Patent Publication Number: US-2022211263-A1

Title: Multi-piece access port imaging systems

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to and the benefit of U.S. Provisional Application No. 63/165,045, filed Mar. 23, 2021, the entire contents of which are herein incorporated by reference in their entirety. 
    
    
     FIELD 
     This disclosure relates to access ports, for example. 
     BACKGROUND 
     Conventional methods and systems in the laparoscopic and access port arts have generally been considered satisfactory for their intended purpose. However, there is still a need in the art for improved systems. The present disclosure provides a solution for this need. 
     SUMMARY 
     An access port system can include a port body configured to be inserted into an incision. The port body can define an imaging assembly opening from a proximal side to a distal side thereof. The system can include an imaging assembly configured to pass through the imaging assembly opening to allow imaging of an interior portion of a patient body. 
     The port body can be flexible and a housing of the imaging assembly can be rigid. The port body can also define an instrument channel from the proximal side thereof to the distal side to allow an instrument pass through to perform a medical procedure. 
     The port body can include one or more anchors extending from the port body. The one or more anchors can include a heal anchor adjacent the distal side of the port body. The one or more anchors can include a toe anchor disposed on an opposite side of the port body relative to the heal anchor and proximal of the heal anchor. 
     The imaging assembly can include a radial portion configured to house an imaging device disposed therein and a leg portion extending proximally from the radial portion. The imaging assembly can include a boot shape, for example. 
     The leg portion can be angled at a right angle to the radial portion. The imaging assembly can include an imaging device located in the radial portion at a radially outward position thereof. 
     The port body can include an instrument channel defined therethrough from a proximal side to a distal side thereof. The port body can include an insufflation port defined therethrough from a proximal side to a distal side thereof. In certain embodiments, the port body is made of silicone. 
     The port body and the imaging assembly can be configured such that imaging assembly does not rotate within the port body when inserted into the port body. The port body can define a window that seals to the radial portion of the imaging assembly. 
     The port body can include a swept back shape. An imaging device housing of the imaging device can include a swept back shape. For example, the imaging device housing can include an oval cross-sectional shape. 
     In certain embodiments, the imaging assembly can be a straight member having an angled distal face. An imaging device can be disposed at the angled distal face to provide an angled view when inserted through the port body. 
     In certain embodiments, the system can include an image processing module configured to allow digital movement of an image in situ. Any other suitable image processing is contemplated herein. 
     These and other features of the embodiments of the subject disclosure will become more readily apparent to those skilled in the art from the following detailed description taken in conjunction with the drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       So that those skilled in the art to which the subject disclosure appertains will readily understand how to make and use the devices and methods of the subject disclosure without undue experimentation, embodiments thereof will be described in detail herein below with reference to certain figures, wherein: 
         FIG. 1  is a top down plan view of an embodiment of a system in accordance with this disclosure; 
         FIG. 2  is a cross-sectional view of the embodiment of  FIG. 1 , the section being taken along line  2 - 2  as shown in  FIG. 1 ; 
         FIG. 3  is a perspective view of the embodiment of  FIG. 1 ; 
         FIG. 4  is a perspective view of the embodiment of  FIG. 1 ; 
         FIG. 5  is a side elevation view of the embodiment of  FIG. 1 ; 
         FIG. 6  is a bottom up plan view of the embodiment of  FIG. 1 ; 
         FIG. 7  is a top down perspective view of the embodiment of  FIG. 1 , showing the radial extension in a rotated position; 
         FIG. 8  is a bottom up view of the embodiment of  FIG. 7 ; 
