CA2104414A1 - Electrohydraulic lithotripsy - Google Patents
Electrohydraulic lithotripsyInfo
- Publication number
- CA2104414A1 CA2104414A1 CA 2104414 CA2104414A CA2104414A1 CA 2104414 A1 CA2104414 A1 CA 2104414A1 CA 2104414 CA2104414 CA 2104414 CA 2104414 A CA2104414 A CA 2104414A CA 2104414 A1 CA2104414 A1 CA 2104414A1
- Authority
- CA
- Canada
- Prior art keywords
- guide member
- nozzle
- distal end
- hollow
- target
- 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.)
- Abandoned
Links
Classifications
-
- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00404—Blood vessels other than those in or around the heart
- A61B2018/00422—Angioplasty
-
- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1472—Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Plasma & Fusion (AREA)
- Medical Informatics (AREA)
- Otolaryngology (AREA)
- Physics & Mathematics (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
IMPROVEMENTS IN ELECTROHYDRAULIC LITHOTRIPSY
ABSTRACT
Method and apparatus for fracturing hard deposits such as urinary and biliary calculi and arteriosclerotic plaque in the human body. An elongate guide member having an apertured hollow adjacent its distal end and an optic viewing system preferably terminating adjacent its distal end is inserted within the body with the distal end positioned adjacent the target. A working fluid is supplied to the hollow, and an electric spark is discharged within the hollow from an external energy source for generating pulse waves in the working fluid.
The resulting pulse waves express working fluid from the hollow to impinge on the target. Makeup fluid is supplied and the spark repeated. The method and apparatus also may advantageously be employed for dilating narrowing in hollow internal structures in the body.
ABSTRACT
Method and apparatus for fracturing hard deposits such as urinary and biliary calculi and arteriosclerotic plaque in the human body. An elongate guide member having an apertured hollow adjacent its distal end and an optic viewing system preferably terminating adjacent its distal end is inserted within the body with the distal end positioned adjacent the target. A working fluid is supplied to the hollow, and an electric spark is discharged within the hollow from an external energy source for generating pulse waves in the working fluid.
The resulting pulse waves express working fluid from the hollow to impinge on the target. Makeup fluid is supplied and the spark repeated. The method and apparatus also may advantageously be employed for dilating narrowing in hollow internal structures in the body.
Description
21~4~1~
.
-3The present invention relates to a system for 4 fracturing hard formations in the body, and more specifically, to a method and apparatus for fracturing 6 deposits such as urinary and biliary calculi as well as 7 arteriosclerotic plaque in the body.
9 Calciferous and similar deposits occur in body fluid passages of various types. Of particular interest are 11 urinary and biliary calculi as well as arteriosclerotic 12 plaque.
13 Electrohydraulic lithotripsy and laser lithotripsy 14 systems frequently are used to fragment urinary and -biliary stones. Both systems utilize plasma-induced 16 stress waves to fragment calculi. Electrohydraulic 17 lithotripsy produces a plasma through an electrical 18 discharge (spark). Electrohydraulic lithotripsy systems 19 are relatively inexpensive. However, with electrohydraulic lithotripsy systems, there is a potential 21 for thermal damage to healthy tissues surrounding the 22 target deposit. With laser lithotripsy, a plasma is 23 produced when a portion of the laser energy is absorbed by 24 the ~tone. However, laser lithotripsy systems are expensive. Also, in the case of laser lithotripsy, the 26 sharp laser delivery fiber may cause damage if 27 inadvertently jabbed into healthy tissue.
28 In my article with Rosen et al entitled "Effects of 29 Shielded or Unshielded Laser and Electrohydraulic Lithotripsy on Rabbit Bladder" published in the Journal of 31 Urology, Vol. 148, Pages 857-860, April 1990, I disclosed 32 a plasma shield for use with either a pulsed laser 33 lithotriptor or an electrohydraulic lithotriptor. As 34 described therein, the hollow shield is provided using a hollow spring fitted with a metal end cap. The pulsed 36 laser source or pulsed electrical voltage source located -' 2~0~
1 in the flexible guide provides a pulse of energy in the
.
-3The present invention relates to a system for 4 fracturing hard formations in the body, and more specifically, to a method and apparatus for fracturing 6 deposits such as urinary and biliary calculi as well as 7 arteriosclerotic plaque in the body.
