Effect of laparoscopic grasper force transmission ratio on grasp control
Identifieur interne : 000776 ( PascalFrancis/Corpus ); précédent : 000775; suivant : 000777Effect of laparoscopic grasper force transmission ratio on grasp control
Auteurs : Eleonora P. Westebring-Van Der Putten ; John J. Van Den Dobbelsteen ; Richard H. M. Goossens ; Jack J. Jakimowicz ; Jenny DankelmanSource :
- Surgical endoscopy [ 0930-2794 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background Surgeons may cause tissue damage by incorrect laparoscopic pinch force control. Unpredictable tissue and grasper properties may cause slips or ruptures. This study investigated how different forms of haptic feedback influence the surgeon's ability to generate a safe laparoscopic grasp while pulling tissues of variable stiffness using graspers with different force transmission ratios. The results will help define design requirements for training facilities and instruments. Methods For this study, 10 participants lifted an object barehanded, with tweezers, or with one of two laparoscopic graspers until they where able to complete five consecutive safe lifts under different tissue stiffness conditions. The participants were presented with indirect visual feedback of pinch force, object location, and target location. Results Lifting with instruments (tweezers or graspers) required 4.5 to 14.5 times as many practice trials as barehanded lifting, where no slips were recorded. Additionally, slips occurred more often with a decreasing force transmission ratio of the graspers and with increasing tissue stiffness. The maximal pinch force was higher in lifting with instruments than in barehanded lifting (26-60%) irrespective of the stiffness conditions. Using a grasper, the slip margin often was not high enough in the stiffest con- dition, resulting in slippage of up to 84%. Conclusions Without the direct tactile feedback that occurs with normal skin-tissue contact, subjects using graspers have trouble anticipating slippage when lifting tissue with variable stiffness. Performance drops with a decreased force transmision ratio of the instrument and increased tissue stiffness. Furthermore, the pinch forces are not adapted to the variable stiffness conditions. The same pinch force is applied irrespective of tissue stiffness. It takes participants longer to learn a safe laparoscopic grasp than to learn barehanded lifts. Additionally, to perform safe laparoscopic surgery, care should be taken when graspers with a low force transmission ratio are used.
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Pour connaître la documentation sur le format Inist Standard.
| pA |
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|---|
Format Inist (serveur)
| NO : | PASCAL 09-0238424 INIST |
|---|---|
| ET : | Effect of laparoscopic grasper force transmission ratio on grasp control |
| AU : | WESTEBRING-VAN DER PUTTEN (Eleonora P.); VAN DEN DOBBELSTEEN (John J.); GOOSSENS (Richard H. M.); JAKIMOWICZ (Jack J.); DANKELMAN (Jenny) |
| AF : | Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15/2628 CE Delft/Pays-Bas (3 aut., 4 aut.); Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology/Delft/Pays-Bas (1 aut., 2 aut., 5 aut.); Department of Surgery, Catharina-Hospital/Eindhoven/Pays-Bas (4 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Surgical endoscopy; ISSN 0930-2794; Coden SUREEX; Etats-Unis; Da. 2009; Vol. 23; No. 4; Pp. 818-824; Bibl. 21 ref. |
| LA : | Anglais |
| EA : | Background Surgeons may cause tissue damage by incorrect laparoscopic pinch force control. Unpredictable tissue and grasper properties may cause slips or ruptures. This study investigated how different forms of haptic feedback influence the surgeon's ability to generate a safe laparoscopic grasp while pulling tissues of variable stiffness using graspers with different force transmission ratios. The results will help define design requirements for training facilities and instruments. Methods For this study, 10 participants lifted an object barehanded, with tweezers, or with one of two laparoscopic graspers until they where able to complete five consecutive safe lifts under different tissue stiffness conditions. The participants were presented with indirect visual feedback of pinch force, object location, and target location. Results Lifting with instruments (tweezers or graspers) required 4.5 to 14.5 times as many practice trials as barehanded lifting, where no slips were recorded. Additionally, slips occurred more often with a decreasing force transmission ratio of the graspers and with increasing tissue stiffness. The maximal pinch force was higher in lifting with instruments than in barehanded lifting (26-60%) irrespective of the stiffness conditions. Using a grasper, the slip margin often was not high enough in the stiffest con- dition, resulting in slippage of up to 84%. Conclusions Without the direct tactile feedback that occurs with normal skin-tissue contact, subjects using graspers have trouble anticipating slippage when lifting tissue with variable stiffness. Performance drops with a decreased force transmision ratio of the instrument and increased tissue stiffness. Furthermore, the pinch forces are not adapted to the variable stiffness conditions. The same pinch force is applied irrespective of tissue stiffness. It takes participants longer to learn a safe laparoscopic grasp than to learn barehanded lifts. Additionally, to perform safe laparoscopic surgery, care should be taken when graspers with a low force transmission ratio are used. |