         FIG. 9  is a front elevation view of the embodiment of  FIG. 7 ; 
         FIG. 10  is a side elevation view of the embodiment of  FIG. 1 , showing a port body being moved upwardly relative to an imaging assembly; 
         FIG. 11  is a perspective view of an imaging assembly of the embodiment of  FIG. 1 , shown in isolation; 
         FIG. 12  is a top down plan view of a port body of the embodiment of  FIG. 1 , shown in isolation; 
         FIG. 13  is a side schematic view of the embodiment of  FIG. 12 , showing internal channels in phantom; 
         FIG. 14  is a perspective view of the embodiment of  FIG. 12 ; 
         FIG. 15  is a perspective view of the embodiment of  FIG. 12 ; 
         FIG. 16  is a perspective view of another embodiment of an imaging assembly in accordance with this disclosure; 
         FIG. 17  is a bottom perspective view of the embodiment of  FIG. 16 ; 
         FIG. 18  is a cross-sectional view of the embodiment of  FIG. 16 ; 
         FIG. 19  is a perspective view of another embodiment of a port body in accordance with this disclosure, shown without an instrument channel; 
         FIG. 20  is a perspective view of the embodiment of  FIG. 19 ; 
         FIG. 21  is a perspective view of another embodiment of a port body in accordance with this disclosure, shown without an instrument channel; 
         FIG. 22  is a perspective view of the embodiment of  FIG. 19 ; 
         FIG. 23  is a perspective view of another embodiment of an access port system in accordance with this disclosure; 
         FIG. 24  is a left side elevation view of the embodiment of  FIG. 23 ; 
         FIG. 25  is a top down plan view of the embodiment of  FIG. 23 ; 
         FIG. 26  is a bottom up plan view of the embodiment of  FIG. 23 ; 
         FIG. 27  is a right side elevation view of the embodiment of  FIG. 23 ; 
         FIG. 28  is a front side elevation view of the embodiment of  FIG. 23 ; 
         FIG. 29  is a cross-sectional view of the embodiment of  FIG. 23 , sectioned along line  29 - 29  in  FIG. 28 ; 
         FIG. 30  is a rear side elevation view of the embodiment of  FIG. 23 ; 
         FIG. 31  is a cross-sectional view of the embodiment of  FIG. 23 , sectioned along line  31 - 31  in  FIG. 30 ; 
         FIG. 32  is a perspective view of the embodiment of  FIG. 23 ; 
         FIG. 33  is another perspective view of the embodiment of  FIG. 23 ; 
         FIG. 34  is a right side elevation view of an embodiment of a port body of the embodiment of  FIG. 23 , shown in isolation; 
         FIG. 35  is a front elevation view of the embodiment of  FIG. 34 ; 
         FIG. 36  is a top down plan view of the embodiment of  FIG. 34 ; 
         FIG. 37  is a perspective view of the embodiment of  FIG. 34 ; 
         FIG. 38  is a rear elevation view of the embodiment of  FIG. 34 ; 
         FIG. 39  is a bottom up plan view of the embodiment of  FIG. 34 ; 
         FIG. 40  is a front elevation view of the embodiment of  FIG. 34 , shown enlarged; 
         FIG. 41  is a cross-sectional view of the embodiment of  FIG. 34 , sectioned along line  40 - 40  in  FIG. 40 , showing an embodiment of an instrument port and a imaging assembly port; 
         FIG. 42  is a front elevation view of the embodiment of  FIG. 34 , shown enlarged; 
         FIG. 43  is a cross-sectional view of the embodiment of  FIG. 34 , sectioned along line  43 - 43  in  FIG. 40 , showing an embodiment of an insufflation port; 
         FIG. 44  is a perspective view of an embodiment of an imaging assembly housing of the embodiment of  FIG. 23 , shown in isolation; 
         FIG. 45  is a right side elevation view of the embodiment of  FIG. 44 ; 
         FIG. 46  is a cross-sectional view of the embodiment of  FIG. 45 , sectioned along line  46 - 46  in  FIG. 40 ; 
         FIG. 47  is a left side elevation view of the embodiment of  FIG. 44 ; 
         FIG. 48  is a cross-sectional view of the embodiment of  FIG. 44 , sectioned along line  48 - 48  in  FIG. 40 ; 
         FIG. 49  is a bottom up plan view of the embodiment of  FIG. 44 ; 
         FIG. 50  is a top down plan view of the embodiment of  FIG. 44 ; 
         FIG. 51  is a left side elevation view of an embodiment of a right half of the embodiment of  FIG. 44 ; 
         FIG. 52  is a right side elevation view of an embodiment of a left half of the embodiment of  FIG. 44 ; 
         FIG. 53  is a front elevation view of the embodiment of  FIG. 44 ; and 
         FIG. 54  is a front elevation view of the embodiment of  FIG. 44 . 
