DE102007005483A1 - Flexible probe for use as waveguide for intracorporal shock wave-lithotripter, has probe tip provided at distal end to destroy body concretion by which shock waves are transmitted from probe body that is formed from two individual strands - Google Patents

Abstract

The probe (11) has a probe body (14) with a probe base (16) at a proximal end of the probe. A probe tip (17) provided at a distal end of the probe destroys body concretion e.g. bladder stone, by which shock waves are transmitted from the body and obtained by the tip. The body is formed from two individual strands (18) made of a metallic material or fiber-reinforced plastic i.e. carbon or glass-fiber reinforced plastic. The body is provided in a receptacle (21) of the base in a force, form and/or material fit manner. The tip is formed as an insertion element (23) and is attached to the body.

Description

The The invention relates to a flexible probe serving as a waveguide for an intracorporeal shockwave lithotripter is provided.

From the DE 43 13 768 A1 is a device for the mechanical fragmentation of body crumbs, a so-called shock wave lithotripter, known. This device comprises a probe which is inserted with the distal end into the body and positioned to the body calculus for its destruction. At the proximal end of the probe, a probe foot is provided, which is acted upon by shock pulses by an electromagnetic drive. The shock pulses generated by the initiated impact energy, which pass through the probe as a shock wave, exit at the probe tip and are used to break up body crumbs.

The Probes of shock wave lithotripters can directly be introduced into a ureter. A big The field of application is the use in flexible endoscopes intracorporeal fragmentation of body crusts, such as urinary, bladder or kidney stones, dar.

For transmission The high kinetic impact energy has been metal probes used, whose diameter is usually in a range of 1 to 2 mm. When using such metal probes in flexible endoscopes be guided, the flexibility is in use the endoscopes usually affected because such metal probes allow only a small amount of bending, without a lasting To experience deformation. Such permanent deformations have an effect detrimental to the transmission of shockwaves. In addition, there was a risk of breakage as soon as one strongly bent metal probe with one or more shock pulses was charged.

To avoid this danger is from the US 5,449,363 a probe, which is flattened along the bend of the endoscope, so that the bending ability is increased. Such a device has the disadvantage that the flexibility in handling is limited because only two Biegerungen are made possible by such a flattening, which are offset by 180 ° to each other.

From the DE 198 14 364 C2 shows a flexible metal probe, which has between the proximal and distal ends of partial lengths in which the probe diameter decreases steadily from a nominal diameter at the probe foot to a smaller nominal diameter and steadily in the vicinity of the probe tip to a nominal diameter of the probe approximated larger diameter increased. Such a flexible metal probe is expensive to manufacture.

Of the The invention is therefore based on the object, a flexible probe to create, which is inexpensive to manufacture and a high bending ability and optimal transmission the initiated impact energy allows.

These The object is achieved by the flexible Probe solved according to the features of claim 1.

The inventive design of a probe body for a flexible probe that serves as a waveguide for an intracorporeal shockwave lithotripter provided is and formed from at least two single strands is, has the advantage that this is a high bending ability which has an optimum transmission of the initiated Impact energy allows. The bending stiffness of the previously used, consisting of a Sondendraht or single strand Probe body is dependent on the diameter. Since this for the transmission of impact energy a relatively large cross-sectional area included, the bending ability was impaired. Now, amazingly, it has been shown that through use at least two single strands comprising a probe body form, the bending stiffness due to the reduction of the cross-sectional area of each single strand increases and yet the transmission the initiated impact energy with no or no noticeable Weakening compared to conventional probe bodies is possible. At the same time is increased by the Flexibility reduces the risk of breakage.

To A preferred embodiment of the invention provides that the probe body in a receptacle or depression of the Probe foot force, form and / or material fit is provided. The recording can be sleeve-shaped or U-shaped. The at least two single strands are in particular glued, clamped and / or in the recording pressed in as well as by further connection techniques firmly with the Probe foot connected, so that an initiated in the probe foot impact energy transferred into the probe body with no or almost no losses and can be forwarded by this to the probe tip.

To a further advantageous embodiment of the invention is provided that the probe tip is designed as an insert or attachment element. This allows the free ends of the single strands and depending on the materials used from damage during the smash protected from body crusts.