9 Calciferous and similar deposits occur in body fluid passages of various types. Of particular interest are 11 urinary and biliary calculi as well as arteriosclerotic 12 plaque.
13 Electrohydraulic lithotripsy and laser lithotripsy 14 systems frequently are used to fragment urinary and -biliary stones. Both systems utilize plasma-induced 16 stress waves to fragment calculi. Electrohydraulic 17 lithotripsy produces a plasma through an electrical 18 discharge (spark). Electrohydraulic lithotripsy systems 19 are relatively inexpensive. However, with electrohydraulic lithotripsy systems, there is a potential 21 for thermal damage to healthy tissues surrounding the 22 target deposit. With laser lithotripsy, a plasma is 23 produced when a portion of the laser energy is absorbed by 24 the ~tone. However, laser lithotripsy systems are expensive. Also, in the case of laser lithotripsy, the 26 sharp laser delivery fiber may cause damage if 27 inadvertently jabbed into healthy tissue.
28 In my article with Rosen et al entitled "Effects of 29 Shielded or Unshielded Laser and Electrohydraulic Lithotripsy on Rabbit Bladder" published in the Journal of 31 Urology, Vol. 148, Pages 857-860, April 1990, I disclosed 32 a plasma shield for use with either a pulsed laser 33 lithotriptor or an electrohydraulic lithotriptor. As 34 described therein, the hollow shield is provided using a hollow spring fitted with a metal end cap. The pulsed 36 laser source or pulsed electrical voltage source located -' 2~0~
1 in the flexible guide provides a pulse of energy in the
2 vicinity of the metal end cap to produce a rapid vapor
3 expansion that causes the metal end cap to undergo a
4 pulse-like movement as the vapor expands against the fluid medium of the passage to impart a high-velocity jack-6 hammer type impact on the target deposit.
7 While the plasma shield impact device as described 8 in my aforesaid publication offers the advantages of 9 protecting surrounding healthy tissue from direct laser/EHL spark, and also eliminates inadvertent 11 puncturing of healthy tissue by a sharply pointed laser 12 delivery fiber, the metal end cap is prone to 13 fragmentation, resulting in the formation of metal fines 14 in the body cavity. -SUMMARY OF THE INVENTION
16 The present invention provides a method and apparatus 17 for selectively fracturing hard deposits such as urinary 18 and biliary calculi and atherosclerotic plaque which 19 overcomes the aforesaid and other disadvantages of the prior art. In accordance with the present invention there 21 is provided an electrohydraulic lithotripsy system in 22 which a shock wave is generated directly in a fluid mass 23 adjacent the target deposit, and the energy contained in 24 the shock wave transferred, through the fluid, to the target deposit. More particularly, in accordance with the 26 present invention, a flexible guide member is provided for -27 insertion through a fluid-containing body passage or 28 surgically created passage. The guide member is 29 positioned with its distal end adjacent the target deposit. The flexible guide member has an optic viewing 31 system preferably terminating adjacent its distal end, and 32 a hollow adjacent its distal end. In use, the hollow is 33 filled with a working fluid, which is continuously 34 replenished from an external source. The device is positioned with its distal end adjacent to or touching the 36 target, energy pulse waves are generated in the working _3_ 2iO~
1 fluid in the hollow adjacent the distal end of the guide 2 member by means of an electrical discharge (spark), and 3 the resultant shock wave expressed from the hollow through 4 an opening in the distal end of the guide member and impinged directly on the deposit whereby to fracture or - 6 erode the deposit. In one embodiment of the invention, - 7 the flexible guide member distal end comprises a metallic 8 body nozzle, and the electrical discharge ~spark) is ` 9 generated across the working fluid between a single electrode extending into the working fluid and the 11 metallic body. In another embodiment of the invention, a 12 pair of spaced electrodes extend into the hollow adjacent 13 the distal end of the guide member, and the electrical 14 discharge (spark) may be generated across the working fluid between the two spaced electrodes.
16 In a preferred embodiment of the invention, a nozzle 17 is provided on the distal end of the guide member for 18 directing or focusing the resulting shock wave to the 3, 19 target, and at the same time protect the surrounding tissue from the spark.