| CC : | 002B01; 002B24E06 |
| FD : | Endoscopie; Laparoscopie; Transmission; Contrôle; Médecine; Chirurgie endoscopique; Traitement |
| FG : | Prévention |
| ED : | Endoscopy; Laparoscopy; Transmission; Check; Medicine; Endoscopic surgery; Treatment |
| EG : | Prevention |
| SD : | Endoscopía; Laparoscopia; Transmisión; Control; Medicina; Cirugía endoscópica; Tratamiento |
| LO : | INIST-21220.354000184953910230 |
| ID : | 09-0238424 |
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Van Den Dobbelsteen</name><affiliation><inist:fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Goossens, Richard H M" sort="Goossens, Richard H M" uniqKey="Goossens R" first="Richard H. M." last="Goossens">Richard H. M. Goossens</name><affiliation><inist:fA14 i1="01"><s1>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15</s1><s2>2628 CE Delft</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Jakimowicz, Jack J" sort="Jakimowicz, Jack J" uniqKey="Jakimowicz J" first="Jack J." last="Jakimowicz">Jack J. Jakimowicz</name><affiliation><inist:fA14 i1="01"><s1>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15</s1><s2>2628 CE Delft</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="03"><s1>Department of Surgery, Catharina-Hospital</s1><s2>Eindhoven</s2><s3>NLD</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Dankelman, Jenny" sort="Dankelman, Jenny" uniqKey="Dankelman J" first="Jenny" last="Dankelman">Jenny Dankelman</name><affiliation><inist:fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0238424</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0238424 INIST</idno><idno type="RBID">Pascal:09-0238424</idno><idno type="wicri:Area/PascalFrancis/Corpus">000776</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Effect of laparoscopic grasper force transmission ratio on grasp control</title><author><name sortKey="Westebring Van Der Putten, Eleonora P" sort="Westebring Van Der Putten, Eleonora P" uniqKey="Westebring Van Der Putten E" first="Eleonora P." last="Westebring-Van Der Putten">Eleonora P. Westebring-Van Der Putten</name><affiliation><inist:fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Van Den Dobbelsteen, John J" sort="Van Den Dobbelsteen, John J" uniqKey="Van Den Dobbelsteen J" first="John J." last="Van Den Dobbelsteen">John J. Van Den Dobbelsteen</name><affiliation><inist:fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Goossens, Richard H M" sort="Goossens, Richard H M" uniqKey="Goossens R" first="Richard H. M." last="Goossens">Richard H. M. Goossens</name><affiliation><inist:fA14 i1="01"><s1>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15</s1><s2>2628 CE Delft</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Jakimowicz, Jack J" sort="Jakimowicz, Jack J" uniqKey="Jakimowicz J" first="Jack J." last="Jakimowicz">Jack J. Jakimowicz</name><affiliation><inist:fA14 i1="01"><s1>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15</s1><s2>2628 CE Delft</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="03"><s1>Department of Surgery, Catharina-Hospital</s1><s2>Eindhoven</s2><s3>NLD</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Dankelman, Jenny" sort="Dankelman, Jenny" uniqKey="Dankelman J" first="Jenny" last="Dankelman">Jenny Dankelman</name><affiliation><inist:fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">Surgical endoscopy</title><title level="j" type="abbreviated">Surg. endosc.</title><idno type="ISSN">0930-2794</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Surgical endoscopy</title><title level="j" type="abbreviated">Surg. endosc.</title><idno type="ISSN">0930-2794</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Check</term><term>Endoscopic surgery</term><term>Endoscopy</term><term>Laparoscopy</term><term>Medicine</term><term>Transmission</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Endoscopie</term><term>Laparoscopie</term><term>Transmission</term><term>Contrôle</term><term>Médecine</term><term>Chirurgie endoscopique</term><term>Traitement</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Surgeons may cause tissue damage by incorrect laparoscopic pinch force control. Unpredictable tissue and grasper properties may cause slips or ruptures. This study investigated how different forms of haptic feedback influence the surgeon's ability to generate a safe laparoscopic grasp while pulling tissues of variable stiffness using graspers with different force transmission ratios. The results will help define design requirements for training facilities and instruments. Methods For this study, 10 participants lifted an object