To a further preferred embodiment of the invention is provided that the insert or attachment element at or near the free end of the Single strands is provided. According to a first embodiment the attachment element can be the free ends of the at least two individual strands of the probe body so that they are bundled and are provided in a fixed arrangement. In an alternative Design can be provided that near the free ends of the at least two single strands of a probe body a sleeve is applied as an attachment element, which at least two single strands positioned to each other and at least slightly fixed to each other so that the free ends of the single strands provided for the destruction of Körperkonkremente or form a probe tip with a separate cap.

The A single or attachment element is according to a preferred Embodiment as a U-shaped or pot-shaped element educated. This allows the tips of the single strands simply includes and recorded. These can be in the length also be slightly different. A simple installation and fixation of the input or attachment element for Probe body is possible.

The Single or top element which serves to form the probe tip, is according to a preferred embodiment of force and / or positive and / or material fit with the probe body connected. Here can be an analog connection as between the probe foot and be provided to the probe body, so that both in the transition region or at the interface between the probe foot and the probe body, as well as between the probe body and input or Ausatzelement same conditions exist.

To a further preferred embodiment, the input or attachment element pointing to the Körperkonkrement a one-sided sanded or concave face on. As a result, the tear and / or Smashing effect on the body calculus increase.

Of Further, it is preferably provided that the U-shaped recess the insert or attachment element has a bottom, which opposite a plane perpendicular to the longitudinal axis of the probe body is inclined. By such an inclined arrangement of the floor can be made possible be that different maturities of the generated shock waves can be introduced into the probe tip. Thereby gets a higher frequency in the probe tip due to the overlay the individual shock waves and thus a higher Smashing effect on the body calculus achieved. Alternatively, the floor can also be designed stepped. It can thus be formed one or more stages, the one or more associated with one or more single strands are. This level or levels can also have a inclined instead of a perpendicular to the longitudinal axis aligned bottom exhibit. In addition, in several stages can also the height of the stage can be varied, thus delay differences when transmitting the shock waves on the attachment element and consequently an increase in the smashing effect to achieve.

To A preferred embodiment of the invention provides that the sum of the individual cross sections of the at least two single strands in Substantially a cross-sectional area of a probe body with a single strand according to the state of Technique corresponds. This will allow the transmission the shockwave energy, which depends on the cross-sectional area of the probe body is, without or almost no adverse effects compared to previous individual probes is made possible, with the bending ability is substantially increased. This allows the handling of Endoscopes facilitated to guide to its location become.

To a first advantageous embodiment of the invention is provided that at least one single strand of the probe body from a Solid material, in particular of a rod-shaped solid material, is trained. This can be a simple and inexpensive Mass production allows, allowing such probes are provided as disposable products. At the same time, such rod-shaped Single strands exact dimensions in cross section over their longitudinal extent, so that constant conditions for shockwave transmission in each Single strand are given.

To an alternative embodiment of the invention, it is provided that at least one single strand is tubular. For probe bodies involved in shockwave lithotripsy can be used in the range of, for example 0.5 to 3 mm of the entire probe body provided. At the Use of at least two single strands also have tubular single strands a high bending ability on.

Of Furthermore, it can be provided that at least one single strand is made Metal is formed. Such a single strand allows the inclusion of high tensile and compressive loads introduced by the Impact energy. This initiated impact energy generated Shock waves, which manifest as compression and expansion movements represent during the wave propagation and from one Probe body with at least two single strands, of which at least one is made of metal, well received and can be forwarded to the destination.

To an alternative embodiment of the invention, it is provided that at least one single strand of a fiber-reinforced plastic, in particular of carbon- or glass-fiber reinforced plastic, is made. The fiber-reinforced, made of plastic Single strand allows analogous use to single strands made of metal.

To a further alternative embodiment of the invention it is provided that the at least two single strands, which form a probe body, each of equal size in diameter are. This allows a simple production, especially in the Use of the same materials allows.

To an alternative embodiment of the invention for forming a Probe body of at least two single strands is provided that they have different diameters. Thereby especially when using multiple single strands a compact design for a probe body be achieved, in which the spaces kept small are. At the same time, this allows an embodiment of the probe body be made possible, in which the probe in one direction more rigid as can be formed in a different direction.