22 The invention will be more fully understood from the 23 following solely exemplary detailed description taken in 24 conjunction with the accompanying drawings, in which like 25 numerals depict like parts, and wherein:
26 Fig. 1 is a fragmentary view, partly in section, and 27 partly in block of a preferred form of the invention;
1 28 Fig. 2 is an enlarged view, in cross-section, and '. 29 showing details of one embodiment of electrohydraulic 30 lithotriptor device made in accordance with the present 31 invention;
32 Fig. 3 is similar to Fig. 2, and illustrating details 33 of another embodiment of electrohydraulic lithotriptor 34 made in accordance with the present invention;
Fig. 4 is a view similar to Fig. 2, and illustrating 36 details of yet another embodiment of electrohydraulic ~ 2iO~
1 lithotriptor made in accordance with the present 2 invention; and 3 Fig. 5 is a cross-sectional view taken along plane 5-5 4 of Fig. 1.
DETAILED DESCRIPTION OF THE INVENTION
6 The present invention contemplates a method and 7 apparatus for fracturing or eroding hard deposits in 8 fluid-containing body passages by means of hydraulic 9 force.
Referring to Fig. 1, in accordance with the present 11 invention, there is provided a guide member 10 having a 12 hollow opening 12 at its distal end 14, and containing a 13 working fluid delivered via fluid conduit 16 from a source 14 18. The guide member 10 comprises an elongate hollow tube, and is positioned with its distal end 14 adjacent, 16 but spaced from, a target deposit 20 which may be a kidney 17 stone arterial plaque or the like, and an electrical ;~
18 discharge spark is generated as will be described in 19 detail hereinafter, in the working fluid adjacent the guide member distal end 14. Working fluid comprises a 21 biologically acceptable fluid such as 1/6 normal USP
22 saline solution, which is flowed into guide member 10 by 23 means of a pump or syringe 22. Alternatively, fluid may ;~
24 be flowed into a guide member 10 from an overhead supply.
Guide member 10 may comprise an elongate, flexible 26 hollow tube as illustrated in Fig. 1, and comprising a 27 metallic, hollow stub tube 24 mounted on the tubing distal 28 end 14. Alternatively, as shown in Fig. 2, an apertured 29 metal nozzle 30, preferably of ellipsoid shape and 30 typically formed of brass or stainless steel, may be f~
31 mounted on the distal end 14 of tubing 10 in fluid 32 communication with the working fluid source through one or 33 more apertures 34 formed in the back wall of nozzle 30. ~ ~ -34 An electrode 36 is insulatively mounted, extending~ - ;
into nozzle 30 in communication with the working fluid 36 contained therein. Electrode 36 is connected via - ` 2~0~
1 conductor wire 40 to one terminal of a spark generator 44.
2 A second conductor wire 42 connects the body of nozzle 30 3 to the other terminal of spark generator 44.
4 Spark generator 44, which may be any one of several commercially available spark generators such as a Wolfe 6 2137.50 or Northgate Research SDI, has its output applied 7 on conductor wires 40 and 42. Spark generator 44 produces 8 an output pulse of up to several microseconds, at several 9 Kv and up to 1 Ka current. The spark generated between the tip of the electrode 36 and the metal nozzle body 11 causes a vapor expansion of the working fluid contained 12 within the nozzle adjacent the electrode tips which in 13 turn causes a shock wave in the working fluid contained in 1~ the nozzle. Nozzle 30 directs or shapes the resultant ~ `
shock wave to a focal zone or focal point 46 permitting 16 the resultant shock wave to fracture calciferous deposits 17 upon which it impinges.
18 The electrohydraulic lithotripsy device of the present 19 invention also includes an optic viewing system carried by the guide member 10 and terminating adjacent the distal 21 end of the guide member. Referring also to Fig. 5, the 22 viewing system comprises an optical viewing conduit 80 23 terminating adjacent the distal end of the guide member 24 10, compiling optics (not shown) of conventional construction for permitting viewing from the external 26 proximal end of the guide member 10, and illuminating 27 means such as a laser light transmitting fibers 82, also 28 terminating adjacent the distal end of the guide member 29 10, for emitting light from a light source (not shown) external to the guide member 10. The viewing conduit 80 31 can be a flexible fiberoptic bundle, a thin lens systems, 32 a rod lens system, or a graded index ~GRIN) system. The 33 operation of viewing conduits, coupling optics and light 34 sources are well-known in the art and need not be described in further detail -- 2 1 0 ~
1 Referring to Fig. 3, there is shown yet another 2 embodiment of the invention. In the Fig. 3 embodiment, 3 the nozzle 54 may have an internal inverse conical hollow 4 56 narrowing to the end 58 of the nozzle. Alternatively, as shown in Fig. 4, the nozzle 62 may have an internal 6 conical hollow 64 opening to the end 66 of the nozzle.