     
    
    
     DETAILED DESCRIPTION 
     Reference will now be made to the drawings wherein like reference numerals identify similar structural features or aspects of the subject disclosure. For purposes of explanation and illustration, and not limitation, an illustrative view of an embodiment of a system in accordance with the disclosure is shown in  FIG. 1  and is designated generally by reference character  100 . Other embodiments and/or aspects of this disclosure are shown in  FIGS. 2-54 . 
     Referring to  FIGS. 1-23  generally, and specifically to  FIGS. 1-10 , an access port system  100  can include a port body  101  configured to be inserted into an incision. Referring additionally to  FIGS. 11-15 , the port body  101  can define an imaging assembly opening  103  from a proximal side to a distal side thereof. The access port system  100  can include and an imaging assembly  105  configured to pass through the imaging assembly opening  103  to allow imaging of an interior portion of a patient body. 
     In certain embodiments, the port body  101  can be flexible (e.g., made of elastomeric material) and a housing  105   a  of the imaging assembly can be rigid (e.g., made of hard plastic or metal). In certain embodiments, the port body  101  can also define an instrument channel  107  from the proximal side thereof to the distal side to allow an instrument pass through to perform a medical procedure. In certain embodiments, e.g., as shown in  FIGS. 19-22 , the port body  201 ,  301  may not have an instrument channel, but only an imaging assembly opening  103 ,  303 . The port body  201 ,  301  may be otherwise similar to the port body  101  as disclosed herein, or may be different in any suitable manner appreciated by those having ordinary skill in the art in view of this disclosure. 
     In certain embodiments, the port body  101  can include one or more anchors  109   a,    109   b  extending from the port body  101 . The one or more anchors  109   a,    109   b  can include a heal anchor  109   a  adjacent the distal side of the port body  101 , e.g., as shown. The one or more anchors  109   a,    109   b  can include a toe anchor  109   b  disposed on an opposite side of the port body  101  relative to the heal anchor  109   a  and proximal of the heal anchor  109   a,  e.g., as shown. 
     In certain embodiments, referring to  FIGS. 2 and 11 , the imaging assembly  105  can include an imaging assembly radial portion  111   a  configured to house an imaging device  113  (e.g., a camera) disposed therein. The imaging assembly  105  can include an imaging assembly leg portion  111   b  extending proximally from the radial portion  111   a  (e.g., at an angle as shown). For example, the imaging assembly  105  can include a boot shape, e.g., as shown. In certain embodiments, the leg portion  111   b  can be angled at a non-right angle to the radial portion  111   a.    
     The imaging assembly  105  can include an imaging device  113  located in the radial portion  111   a  at a radially outward position thereof, e.g., radially away from the leg portion  111   b . A transparent layer  115  (e.g., made of glass or plastic) can be disposed on a distal side of the imaging device  113  (e.g., along the length of the radial portion  111   a ). The imaging assembly  105  can include one or more irrigation ports  117  (e.g., defied through the transparent layer  115 ) disposed proximate to the imaging device  113  to provide irrigation proximate the imaging device  113  (e.g., to clean the transparent layer  115  where the imaging device  113  is located). 
     The imaging assembly  105  can include one or more irrigation channels  119  connected to one or more irrigation ports  117 . The one or more irrigation channels  119  can extend from the one or more irrigation ports  117 , through the radial portion  111   a,  and through the leg portion  111   b  to a proximal end of the leg portion  111   b  (e.g., and exit therefrom), e.g., as shown. In certain embodiments, the housing  105   a  may include a data port (e.g., USB-C, USB3.0, or other suitable port) disposed at a proximal side thereof (e.g., shown having a data cable plugged in). 
     In certain embodiments, the port body  101  can include one or more insufflation  121  defined therethrough. The one or more insufflation ports  121  may include a tube connected or disposed therein, e.g., as shown in  FIGS. 1-10 . 