To a further alternative embodiment of the invention is provided that the single strands in the longitudinal extension one have a tapered cross-section. This can be a Arrangement of single strands may be provided, which in the same direction are aligned, d. h., That the thick cross sections of the single strands all associated with one end of the probe body, wherein the thick ends are preferably associated with the probe foot and point the thin ends to the probe tip. alternative can also be provided that the single strands with it tapered cross-section are arranged in opposite directions, so that depending on the number of single strands, as well as the opposite or the same direction alignment of the diameter profile of the probe body formed by the single strands is determined.

To a further preferred embodiment of the invention is provided that formed of at least two single strands Probe body a central single strand and several, this comprising single strands surrounding central single strand, in diameter equal to or smaller than the central single strand are formed. As a result, a symmetrical structure can be created, whose bending ability is the same in all directions. About that In addition, at an outer fixed diameter a high surface area at cross-sectional areas allows the individual probes.

In a further preferred embodiment of the invention is provided that the at least two single strands, the probe body form, twisted against each other. By such a twist can affect the degree of bending ability and possibly also specifically by the degree of twist be set.

To a further preferred embodiment of the invention is provided that several bundles that also twisted out of each other Single strands may be formed to form a probe body. This allows special requirements in the design the flexible probe are enabled. Alternatively, it is intended that a probe body of mutually twisted bundles consists of single strands, with the bundles off parallel to each other or mutually twisted Single strands can exist.

Of Further, it is preferably provided that each single strand one Coating, painting or has a shell. Thereby will allow for mutual interference during the transmission of the generated shock waves is prevented.

Prefers it is provided that the probe body from a shell, in particular a Teflon sheath or a shrink tube, is surrounded. This bundles the single strands and fixed to each other, so that at a bend of the single strands all single strands are aligned in the same direction become.

The aforementioned features for the design of the individual strands for forming a probe body from at least two single strands can be combined with each other. For example, you can the single strands of a fiber-reinforced plastic and the input or attachment element may be formed from a metal. Furthermore, the single strands of a first metal alloy and the input or attachment element of a be made of different metal alloy. alternative can also do the single strands for one Probe body made of different materials so that different combinations to form a probe body or in dependence on the use of the input or attachment element different flexible probes can be formed.

The invention and further advantageous embodiments and developments thereof are described in more detail below with reference to the examples shown in the drawings and explained. The features to be taken from the description and the drawings may be invented individually or in combination in any combination according to the application. Show it:

1 a schematic longitudinal section of a flexible probe,

2 a schematic sectional view taken along the line II in 1 .

3 a schematic longitudinal section of an alternative embodiment of the flexible probe in 1 .

4 a schematic sectional view taken along the line II-II in 1 an alternative cross section for a probe body,

5 a schematic sectional view taken along the line II-II in 1 an alternative cross section for a probe body,

6 a schematic sectional view taken along the line II-II in 1 an alternative cross section for a probe body,

7 a schematic sectional view of an alternative embodiment of a probe tip to 1 and

8th a schematic sectional view of another alternative embodiment of a probe tip to 1 ,

In 1 is a schematic longitudinal section of a flexible probe according to the invention 11 shown. Such a probe 11 is used in intracorporeal shockwave lithotripty. Such a flexible probe 11 may be introduced directly into a ureter for disintegration of ureteral or bladder stone or into endoscopes for disintegration of, for example, kidney stones or the like. The flexible probe 11 is not limited to these exemplified applications.

The flexible probe 11 includes a probe body 14 , which at one end has a probe foot 16 and at the opposite end a probe tip 17 includes. The design of the probe foot 16 is dependent on a used drive for generating a shock pulse. To drive such a flexible probe, an electromagnetic drive may be provided, for example, from the DE 43 13 768 A1 is known, wherein the shock pulse by the impact of a massive body on the probe foot 16 generated and the impact energy in the flexible probe 11 is initiated. An alternative embodiment of the electromagnetic drive is, for example, a pneumatic drive of a mass body. Alternatively, a hydraulic drive may be provided. In addition, an ultrasonic transducer can also be considered, which has a corresponding impact part on the probe foot 16 the flexible probe 11 acting directly or indirectly. A non-contact shock pulse generation can be provided as a drive, as this example, in the DE 198 41 628 C3 is disclosed.