7 One or more apertures 68 are formed in the back wall 70 of 8 nozzle 62 for permitting replenishment of working fluid 9 from the fluid source.
In use, the guide member or nozzle tip distal end is 11 positioned in close spaced relation to the target deposit. -12 Pump 22 is activated, whereby to force a continuous stream 13 of working fluid into the nozzle hollow. The pulse 14 generator is activated, providing a spark within the working fluid contained in the guide member or nozzle 16 hollow. This spark, in turn, causes a rapid vapor 17 expansion which, in turn, causes a pulse-like shock wave 18 in the working fluid which is expressed from the hollow in 19 pulsed shock waves to impinge directly on the target deposit to be removed. The pulsed shock waves impinging 21 on the target nozzle fractures and erodes the target 22 deposit.
23 A feature and advantage of the present invention is 24 that only the working fluid and shock wave contacts the 25 target deposit. Thus, the problems of impact tip ~ ~-26 fragmentation and metal fines formation experienced with 27 metal tip impact lithotripsy devices of the prior art is 28 eliminated. Also, since the spark is generated in a 29 confined tube, the surrounding tissue is protected from the damaging effects of the plasma.
31 Various changes may be made in the above invention ~ -32 without departing from the spirit and scope thereof. For 33 example, the tube distal end or nozzle may be formed of a 34 strong, heat-resistant, reinforced material such as a ceramic, or a suitable plastic such as Teflon or other 36 materials having sufficient heat resistance and burst ~ 21Q~4~
1 strength to withstand the heat and shock wave generated by 2 the spark. In such case the nozzle or tube distal end 3 should be fitted with a pair of spaced electrodes, each 4 connected via a conductor wire to one terminal of the spark generator 44, whereby a spark may be generated 6 between the spaced electrodes. The electrodes may also 7 comprise a coaxial wire electrode sytem or a parallel wire 8 electrode system as are well known in the art. Also, the 9 device may be dimensioned so as to provide a low energy spark which may be useful for resolving spasms in vessels, 11 or to dilate narrowing of hollow internal structures.
12 It will therefore be understood that all matter herein 13 described or shown in the accompanying drawings is to be 14 interpreted as illustrative only, and is not to limit the invention defined in the following claims.
7 While the plasma shield impact device as described 8 in my aforesaid publication offers the advantages of 9 protecting surrounding healthy tissue from direct laser/EHL spark, and also eliminates inadvertent 11 puncturing of healthy tissue by a sharply pointed laser 12 delivery fiber, the metal end cap is prone to 13 fragmentation, resulting in the formation of metal fines 14 in the body cavity. -SUMMARY OF THE INVENTION
16 The present invention provides a method and apparatus 17 for selectively fracturing hard deposits such as urinary 18 and biliary calculi and atherosclerotic plaque which 19 overcomes the aforesaid and other disadvantages of the prior art. In accordance with the present invention there 21 is provided an electrohydraulic lithotripsy system in 22 which a shock wave is generated directly in a fluid mass 23 adjacent the target deposit, and the energy contained in 24 the shock wave transferred, through the fluid, to the target deposit. More particularly, in accordance with the 26 present invention, a flexible guide member is provided for -27 insertion through a fluid-containing body passage or 28 surgically created passage. The guide member is 29 positioned with its distal end adjacent the target deposit. The flexible guide member has an optic viewing 31 system preferably terminating adjacent its distal end, and 32 a hollow adjacent its distal end. In use, the hollow is 33 filled with a working fluid, which is continuously 34 replenished from an external source. The device is positioned with its distal end adjacent to or touching the 36 target, energy pulse waves are generated in the working _3_ 2iO~
1 fluid in the hollow adjacent the distal end of the guide 2 member by means of an electrical discharge (spark), and 3 the resultant shock wave expressed from the hollow through 4 an opening in the distal end of the guide member and impinged directly on the deposit whereby to fracture or - 6 erode the deposit. In one embodiment of the invention, - 7 the flexible guide member distal end comprises a metallic 8 body nozzle, and the electrical discharge ~spark) is ` 9 generated across the working fluid between a single electrode extending into the working fluid and the 11 metallic body. In another embodiment of the invention, a 12 pair of spaced electrodes extend into the hollow adjacent 13 the distal end of the guide member, and the electrical 14 discharge (spark) may be generated across the working fluid between the two spaced electrodes.
