EP0133665B1 - Appareils pour détruire les calculs à distance - Google Patents

Appareils pour détruire les calculs à distance Download PDF

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Publication number
EP0133665B1
EP0133665B1 EP84108750A EP84108750A EP0133665B1 EP 0133665 B1 EP0133665 B1 EP 0133665B1 EP 84108750 A EP84108750 A EP 84108750A EP 84108750 A EP84108750 A EP 84108750A EP 0133665 B1 EP0133665 B1 EP 0133665B1
Authority
EP
European Patent Office
Prior art keywords
shock wave
shock
lens
tube
wave
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.)
Expired
Application number
EP84108750A
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German (de)
English (en)
Other versions
EP0133665A3 (en
EP0133665A2 (fr
Inventor
Karlheinz Dr. Pauli
Helmut Dr. Reichenberger
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Siemens AG
Original Assignee
Siemens AG
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Siemens AG filed Critical Siemens AG
Publication of EP0133665A2 publication Critical patent/EP0133665A2/fr
Publication of EP0133665A3 publication Critical patent/EP0133665A3/de
Application granted granted Critical
Publication of EP0133665B1 publication Critical patent/EP0133665B1/fr
Expired legal-status Critical Current

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    • G—PHYSICS
    • G10—MUSICAL INSTRUMENTS; ACOUSTICS
    • G10K—SOUND-PRODUCING DEVICES; METHODS OR DEVICES FOR PROTECTING AGAINST, OR FOR DAMPING, NOISE OR OTHER ACOUSTIC WAVES IN GENERAL; ACOUSTICS NOT OTHERWISE PROVIDED FOR
    • G10K9/00—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers
    • G10K9/12—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers electrically operated
    • G—PHYSICS
    • G10—MUSICAL INSTRUMENTS; ACOUSTICS
    • G10K—SOUND-PRODUCING DEVICES; METHODS OR DEVICES FOR PROTECTING AGAINST, OR FOR DAMPING, NOISE OR OTHER ACOUSTIC WAVES IN GENERAL; ACOUSTICS NOT OTHERWISE PROVIDED FOR
    • G10K11/00—Methods or devices for transmitting, conducting or directing sound in general; Methods or devices for protecting against, or for damping, noise or other acoustic waves in general
    • G10K11/18—Methods or devices for transmitting, conducting or directing sound
    • G10K11/26—Sound-focusing or directing, e.g. scanning
    • G10K11/30—Sound-focusing or directing, e.g. scanning using refraction, e.g. acoustic lenses