The probe body 14 consists of at least two single strands 18 , These single strands 18 are, for example, tubular or rod-shaped and have according to the embodiment in 1 along its entire longitudinal extent a constant cross-section. The single strands 18 For example, in a U-shaped recording 21 which are in the probe foot 16 is provided, recorded. Alternatively to the U-shaped or cup-shaped receptacle 21 can also be a sleeve section with a through hole in the probe foot 16 be provided. The single strands 18 are force and / or positive and / or cohesive in the recording 21 intended. These can, for example, in a U-shaped recording 21 with their ends on a ground 22 the recording 21 issue. The single strands are preferred 18 glued and / or clamped and / or pressed. The material selection of the probe foot 16 occurs essentially after the shock pulse generating device.

The probe foot 16 opposite is the probe tip 17 educated. This comprises an attachment element 23 with a recording 24 , which in analogy to the recording 21 trained and in analogy the single strands 18 can record. An end facing the Körperkonkrement 26 of the attachment element 21 is sanded. As a result, the smashing effect can be increased. At the same time this is during operation of the flexible probe 11 achieved that due to the uneven mass distribution of the receiving element 23 to the longitudinal axis of the flexible probe 11 an at least slight wobbling arises, which also increases the fragmentation effect.

In the 1 illustrated embodiment of a flexible probe 11 may additionally comprise a shell through which the single strands 18 positioned to each other or held to each other, as in 3 is described.

In 2 is a sectional view taken along the line II-II in 1 shown. The probe body 14 For example, it consists of five single strands 18 , which are of the same size in diameter and comprise an arrangement in which a central single strand 18 and four more individual strands evenly spaced at the outer circumference of the central single strand 18 issue. Alternatively, it can also be provided that these individual strands 18 are arranged without central single strand or a different number of single strands, but at least two single strands 18 , are provided.

In one embodiment of the flexible probe according to 1 and 2 are the single strands 18 preferably formed of a metallic material, wherein the attachment element 23 from the same material as the single strands 18 or another other metallic material may be formed. An alternative embodiment provides that the single strands 18 are formed of a fiber-reinforced plastic, in particular of a carbon or glass fiber reinforced plastic, wherein the single strands 18 through the shell 28 are surrounded. The attachment element 23 is preferably formed of a metal.

In 3 is an alternative embodiment of the flexible probe 11 to 1 shown. This embodiment differs in that the probe tip 17 a front side 26 which is perpendicular to the longitudinal extent of the flexible probe 11 is arranged. Alternatively, this front page 26 also have a concave or serrated cross-section. The single strands 18 are from a shell 28 surround. This shell 28 can be formed, for example, as a Teflon sheath or shrink tubing. The case 28 has an outer periphery, so that a paragraph-free transition to an outer periphery of the attachment element 23 and preferably to an outer periphery of the probe foot 16 is given, which is part of the recording 21 forms.

In 4 is an alternative embodiment of an arrangement of single strands 18 for a probe body 14 shown. For example, the central single strand 18 in its cross-sectional area larger than the other single strands 18 provided on the outer circumference of the central single strand 18 issue.

In 5 is another arrangement variant of single strands 18 for the formation of the probe body 14 shown. For example, four are equal single strands 18 arranged in the form of a mathematical plus and in the interstices another four single strands 18 provided, however, smaller in diameter than those single strands 18 are formed, which are arranged as a mathematical plus each other.

In 6 is another schematic sectional view of an arrangement of single strands 18 for forming a probe body 14 shown. Here are, for example, two different sizes of single strands 18 provided, which are arranged in the manner of an equilateral triangle to each other, wherein the equilateral triangles are rotated by 180 ° to each other and arranged intermeshing.

The above embodiments represent a small number of the many possible solutions, which also consists in that several different diameters of single strands 18 for forming a probe body 14 can be used, with the cross sections of the single strands 18 also change along the longitudinal extent and / or the total diameter of the probe body 14 along the longitudinal extent through the arrangement and selection of the single strands 18 can change.

In 7 is a further alternative embodiment of an attachment element 23 to form a probe tip 17 shown. In this attachment element 23 is a floor 25 in the U-shaped recording 24 inclined relative to a plane arranged at right angles to the longitudinal axis. This can increase the frequency of the probe tip 17 be achieved during operation, whereby the fragmentation performance is increased. Such a floor 25 can in an attachment element 23 be introduced by a pressing or stamping process. The front side 23 can be flat, concave or inclined.