16 In a preferred embodiment of the invention, a nozzle 17 is provided on the distal end of the guide member for 18 directing or focusing the resulting shock wave to the 3, 19 target, and at the same time protect the surrounding tissue from the spark.
22 The invention will be more fully understood from the 23 following solely exemplary detailed description taken in 24 conjunction with the accompanying drawings, in which like 25 numerals depict like parts, and wherein:
26 Fig. 1 is a fragmentary view, partly in section, and 27 partly in block of a preferred form of the invention;
1 28 Fig. 2 is an enlarged view, in cross-section, and '. 29 showing details of one embodiment of electrohydraulic 30 lithotriptor device made in accordance with the present 31 invention;
32 Fig. 3 is similar to Fig. 2, and illustrating details 33 of another embodiment of electrohydraulic lithotriptor 34 made in accordance with the present invention;
Fig. 4 is a view similar to Fig. 2, and illustrating 36 details of yet another embodiment of electrohydraulic ~ 2iO~
1 lithotriptor made in accordance with the present 2 invention; and 3 Fig. 5 is a cross-sectional view taken along plane 5-5 4 of Fig. 1.
DETAILED DESCRIPTION OF THE INVENTION
6 The present invention contemplates a method and 7 apparatus for fracturing or eroding hard deposits in 8 fluid-containing body passages by means of hydraulic 9 force.
Referring to Fig. 1, in accordance with the present 11 invention, there is provided a guide member 10 having a 12 hollow opening 12 at its distal end 14, and containing a 13 working fluid delivered via fluid conduit 16 from a source 14 18. The guide member 10 comprises an elongate hollow tube, and is positioned with its distal end 14 adjacent, 16 but spaced from, a target deposit 20 which may be a kidney 17 stone arterial plaque or the like, and an electrical ;~
18 discharge spark is generated as will be described in 19 detail hereinafter, in the working fluid adjacent the guide member distal end 14. Working fluid comprises a 21 biologically acceptable fluid such as 1/6 normal USP
22 saline solution, which is flowed into guide member 10 by 23 means of a pump or syringe 22. Alternatively, fluid may ;~
24 be flowed into a guide member 10 from an overhead supply.
Guide member 10 may comprise an elongate, flexible 26 hollow tube as illustrated in Fig. 1, and comprising a 27 metallic, hollow stub tube 24 mounted on the tubing distal 28 end 14. Alternatively, as shown in Fig. 2, an apertured 29 metal nozzle 30, preferably of ellipsoid shape and 30 typically formed of brass or stainless steel, may be f~
31 mounted on the distal end 14 of tubing 10 in fluid 32 communication with the working fluid source through one or 33 more apertures 34 formed in the back wall of nozzle 30. ~ ~ -34 An electrode 36 is insulatively mounted, extending~ - ;
into nozzle 30 in communication with the working fluid 36 contained therein. Electrode 36 is connected via - ` 2~0~
1 conductor wire 40 to one terminal of a spark generator 44.
2 A second conductor wire 42 connects the body of nozzle 30 3 to the other terminal of spark generator 44.
4 Spark generator 44, which may be any one of several commercially available spark generators such as a Wolfe 6 2137.50 or Northgate Research SDI, has its output applied 7 on conductor wires 40 and 42. Spark generator 44 produces 8 an output pulse of up to several microseconds, at several 9 Kv and up to 1 Ka current. The spark generated between the tip of the electrode 36 and the metal nozzle body 11 causes a vapor expansion of the working fluid contained 12 within the nozzle adjacent the electrode tips which in 13 turn causes a shock wave in the working fluid contained in 1~ the nozzle. Nozzle 30 directs or shapes the resultant ~ `
shock wave to a focal zone or focal point 46 permitting 16 the resultant shock wave to fracture calciferous deposits 17 upon which it impinges.