     Referring to  FIGS. 7-9 , in certain embodiments, the port body  101  and the imaging assembly  105  can be configured such that the port body  101  allows the imaging assembly  105  to rotate within the port body  101 . For example, the port body  101  can define a window  123  (e.g., a portion of the distal end of the imaging assembly opening  103 ) that limits a rotation of the radial portion  111   a  of the imaging assembly  105 . For example, the window  123  can be sized limit rotation of the radial portion to about 25 degrees or less, e.g., about 19 degrees as shown. Any suitable limit is contemplated herein. 
     In certain embodiments, as shown in  FIG. 9 , the non-right angle between the leg portion  111   b  and the radial portion  111   a  causes a lifting angle  125  when rotated within the port body  101 . For example, the lifting angle  125  can be about 3 degrees, e.g., as shown. Any suitable lifting angle  125 , and any suitable non-right angle of the leg portion  111   b  is contemplated herein. In certain embodiments, e.g., as shown best in  FIG. 2 , the leg portion  111   b  can house imaging electronics (e.g., circuit board  127 , data cable  129  to imaging device  113 , and/or data port  131 ) and/or can act as a handle for rotation of the imaging assembly  105 , for example. Any other suitable features are contemplated herein. 
     In certain embodiments, the non-right angle of the radial portion  111   a  between the rotatable axis and the vector of the radial extension of the radial portion  111   a  can be between about 30 degrees and about 120 degrees. The effect of decreasing the angle can cause an increase in the change of viewing angle. The angle of viewing can be further adjusted by the raising or lowering a slope of the lower surface of the radial extension from the tip to the leg portion  111   b.  Furthermore, the combination of variability of these characteristics can allow for the device to function facing any direction around an incision, for example. 
     Referring to  FIGS. 16-18 , in certain embodiments, instead of a boot shape for example, the imaging assembly  205  can be a straight member having an angled distal face  211 . An imaging device  113  can be disposed at the angled distal face  211  to provide an angled view when inserted through the port body, e.g.,  101 ,  201 . The imaging assembly  205  can include one or more irrigation ports  217  disposed at the angled distal face  211  proximate the imaging device  113 . The imaging assembly  205  can otherwise include any suitable features of the imaging assembly  105  fit into the straight housing (e.g., electronics, data port, irrigation channels, etc.). Any suitable software and/or hardware modules for imaging and/or performing any other procedure are contemplated herein. 
     Referring to  FIG. 23-33 , another embodiment of an access port system  400  is shown in accordance with this disclosure.  FIGS. 34-43  show an embodiment of a port body  401  of the embodiment of a system  400 , shown in isolation.  FIGS. 44-52  show an embodiment of an imaging assembly housing  405   a  of the embodiment of a system  400 , shown in isolation. 
     The system  400  can be similar to the system  100  in certain embodiments. For example, the system can have a port body  401  that can be configured to be inserted into an incision, and the port body  401  can define an imaging assembly opening  403  from a proximal side to a distal side thereof. 
     The port body  401  can be similar to the port body  101 ,  201 ,  301  in certain embodiments. For example, the port body  401  can be made of a flexible material (e.g., silicone). The port body  401  can include an instrument channel  407  and an insufflation port  421 . The port body  401  can include a swept back shape as shown, e.g., as opposed to a more rounded shape as shown for the port body  101 ,  201 ,  301 . The swept back shape can allow for a smaller incision to be made. 
     The system  400  can include an imaging assembly  405  configured to pass through the imaging assembly opening  403  to allow imaging of an interior portion of a patient body (e.g., an abdomen location, e.g., a gallbladder area). The imaging assembly  405  can include an imaging assembly housing  405   a.  The imaging assembly housing  405   a  can include a similar overall shape as assembly  105  (e.g., a boot shape having a leg portion  411   b  and radial portion  411   a ). The imaging assembly housing  405   a  can have about a 90 degree angle between the radial portion  411   a  and the leg portion  411   b.  Any suitable angle is contemplated herein. 
