending portion, the tension wire, and the rigidity of the probe have the following relationship.
Straightening wire> Base end side bend> Tip side bend and tension wire> Probe   The probe position adjusting device according to any one of claims 1 to 5, wherein the probe position adjusting device is formed in a tube shape having an inner hole through which the probe is inserted.   The probe position adjusting device according to any one of claims 1 to 5, wherein the tip portion includes a fixing portion that is fixed to the tip of the probe. The probe position adjusting device according to claim 7, wherein the fixed portion is swingably attached to the tip portion.

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