18 The electrohydraulic lithotripsy device of the present 19 invention also includes an optic viewing system carried by the guide member 10 and terminating adjacent the distal 21 end of the guide member. Referring also to Fig. 5, the 22 viewing system comprises an optical viewing conduit 80 23 terminating adjacent the distal end of the guide member 24 10, compiling optics (not shown) of conventional construction for permitting viewing from the external 26 proximal end of the guide member 10, and illuminating 27 means such as a laser light transmitting fibers 82, also 28 terminating adjacent the distal end of the guide member 29 10, for emitting light from a light source (not shown) external to the guide member 10. The viewing conduit 80 31 can be a flexible fiberoptic bundle, a thin lens systems, 32 a rod lens system, or a graded index ~GRIN) system. The 33 operation of viewing conduits, coupling optics and light 34 sources are well-known in the art and need not be described in further detail -- 2 1 0 ~
1 Referring to Fig. 3, there is shown yet another 2 embodiment of the invention. In the Fig. 3 embodiment, 3 the nozzle 54 may have an internal inverse conical hollow 4 56 narrowing to the end 58 of the nozzle. Alternatively, as shown in Fig. 4, the nozzle 62 may have an internal 6 conical hollow 64 opening to the end 66 of the nozzle.
7 One or more apertures 68 are formed in the back wall 70 of 8 nozzle 62 for permitting replenishment of working fluid 9 from the fluid source.
In use, the guide member or nozzle tip distal end is 11 positioned in close spaced relation to the target deposit. -12 Pump 22 is activated, whereby to force a continuous stream 13 of working fluid into the nozzle hollow. The pulse 14 generator is activated, providing a spark within the working fluid contained in the guide member or nozzle 16 hollow. This spark, in turn, causes a rapid vapor 17 expansion which, in turn, causes a pulse-like shock wave 18 in the working fluid which is expressed from the hollow in 19 pulsed shock waves to impinge directly on the target deposit to be removed. The pulsed shock waves impinging 21 on the target nozzle fractures and erodes the target 22 deposit.
23 A feature and advantage of the present invention is 24 that only the working fluid and shock wave contacts the 25 target deposit. Thus, the problems of impact tip ~ ~-26 fragmentation and metal fines formation experienced with 27 metal tip impact lithotripsy devices of the prior art is 28 eliminated. Also, since the spark is generated in a 29 confined tube, the surrounding tissue is protected from the damaging effects of the plasma.
31 Various changes may be made in the above invention ~ -32 without departing from the spirit and scope thereof. For 33 example, the tube distal end or nozzle may be formed of a 34 strong, heat-resistant, reinforced material such as a ceramic, or a suitable plastic such as Teflon or other 36 materials having sufficient heat resistance and burst ~ 21Q~4~
1 strength to withstand the heat and shock wave generated by 2 the spark. In such case the nozzle or tube distal end 3 should be fitted with a pair of spaced electrodes, each 4 connected via a conductor wire to one terminal of the spark generator 44, whereby a spark may be generated 6 between the spaced electrodes. The electrodes may also 7 comprise a coaxial wire electrode sytem or a parallel wire 8 electrode system as are well known in the art. Also, the 9 device may be dimensioned so as to provide a low energy spark which may be useful for resolving spasms in vessels, 11 or to dilate narrowing of hollow internal structures.
12 It will therefore be understood that all matter herein 13 described or shown in the accompanying drawings is to be 14 interpreted as illustrative only, and is not to limit the invention defined in the following claims.
Claims (11)
1. Apparatus adapted for fracturing hard targets, reducing spasm in target vessels or dilating narrowing in hollow targets within a body and comprising, in combination:
a flexible elongate guide member adapted for insertion within the body with the distal end thereof positioned adjacent a target, said guide member having an apertured hollow adjacent its distal end;
means for supplying a working fluid to said hollow from an external source;
a hollow tube mounted on the distal end of said guide member;
means for discharging an electric spark within said hollow tube from an external energy source for generating pulsed shock waves in the working fluid within said guide member for impinging on said target;
a shock and heat resistant nozzle mounted on the distal end of said guide member, said nozzle having an internal shape and dimension for affecting the shape of said pulsed shock waves and for directing said pulsed shock waves to a focal point for impinging on said target;
and an optic viewing system carried by said guide member and terminating adjacent the distal end of said guide member for permitting viewing from external the proximal end of said guide member.
a flexible elongate guide member adapted for insertion within the body with the distal end thereof positioned adjacent a target, said guide member having an apertured hollow adjacent its distal end;
means for supplying a working fluid to said hollow from an external source;
a hollow tube mounted on the distal end of said guide member;
means for discharging an electric spark within said hollow tube from an external energy source for generating pulsed shock waves in the working fluid within said guide member for impinging on said target;
a shock and heat resistant nozzle mounted on the distal end of said guide member, said nozzle having an internal shape and dimension for affecting the shape of said pulsed shock waves and for directing said pulsed shock waves to a focal point for impinging on said target;
and an optic viewing system carried by said guide member and terminating adjacent the distal end of said guide member for permitting viewing from external the proximal end of said guide member.