Definitions

  • the invention relates to a device for the contactless smashing of a concrement located in the body of a living being with a shock wave generator which can be aligned with a target area in the body.
  • Devices of this type are used in medicine, e.g. to destroy stones in the kidney of humans. They are particularly beneficial because they avoid any intervention in the body. It is not necessary to operate surgically. There is also no need to bring probes and devices to the concrement. A risk from infection or injury, e.g. when inserting the probe or operations, can not occur in contactless smashing.
  • a device for crushing concrements is described in DE-AS 2351 247.
  • a spark discharge is brought about between two electrodes in a first focal point.
  • This causes a shock wave, the wavefront of which extends on all sides, i.e. spreads spherically.
  • the waves are reflected on the wall of the ellipsoid of revolution. They collect in the second focal point of the ellipsoid of revolution.
  • the reflected waves arrive simultaneously in this second focal point, in which the concrement is placed.
  • the concrement is destroyed under the collision of the shock waves.
  • the coupling between the ellipsoid of revolution and the body in which the concrement is located takes place via a thin film that lies against the body without an air gap.
  • the focus chamber is filled with water.
  • This device has the disadvantage that changes in the shock wave energy are possible only within small limits and only with considerable expenditure on equipment by changing the distance between the underwater electrodes.
  • a further disadvantage is that the mutual distance between the electrodes for generating high-intensity shock waves generally has to be a few millimeters, as a result of which the shock wave source has no punctiform geometry and imaging errors can occur during focusing.
  • the underwater electrodes wear heavily with each discharge, so that their lifespan is limited, which necessitates regular maintenance of the device.
  • the device according to DE-AS 2351247 also entails the fact that the patient's body is separated from the high-voltage spark gap only by the coupling film which is in contact with the body and by the water. Damage to the coupling foil carries a certain risk for the patient.
  • DE-OS 2 902 331 describes a device for transcutaneous, bloodless obliteration of small reticular and spider vein varices.
  • controllable ultrasound elements are used as the wave generator, which are arranged parabolically so that their sound energies meet at a focal point in which the varice to be destroyed is placed.
  • the entire arrangement of the ultrasonic elements is longitudinally displaceable by means of a worm drive and an adjusting screw. This allows different distances of the focal point from the applicator end to be set.
  • the power of the ultrasound crystals is not sufficient to crush stones in the deep interior of a human body.
  • the exact setting of the individual ultrasonic vibrators with regard to both the location and the energy is therefore not critical. Switching off individual ultrasonic crystals for the purpose of adjusting the ultrasonic energy in the focal point is not provided.
  • DE-OS 3119 295 describes a device for destroying concrements in body cavities with the aid of a large-area ultrasound transducer as a vibration generator.
  • a focusing ultrasonic transducer with a pulse peak power of at least 100 kW is used.
  • An embodiment is also shown in which individual ring-shaped ultrasonic elements, which form the transducer, are arranged on a spherical surface. None is said about a change in performance according to the type and depth of the concretion.
  • the effort for such a device, in particular with regard to the formation of the ring-shaped ultrasound elements should be considerable.
  • shock tube As it is used in principle in the present invention, is described.
  • a copper membrane is located in front of a flat coil, separated by an insulating film.
  • a tube filled with water connects to this copper membrane.
  • a voltage in the range of 2-20 kV to the flat coil, a magnetic field is induced in the copper membrane, which causes repulsive forces that suddenly push the membrane away from the coil.
  • Such a shock wave tube is used e.g. for substance studies in chemistry.
  • a device according to the preamble of claim 1 is known from JP-B 5 540 257.
  • the object of the present invention is to increase the operational reliability of such a device, to obtain an image on a target area with the smallest possible imaging error and to reduce maintenance work.
  • this object is achieved in that a shock wave generator, known per se and producing the flat shock wave, with an electrical coil and a membrane arranged in front of it is provided as the shock wave generator.
  • this device uses a shock wave generator that generates plane waves, the shock waves coming from only one direction have to be bundled and focused.
  • imaging errors are less likely than if spherical waves proceeding from a spark gap and traveling in all directions have to be focused.
  • the temporal and spatial reproducibility of the shock wave is significantly improved when generated with a shock wave tube compared to the generation with a spark gap.
  • there is no maintenance work due to wear and tear of the electrodes in a spark gap. Because a shock wave tube generates the shock waves with the help of electromagnetic forces and does not require a spark gap.
  • a shock wave tube is constructed in such a way that it contains a copper membrane at one end of a tube filled with liquid, preferably with water, which is arranged in front of a flat coil, separated by an insulating film. Due to a current pulse in the flat coil, the copper membrane is repelled by it and thereby generates the shock wave in the liquid.