barehanded, with tweezers, or with one of two laparoscopic graspers until they where able to complete five consecutive safe lifts under different tissue stiffness conditions. The participants were presented with indirect visual feedback of pinch force, object location, and target location. Results Lifting with instruments (tweezers or graspers) required 4.5 to 14.5 times as many practice trials as barehanded lifting, where no slips were recorded. Additionally, slips occurred more often with a decreasing force transmission ratio of the graspers and with increasing tissue stiffness. The maximal pinch force was higher in lifting with instruments than in barehanded lifting (26-60%) irrespective of the stiffness conditions. Using a grasper, the slip margin often was not high enough in the stiffest con- dition, resulting in slippage of up to 84%. Conclusions Without the direct tactile feedback that occurs with normal skin-tissue contact, subjects using graspers have trouble anticipating slippage when lifting tissue with variable stiffness. Performance drops with a decreased force transmision ratio of the instrument and increased tissue stiffness. Furthermore, the pinch forces are not adapted to the variable stiffness conditions. The same pinch force is applied irrespective of tissue stiffness. It takes participants longer to learn a safe laparoscopic grasp than to learn barehanded lifts. Additionally, to perform safe laparoscopic surgery, care should be taken when graspers with a low force transmission ratio are used.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0930-2794</s0></fA01><fA02 i1="01"><s0>SUREEX</s0></fA02><fA03 i2="1"><s0>Surg. endosc.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Effect of laparoscopic grasper force transmission ratio on grasp control</s1></fA08><fA11 i1="01" i2="1"><s1>WESTEBRING-VAN DER PUTTEN (Eleonora P.)</s1></fA11><fA11 i1="02" i2="1"><s1>VAN DEN DOBBELSTEEN (John J.)</s1></fA11><fA11 i1="03" i2="1"><s1>GOOSSENS (Richard H. M.)</s1></fA11><fA11 i1="04" i2="1"><s1>JAKIMOWICZ (Jack J.)</s1></fA11><fA11 i1="05" i2="1"><s1>DANKELMAN (Jenny)</s1></fA11><fA14 i1="01"><s1>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15</s1><s2>2628 CE Delft</s2><s3>NLD</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology</s1><s2>Delft</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Surgery, Catharina-Hospital</s1><s2>Eindhoven</s2><s3>NLD</s3><sZ>4 aut.</sZ></fA14><fA20><s1>818-824</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>21220</s2><s5>354000184953910230</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>21 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0238424</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Surgical endoscopy</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Background Surgeons may cause tissue damage by incorrect laparoscopic pinch force control. Unpredictable tissue and grasper properties may cause slips or ruptures. This study investigated how different forms of haptic feedback influence the surgeon's ability to generate a safe laparoscopic grasp while pulling tissues of variable stiffness using graspers with different force transmission ratios. The results will help define design requirements for training facilities and instruments. Methods For this study, 10 participants lifted an object barehanded, with tweezers, or with one of two laparoscopic graspers until they where able to complete five consecutive safe lifts under different tissue stiffness conditions. The participants were presented with indirect visual feedback of pinch force, object location, and target location. Results Lifting with instruments (tweezers or graspers) required 4.5 to 14.5 times as many practice trials as barehanded lifting, where no slips were recorded. Additionally, slips occurred more often with a decreasing force transmission ratio of the graspers and with increasing tissue stiffness. The maximal pinch force was higher in lifting with instruments than in barehanded lifting (26-60%) irrespective of the stiffness conditions. Using a grasper, the slip margin often was not high enough in the stiffest con- dition, resulting in slippage of up to 84%. Conclusions Without the direct tactile feedback that occurs with normal skin-tissue contact, subjects using graspers have trouble anticipating slippage when lifting tissue with variable stiffness. Performance drops with a decreased force transmision ratio of the instrument and increased tissue stiffness. Furthermore, the pinch forces are not adapted to the variable stiffness conditions. The same pinch force is applied irrespective of tissue stiffness. It takes participants longer to learn a safe laparoscopic grasp than to learn barehanded lifts. Additionally, to perform safe laparoscopic surgery, care should be taken when graspers with a low force transmission ratio are used.