     The imaging assembly  405  can include similar components (e.g., imaging devices, cables, etc.) and in similar locations to the imaging assembly  105  for example. For example, the imaging assembly  405  can include an imaging device and/or lighting in the radial extension  411   a  (e.g., a locations. One or more cables (e.g., a MIPI cable) can travel through the interior cavity of the imaging assembly housing  405   a  to a location to be connected. A transparent layer (not shown, similar to layer  115 ), e.g., made of glass or plastic, can be disposed on a distal side of the imaging device (e.g., along the length of the radial portion  411   a ). 
     As shown, the imaging assembly housing  405   a  can include a swept back shape. For example, the imaging assembly housing can have an oval cross-sectional shape. Such a swept back shape can allow for a reduction in the width of the entire system  400  including the port body  401 . For example, as shown, the imaging assembly opening  403  can include a complimentary shape to the imaging assembly housing  405   a  to create a suitable seal. Any suitable shape to allow for a seal is contemplated herein. As disclosed above, the port body  401  can also include a swept back shape aiding in reduction of overall width and reduction in incision size, for example. Any other suitable form factor for reducing incision size is contemplated herein. In certain embodiments, the components of system  400  can be sized to allow for an 8 mm incision or smaller. 
     The port body  401  can define a window  423  (e.g., a portion of the distal end of the imaging assembly opening  403 ) where the radial extension  411   a  of the imaging assembly  405  extends from. For example, the window  123  can be sized to seal against the radial extension  411   a.  As shown, the oval shape for the imaging assembly housing  405   a  and complimentary shaped opening  403  can prevent rotation of the housing  405   a  relative to the port body  401 , and a wider window with clearance is not necessary for the system  400 . As shown, the imaging assembly  405  can be fixed in relative rotational position to the port body  401 . The port body  401  and/or the opening  403  can be shaped to prevent rotation of the imaging assembly  405 , unlike the embodiment of  FIG. 1 . The port body  401  can include any suitable openings, ports, etc. as appreciated by those having ordinary skill in the art in view of this disclosure (e.g., as described above with respect to other embodiments). 
     The imaging assembly housing  405   a  can be made of a rigid material in certain embodiments. The imagine assembly housing  405   a  can be inserted through the imaging assembly opening  403  (e.g., which is made easier by the port body  401  being compliant). 
     Once assembled, the system  400  can be inserted into an incision (e.g., in a shoehorning motion). The area can be insufflated if desired, e.g., through port  421 . Images can be received from the imaging device in the radial extension  411   a  and the surgical area can be viewed. The surgical site can be accessed via the instrument channel  407  while viewing the area. 
     Certain embodiments of this disclosure can employ one or more imaging devices, e.g., as disclosed above. Certain image processing can be conducted on data received from the imaging device. For example, in the embodiment of a system  400 , where the imaging assembly  405  may be fixed relative to the port body  401 , no mechanical movement of the imaging device may be possible. In fact, certain embodiments, e.g., system  400 , may have no moving parts at all. In view of this, embodiments can include an image processing module configured to allow digital movement of an image in situ. For example, where a resolution of a camera is sufficiently high (e.g., 4K), no magnification may be needed (e.g., at the distances of an abdominal procedure using insufflation). The resolution of the surgical site with an unmagnified camera of suitable resolution can be equivalent or better than a traditional endoscope provides. In such embodiments, the image processing module (which can be located internal or external to the system  400 ), can receive one or more commands from a user to provide a digital zoom and/or pan of the images/video stream. 
     The image processing module can be configured to connect to a controller (e.g., a dual joystick controller and/or any other suitable controller) to receive the commands. For example, one stick can control zoom, and another stick can control vertical and lateral pan. The image processing module can be configured to output the processed images/video stream to a screen for the user to view in real time. Any suitable input mechanism for digital image pan and/or zoom is contemplated herein. Such a control mechanism eliminates the need to learn reverse control of an endoscope in use, speeds up target image acquisition, and reduces chances for error. Such control schemes also allow elimination of moving parts and a wider field of view overall. Any other suitable additional image processing (e.g., dewarping to create a flat image, 3D image creation using different flashing light positions to provide differing shadows, etc.) are contemplated herein. 