  • the copper membrane itself and the pipe section adjoining it are usually connected to a common reference potential, i.e. they are grounded. There is therefore no high voltage at the coupling medium that conducts the shock wave, which increases the electrical safety of patient and staff.
  • FIG. 1 shows a shock wave tube 1 known per se, consisting of a jacket 2, a flat coil 3 with two electrical connections 5 and 7, an insulating film 9, a copper membrane 11 and a metallic tube piece 13, in front of an acoustic converging lens 15 , which has a focal point F, placed.
  • the pipe section 13 is filled with a liquid 14, e.g. filled with water.
  • the shock wave tube 1 is coupled to a body 19 via a coupling medium 17 with water-like acoustic properties.
  • the body 19, e.g. a patient has a concretion 23, e.g. a kidney stone.
  • the converging lens 15 can be displaced relative to the jacket 2 of the shock tube 1 via a fine adjustment 24 with a bolt 24a and a locking edge 24b in the direction of a double arrow 25.
  • the bolt 24a is guided in a slot-shaped recess 24c in the casing 2.
  • the shock wave tube 1, the converging lens 15 and the fine adjustment 24 are mounted on a common frame, tripod or a mounting plate 26.
  • This mounting plate 26 is mounted on a bearing 26a which can be pivoted on all sides and is displaceable in all spatial directions. As a result, the shock wave tube 1 can be aligned with the concretion 23 such that the focal point F lies in the concretion 23.
  • the copper membrane 11 and the pipe section 13 are electrically connected to a protective potential such as earth 27, as is the one connection 7 of the flat coil 3.
  • the other connection 5 of the flat coil 3 is connected to a supply and via a switch 29, which includes an auxiliary contact 31 Control unit 33 out.
  • a high voltage U is generated in the supply and control unit 33 via a capacitor / resistance circuit (not shown). This can be several kilovolts, for example 20 kV. The voltage U can be adjustable.
  • a control signal which is supplied from the supply and control unit 33 to the auxiliary contact 31 via a control line 35, causes the switch 29 to close.
  • a part of the energy stored in the (not shown) capacitor of the supply and control unit 33 is discharged abruptly into the flat coil 3, which builds up a magnetic field very quickly.
  • a current is induced in the copper membrane 11, which is opposite to the current in the flat coil 3 and a magnetic opposing field testifies. The copper membrane 11 is knocked away from the flat coil 3 by the force of the opposing field.
  • This knocking away of the copper membrane 11 creates a flat shock wave, ie an abrupt compression in the liquid 14 upstream of the membrane 11.
  • This shock wave shows a steep pressure increase, for example to 200 bar.
  • the pressure wave gains steepness in its course through the pipe section 13, the converging lens 15 and the patient's body 19.
  • the shock wave After passing through the converging lens 15, the shock wave is shaped such that it converges at the focal point F.
  • the concrement 23 is placed there, and the focused shock wave releases part of its energy content to the concrement 23, which is brittle compared to the environment, by means of tensile or compressive forces. These forces break up the concrement 23 into several parts and thus cause it to be broken up.
  • This explained crushing device offers the considerable advantage that the grounded copper membrane 11 and the grounded pipe section 13 do not represent a source of danger for the patient 19 or the operating personnel.
  • the electrical safety of the device can be improved for the operating personnel by an additional insulating sheath (not shown), e.g. in the form of a plastic coating of the outer surface of the jacket 2, can be increased.
  • an additional insulating sheath e.g. in the form of a plastic coating of the outer surface of the jacket 2
  • a sack 37 filled with the coupling medium 17 is used at the point of entry of the shock wave in the patient 19, there is a double security for the patient 19 from the high electrical voltage. This security is determined on the one hand by the insulating bag wall and on the other hand by the insulating film 9 in front of the flat coil 3.
  • the switch 29 can also be integrated in the supply and control unit 33. It can also be located away from the shock tube assembly. Since a spark gap does not necessarily have to be used for triggering, namely e.g. Vacuum or, more recently, SF6 switches are also out of the question, eliminating the need for complex maintenance and operating work that would be associated with the spark gap.
  • FIG. 2 shows a shock wave tube 1 known per se, to which a system 40 of acoustic lenses for imaging a flat shock wave onto a concrement 23 in the body of a patient 19 is assigned.
  • the acoustic lens system 40 consists of a diverging lens 42, a condenser 44 and a converging lens 46 and has a focal point F.
  • the preferred material for the acoustic lens system 40 is acrylic glass or polystyrene.
  • the plane shock wave generated in the shock wave tube 1 is widened in its cross section by the diverging lens 42. The shock wave is then directed in parallel by the capacitor 44 and then focused on the focal point F by the converging lens 46.
  • the configurations of the shock wave tube 1 and the holding device described for FIG. 1 also apply to this embodiment of the imaging system.
  • the entire system 40 of acoustic lenses can be displaced relative to the shock wave tube 1 in the axial direction of the double arrow 25.
  • the advantage of this exemplary embodiment is that the shock wave enters the patient's body 19 over a larger cross section of the body surface. This makes it possible to keep the energy density in the patient's tissue, in particular on the body surface 48, low.