</s0></fC01><fC02 i1="01" i2="X"><s0>002B01</s0></fC02><fC02 i1="02" i2="X"><s0>002B24E06</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Endoscopie</s0><s5>04</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Endoscopy</s0><s5>04</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Endoscopía</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Laparoscopie</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Laparoscopy</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Laparoscopia</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Transmission</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Transmission</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Transmisión</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Contrôle</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Check</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Control</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Médecine</s0><s5>13</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Medicine</s0><s5>13</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Medicina</s0><s5>13</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Chirurgie endoscopique</s0><s5>30</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Endoscopic surgery</s0><s5>30</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Cirugía endoscópica</s0><s5>30</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Traitement</s0><s5>31</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Treatment</s0><s5>31</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Tratamiento</s0><s5>31</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Prévention</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Prevention</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Prevención</s0><s5>37</s5></fC07><fN21><s1>173</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 09-0238424 INIST</NO><ET>Effect of laparoscopic grasper force transmission ratio on grasp control</ET><AU>WESTEBRING-VAN DER PUTTEN (Eleonora P.); VAN DEN DOBBELSTEEN (John J.); GOOSSENS (Richard H. M.); JAKIMOWICZ (Jack J.); DANKELMAN (Jenny)</AU><AF>Department of Applied Ergonomics and Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15/2628 CE Delft/Pays-Bas (3 aut., 4 aut.); Department of Biomedical Engineering, Faculty of Mechanical, Maritime and Materials Sciences, Delft University of Technology/Delft/Pays-Bas (1 aut., 2 aut., 5 aut.); Department of Surgery, Catharina-Hospital/Eindhoven/Pays-Bas (4 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Surgical endoscopy; ISSN 0930-2794; Coden SUREEX; Etats-Unis; Da. 2009; Vol. 23; No. 4; Pp. 818-824; Bibl. 21 ref.</SO><LA>Anglais</LA><EA>Background Surgeons may cause tissue damage by incorrect laparoscopic pinch force control. Unpredictable tissue and grasper properties may cause slips or ruptures. This study investigated how different forms of haptic feedback influence the surgeon's ability to generate a safe laparoscopic grasp while pulling tissues of variable stiffness using graspers with different force transmission ratios. The results will help define design requirements for training facilities and instruments. Methods For this study, 10 participants lifted an object barehanded, with tweezers, or with one of two laparoscopic graspers until they where able to complete five consecutive safe lifts under different tissue stiffness conditions. The participants were presented with indirect visual feedback of pinch force, object location, and target location. Results Lifting with instruments (tweezers or graspers) required 4.5 to 14.5 times as many practice trials as barehanded lifting, where no slips were recorded. Additionally, slips occurred more often with a decreasing force transmission ratio of the graspers and with increasing tissue stiffness. The maximal pinch force was higher in lifting with instruments than in barehanded lifting (26-60%) irrespective of the stiffness conditions. Using a grasper, the slip margin often was not high enough in the stiffest con- dition, resulting in slippage of up to 84%. Conclusions Without the direct tactile feedback that occurs with normal skin-tissue contact, subjects using graspers have trouble anticipating slippage when lifting tissue with variable stiffness. Performance drops with a decreased force transmision ratio of the instrument and increased tissue stiffness. Furthermore, the pinch forces are not adapted to the variable stiffness conditions. The same pinch force is applied irrespective of tissue stiffness. It takes participants longer to learn a safe laparoscopic grasp than to learn barehanded lifts. Additionally, to perform safe laparoscopic surgery, care should be taken when graspers with a low force transmission ratio are used.</EA><CC>002B01; 002B24E06</CC><FD>Endoscopie; Laparoscopie; Transmission; Contrôle; Médecine; Chirurgie endoscopique; Traitement</FD><FG>Prévention</FG><ED>Endoscopy; Laparoscopy; Transmission; Check; Medicine; Endoscopic surgery; Treatment</ED><EG>Prevention</EG><SD>Endoscopía; Laparoscopia; Transmisión; Control; Medicina; Cirugía endoscópica; Tratamiento</SD><LO>INIST-21220.354000184953910230</LO><ID>09-0238424</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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