     As will be appreciated by those skilled in the art, aspects of the present disclosure may be embodied as a system, method or computer program product. Accordingly, aspects of this disclosure may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.), or an embodiment combining software and hardware aspects, all possibilities of which can be referred to herein as a “circuit,” “module,” or “system.” A “circuit,” “module,” or “system” can include one or more portions of one or more separate physical hardware and/or software components that can together perform the disclosed function of the “circuit,” “module,” or “system”, or a “circuit,” “module,” or “system” can be a single self-contained unit (e.g., of hardware and/or software). Furthermore, aspects of this disclosure may take the form of a computer program product embodied in one or more computer readable medium(s) having computer readable program code embodied thereon. 
     Any combination of one or more computer readable medium(s) may be utilized. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device. 
     A computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated signal may take any of a variety of forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A computer readable signal medium may be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device. 
     Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing. 
     Computer program code for carrying out operations for aspects of this disclosure may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C++ or the like and conventional procedural programming languages, such as the “C” programming language or similar programming languages. The program code may execute entirely on the user&#39;s computer, partly on the user&#39;s computer, as a stand-alone software package, partly on the user&#39;s computer and partly on a remote computer or entirely on the remote computer or server. In the latter scenario, the remote computer may be connected to the user&#39;s computer through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet Service Provider). 
     Aspects of this disclosure may be described above with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of this disclosure. It will be understood that each block of any flowchart illustrations and/or block diagrams, and combinations of blocks in any flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in any flowchart and/or block diagram block or blocks. 
     These computer program instructions may also be stored in a computer readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram block or blocks. 
     The computer program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other devices to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide processes for implementing the functions/acts specified herein. 
     Those having ordinary skill in the art understand that any numerical values disclosed herein can be exact values or can be values within a range. Further, any terms of approximation (e.g., “about”, “approximately”, “around”) used in this disclosure can mean the stated value within a range. For example, in certain embodiments, the range can be within (plus or minus) 20%, or within 10%, or within 5%, or within 2%, or within any other suitable percentage or number as appreciated by those having ordinary skill in the art (e.g., for known tolerance limits or error ranges). 
     The articles “a”, “an”, and “the” as used herein and in the appended claims are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article unless the context clearly indicates otherwise. By way of example, “an element” means one element or more than one element. 
     The phrase “and/or,” as used herein in the specification and in the claims, should be understood to mean “either or both” of the elements so conjoined, i.e., elements that are conjunctively present in some cases and disjunctively present in other cases. Multiple elements listed with “and/or” should be construed in the same fashion, i.e., “one or more” of the elements so conjoined. Other elements may optionally be present other than the elements specifically identified by the “and/or” clause, whether related or unrelated to those elements specifically identified. Thus, as a non-limiting example, a reference to “A and/or B”, when used in conjunction with open-ended language such as “comprising” can refer, in one embodiment, to A only (optionally including elements other than B); in another embodiment, to B only (optionally including elements other than A); in yet another embodiment, to both A and B (optionally including other elements); etc. 
     As used herein in the specification and in the claims, “or” should be understood to have the same meaning as “and/or” as defined above. For example, when separating items in a list, “or” or “and/or” shall be interpreted as being inclusive, i.e., the inclusion of at least one, but also including more than one, of a number or list of elements, and, optionally, additional unlisted items. Only terms clearly indicated to the contrary, such as “only one of” or “exactly one of,” or, when used in the claims, “consisting of,” will refer to the inclusion of exactly one element of a number or list of elements. In general, the term “or” as used herein shall only be interpreted as indicating exclusive alternatives (i.e., “one or the other but not both”) when preceded by terms of exclusivity, such as “either,” “one of,” “only one of,” or “exactly one of.” 
     Any suitable combination(s) of any disclosed embodiments and/or any suitable portion(s) thereof are contemplated herein as appreciated by those having ordinary skill in the art in view of this disclosure. 
     The embodiments of the present disclosure, as described above and shown in the drawings, provide for improvement in the art to which they pertain. While the subject disclosure includes reference to certain embodiments, those skilled in the art will readily appreciate that changes and/or modifications may be made thereto without departing from the spirit and scope of the subject disclosure.