In 8th is an alternative embodiment to 7 for an attachment element 23 shown. For easy production of such inclined soil 25 is provided that a pin or a bolt 29 whose end face is the inclined ground 25 forms, in a trained as a sleeve attachment element 23 used and fixed, in particular pressed or glued, is. The front side 26 of the attachment element 23 can be alternative to 7 be inclined, with this inclination parallel to that to the ground 25 oriented inclination or at a different angle thereto in the same direction of inclination and inclined in the opposite direction of inclination.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 4313768 A1 [0002, 0041]
• US 5449363 [0005]
• - DE 19814364 C2 [0006]
• DE 19841628 C3 [0041]

Claims (22)

Flexible probe intended as a waveguide for an intracorporeal shockwave lithotripter, comprising a probe body ( 14 ) located at a proximal end of the probe ( 11 ) a probe foot ( 16 ) and at the distal end of the probe ( 11 ) a probe tip ( 17 ) for the disintegration of body crumbs by that of the probe body ( 14 ) and with the probe tip ( 17 ) mediated shock waves, characterized in that the probe body ( 14 ) from at least two single strands ( 18 ) is trained. Flexible probe according to claim 1, characterized in that the probe body ( 14 ) into a recording ( 21 ) or deepening of the probe foot ( 16 ) is provided in a force, shape and / or material fit. Flexible probe according to claim 1 or 2, characterized in that the probe tip ( 17 ) as an insert or attachment element ( 23 ) and on the probe body ( 14 ) is attached. Flexible probe according to one of the preceding claims, characterized in that the insert or attachment element ( 23 ) at or near the free end of the single strands ( 18 ) is provided. Flexible probe according to claim 3, characterized in that the on or attachment element ( 23 ) a U- or cup-shaped receptacle ( 24 ) having. Flexible probe according to claim 3 to 5, characterized in that the input or attachment element ( 23 ) with the probe body ( 14 ) is positively, positively and / or materially connected. Flexible probe according to one of claims 3 to 6, characterized in that an end face ( 26 ) of the single or top element ( 23 ) is ground on one side, concave or jagged. Flexible probe according to one of claims 3 to 7, characterized in that the receptacle ( 24 ) of the single or top element ( 23 ) a floor ( 25 ), which is opposite to a plane which is perpendicular to the longitudinal axis of the probe body ( 14 ), inclined or stepped is formed. Flexible probe according to claim 8, characterized in that the inclined floor ( 25 ) on a in a sleeve-shaped attachment element ( 23 ) element ( 29 ), in particular a pin, is formed with at least one inclined end face. Flexible probe according to one of the preceding claims, characterized in that the sum of the individual cross-sections of the at least two individual strands ( 18 ) substantially corresponds to a cross-sectional area of a single-stranded probe. Flexible probe according to one of the preceding claims, characterized in that at least one single strand ( 18 ) is formed of a solid material and preferably as a rod-shaped solid material. Flexible probe according to one of claims 1 to 10, characterized in that the at least one single strand ( 18 ) is tubular. Flexible probe according to one of the preceding claims, characterized in that the at least one single strand ( 18 ) is formed of a metallic material. Flexible probe according to one of the preceding claims, characterized in that the at least one single strand ( 18 ) made of fiber-reinforced plastic, in particular carbon or glass fiber reinforced plastic, is formed. Flexible probe according to one of the preceding claims, characterized in that the at least two single strands ( 18 ) of a probe body ( 14 ) are each formed the same size in diameter. Flexible probe according to one of claims 1 to 13, characterized in that at least two single strands ( 18 ) of the probe body ( 14 ) differ in diameter from each other. Flexible probe according to one of the preceding claims, characterized in that the at least one single strand ( 18 ) a tapering in the longitudinal direction of cross-section, preferably to the probe tip ( 17 ) has a tapered cross section. Flexible probe according to one of the preceding claims, characterized in that at least two a probe body ( 14 ) forming single strands ( 18 ) are twisted against each other. Flexible probe according to one of claims 1 to 17, characterized in that the probe body ( 14 ) from several bundles of single strands ( 18 ), wherein the bundles of untwisted or mutually twisted single strands ( 18 ) are formed. Flexible probe according to claim 19, characterized in that the at least two bundles of single strands ( 18 ) containing a probe body ( 14 ), are arranged twisted to each other. Flexible probe according to one of the preceding claims, characterized in that the at least one single strand ( 18 ) has a coating, paint or a shell. Flexible probe according to one of the preceding claims, characterized in that the probe body ( 14 ) from a shell ( 28 ), which is formed in particular by a Teflon sheath or a shrink tube.