Claims (8)

1. Dispositif pour détruire sans contact une concrétion (23) située dans le corps (19) d'un être vivant, et qui peut être orinté vers une zone de visée (21) située dans le corps (19) et comporte un générateur d'ondes de choc, qui produit une onde de choc essentiellement plane, et un dispositif à lentilles (15; 40), qui est associé au générateur d'ondes de choc et focalise l'onde de choc par l'intermédiaire d'un milieu de couplage (17), sur un foyer (F) situé dans la zone de visée (21), et un liquide (14) situé entre le générateur d'ondes de choc et le dispositif à lentilles (15; 40) caractérisé par le fait qu'il est prévu, comme générateur d'ondes de choc, un tube générateur d'ondes de choc (1), connu en soi, qui produit une onde de choc plane et comporte une bobine électrique (3) et une membrane (11) devant cette bobine.
2. Dispositif selon la revendication 1, caractérisé en ce que le dispositif à lentilles est un système de lentilles (40), qui est constitué par plusieurs lentilles (42, 44, 46) et accroît le diamètre de l'onde de choc au niveau de la surface (48) du corps, par rapport au diamètre de l'onde de choc dans le tube générateur d'ondes de choc (40).
3. Dispositif suivant la revendication 1 ou 2, caractérisé par le fait qu'il est prévu un dispositif mécanique pour orienter le tube générateur d'ondes de choc (1) sur la région de visée (21).
4. Dispositif suivant la revendication 3, caractérisé par le fait que le dispositif mécanique comporte un dispositif d'entraînement fin (24) qui sert à décaler la profondeur du foyer (F) dans le corps (19).
5. Dispositif suivant la revendication 3, caractérisé par le fait que le dispositif mécanique comporte un dispositif d'entraînement fin (26, 26a); qui sert à décaler le foyer (F) perpendiculairement à la direction de propagation de l'onde de choc.
6. Dispositif suivant l'une des revendications 1 à 5, caractérisé par le fait que le système de lentilles (40) est constitué par une lentille acoustique divergente (42), un condenseur (44) et une lentille acoustique convergente (46) (figure 2).
7. Dispositif suivant l'une des revendications 1 à 6, caractérisé par le fait que le dispositif à lentilles (15; 40) est prévu en tant qu'élément de fermeture du tube générateur d'ondes de choc (1).
8. Dispositif suivant l'une des revendications 1 à 7, caractérisé par le fait que l'enveloppe extérieure (2) du tube d'ondes de choc (1) est raccordée électriquement à un potentiel de protection (27).
EP84108750A 1983-08-03 1984-07-24 Appareils pour détruire les calculs à distance Expired EP0133665B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19833328051 DE3328051A1 (de) 1983-08-03 1983-08-03 Einrichtung zum beruehrungslosen zertruemmern von konkrementen
DE3328051 1983-08-03

Publications (3)

Publication Number Publication Date
EP0133665A2 EP0133665A2 (fr) 1985-03-06
EP0133665A3 EP0133665A3 (en) 1985-04-03
EP0133665B1 true EP0133665B1 (fr) 1988-06-22

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Family Applications (1)

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EP84108750A Expired EP0133665B1 (fr) 1983-08-03 1984-07-24 Appareils pour détruire les calculs à distance

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US (1) US4674505A (fr)
EP (1) EP0133665B1 (fr)
DE (2) DE3328051A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19916891C1 (de) * 1999-04-14 2000-08-31 Siemens Ag Einrichtung zur Erzeugung akustischer Wellen und Verwendung einer derartigen Einrichtung
DE10207737C1 (de) * 2002-02-22 2003-04-17 Siemens Ag Schaltkreis für eine elektromagnetische Quelle zur Erzeugung akustischer Wellen

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DE3328051A1 (de) 1985-02-14
EP0133665A2 (fr) 1985-03-06
US4674505A (en) 1987-06-23
DE3472209D1 (en) 1988-07-28

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