2. Apparatus according to claim 1, wherein said nozzle has an internal shape of an ellipsoid.
3. Apparatus according to claim 1, wherein said nozzle has an internal shape of a conical section.
4. Apparatus according to claim 1, wherein said nozzle comprises a hollow tube.
5. Apparatus according to claim 1, wherein said nozzle is formed of metal.
6. Apparatus according to claim 1, wherein said nozzle is formed of ceramic.
7. Apparatus according to claim 1, wherein said nozzle is formed of a heat-resistant plastic.
8. Apparatus according to claim 1, wherein said external energy source comprises a spark generator.
9. Apparatus according to claim 1, wherein said optic viewing system comprises a fiberoptic bundle.
10. Apparatus according to claim 1, wherein said optic viewing system comprises thin lens system, a rod lens system, or a graded index system.
11. Apparatus according to claim 1, and including an illuminating means terminating adjacent the distal end of said guide member for emitting light from a light source external to the guide member.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2104414 CA2104414A1 (en) | 1993-08-19 | 1993-08-19 | Electrohydraulic lithotripsy |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2104414 CA2104414A1 (en) | 1993-08-19 | 1993-08-19 | Electrohydraulic lithotripsy |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2104414A1 true CA2104414A1 (en) | 1995-02-20 |
Family
ID=4152173
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 2104414 Abandoned CA2104414A1 (en) | 1993-08-19 | 1993-08-19 | Electrohydraulic lithotripsy |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA2104414A1 (en) |
Cited By (17)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7087061B2 (en) | 2002-03-12 | 2006-08-08 | Lithotech Medical Ltd | Method for intracorporeal lithotripsy fragmentation and apparatus for its implementation |
| WO2006087360A1 (en) * | 2005-02-16 | 2006-08-24 | The European Atomic Energy Community (Euratom), Represented By The European Commission | Head-end process for the reprocessing of reactor core material |
| US20080159464A1 (en) * | 2005-02-16 | 2008-07-03 | Forschungszentrum Karlsruhe Gmbh | Head-End Process for the Reprocessing of Reactor Core Material |
| EP2359756A2 (en) | 2010-02-24 | 2011-08-24 | Lithotech Medical Ltd | Method and system for destroying of undersirable formations in mammalian body |
| US9743980B2 (en) | 2010-02-24 | 2017-08-29 | Safepass Vascular Ltd | Method and system for assisting a wire guide to cross occluded ducts |
| US10959743B2 (en) | 2008-06-13 | 2021-03-30 | Shockwave Medical, Inc. | Shockwave balloon catheter system |
| US11478261B2 (en) | 2019-09-24 | 2022-10-25 | Shockwave Medical, Inc. | System for treating thrombus in body lumens |
| US11992232B2 (en) | 2020-10-27 | 2024-05-28 | Shockwave Medical, Inc. | System for treating thrombus in body lumens |
| US12011185B2 (en) | 2021-10-19 | 2024-06-18 | Shockwave Medical, Inc. | Intravascular lithotripsy catheter with interfering shock waves |
| US12023098B2 (en) | 2021-10-05 | 2024-07-02 | Shockwave Medical, Inc. | Lesion crossing shock wave catheter |
| US12035932B1 (en) | 2023-04-21 | 2024-07-16 | Shockwave Medical, Inc. | Intravascular lithotripsy catheter with slotted emitter bands |
| US12064129B2 (en) | 2015-11-18 | 2024-08-20 | Shockwave Medical, Inc. | Shock wave electrodes |
| US12089861B2 (en) | 2021-08-05 | 2024-09-17 | Nextern Innovation, Llc | Intravascular lithotripsy system and device |
| US12096950B2 (en) | 2012-09-13 | 2024-09-24 | Shockwave Medical, Inc. | Shockwave catheter system with energy control |
| US12102342B2 (en) | 2008-11-05 | 2024-10-01 | Shockwave Medical, Inc. | Shockwave valvuloplasty catheter system |
| US12114874B2 (en) | 2018-06-21 | 2024-10-15 | Shockwave Medical, Inc. | System for treating occlusions in body lumens |
| US12114923B2 (en) | 2012-06-27 | 2024-10-15 | Shockwave Medical, Inc. | Shock wave balloon catheter with multiple shock wave sources |
-
1993
- 1993-08-19 CA CA 2104414 patent/CA2104414A1/en not_active Abandoned
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| US7087061B2 (en) | 2002-03-12 | 2006-08-08 | Lithotech Medical Ltd | Method for intracorporeal lithotripsy fragmentation and apparatus for its implementation |
| US9168049B2 (en) | 2002-03-12 | 2015-10-27 | Vladimir Chemenko | Method for intracorporeal lithotripsy fragmentation and apparatus for its implementation |
| WO2006087360A1 (en) * | 2005-02-16 | 2006-08-24 | The European Atomic Energy Community (Euratom), Represented By The European Commission | Head-end process for the reprocessing of reactor core material |
| US20080159464A1 (en) * | 2005-02-16 | 2008-07-03 | Forschungszentrum Karlsruhe Gmbh | Head-End Process for the Reprocessing of Reactor Core Material |
| NO339204B1 (en) * | 2005-02-16 | 2016-11-14 | The European Atomic Energy Community Euratom | Entrance step process for recycling reactor core material |
| US8498371B2 (en) | 2005-03-25 | 2013-07-30 | The European Atomic Energy Community (Euratom), Represented By The European Commission | Head-end process for the reprocessing of reactor core material |
| US10959743B2 (en) | 2008-06-13 | 2021-03-30 | Shockwave Medical, Inc. | Shockwave balloon catheter system |
| US11771449B2 (en) | 2008-06-13 | 2023-10-03 | Shockwave Medical, Inc. | Shockwave balloon catheter system |
| US12102342B2 (en) | 2008-11-05 | 2024-10-01 | Shockwave Medical, Inc. | Shockwave valvuloplasty catheter system |
| US8777963B2 (en) | 2010-02-24 | 2014-07-15 | Lithotech Medical Ltd | Method and system for destroying of undesirable formations in mammalian body |
| US9498237B2 (en) | 2010-02-24 | 2016-11-22 | Lithotech Medical Ltd | Method and system for destroying of undesirable formations in mammalian body |
| US9743980B2 (en) | 2010-02-24 | 2017-08-29 | Safepass Vascular Ltd | Method and system for assisting a wire guide to cross occluded ducts |
| EP2359756A2 (en) | 2010-02-24 | 2011-08-24 | Lithotech Medical Ltd | Method and system for destroying of undersirable formations in mammalian body |
| US12114923B2 (en) | 2012-06-27 | 2024-10-15 | Shockwave Medical, Inc. | Shock wave balloon catheter with multiple shock wave sources |
| US12096950B2 (en) | 2012-09-13 | 2024-09-24 | Shockwave Medical, Inc. | Shockwave catheter system with energy control |
| US12064129B2 (en) | 2015-11-18 | 2024-08-20 | Shockwave Medical, Inc. | Shock wave electrodes |
| US12114874B2 (en) | 2018-06-21 | 2024-10-15 | Shockwave Medical, Inc. | System for treating occlusions in body lumens |
| US11478261B2 (en) | 2019-09-24 | 2022-10-25 | Shockwave Medical, Inc. | System for treating thrombus in body lumens |
| US11992232B2 (en) | 2020-10-27 | 2024-05-28 | Shockwave Medical, Inc. | System for treating thrombus in body lumens |
| US12089861B2 (en) | 2021-08-05 | 2024-09-17 | Nextern Innovation, Llc | Intravascular lithotripsy system and device |
| US12023098B2 (en) | 2021-10-05 | 2024-07-02 | Shockwave Medical, Inc. | Lesion crossing shock wave catheter |
| US12011185B2 (en) | 2021-10-19 | 2024-06-18 | Shockwave Medical, Inc. | Intravascular lithotripsy catheter with interfering shock waves |
| US12035932B1 (en) | 2023-04-21 | 2024-07-16 | Shockwave Medical, Inc. | Intravascular lithotripsy catheter with slotted emitter bands |
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