EP2015686A1 - Tete a ondes de choc pour un dispositif de traitement par ondes de choc et procede de fragmentation et de controle de la fragmentation d'un objet a fragmenter dispose dans un objet a analyser - Google Patents

Tete a ondes de choc pour un dispositif de traitement par ondes de choc et procede de fragmentation et de controle de la fragmentation d'un objet a fragmenter dispose dans un objet a analyser

Info

Publication number
EP2015686A1
EP2015686A1 EP07726992A EP07726992A EP2015686A1 EP 2015686 A1 EP2015686 A1 EP 2015686A1 EP 07726992 A EP07726992 A EP 07726992A EP 07726992 A EP07726992 A EP 07726992A EP 2015686 A1 EP2015686 A1 EP 2015686A1
Authority
EP
European Patent Office
Prior art keywords
shock wave
fragmentation
shockwave
source
shock
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.)
Withdrawn
Application number
EP07726992A
Other languages
German (de)
English (en)
Inventor
Jens Fehre
Ralf Nanke
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 EP2015686A1 publication Critical patent/EP2015686A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2256—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means
    • A61B17/2258—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means integrated in a central portion of the shock wave apparatus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2251—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005—Effects, e.g. on tissue
    • A61B2017/22007—Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing

Definitions

  • the invention relates to a shock wave head for a Stoßwel- len aspectsvorraum, wherein the shock wave head operates- least a first shock wave source for emitting the shock waves and a focusing means for focusing the shock waves on a treatment area of an examination object on ⁇ has.
  • the invention further relates to a process for fragmentation of a arranged in an object under examination fragmentation object by means of shock waves and to control this fragmentation, at least one shock wave with ⁇ means of a first, disposed on or within a shock wave head shock wave source emits, by means of a focus ⁇ sier planted the fragmentation object focused and is coupled into the examination object.
  • shock waves methods for their use and devices for their production have been established in the past years and decades in the field of medical technology.
  • a shockwave head for generating shockwaves is usually a component of a shockwave treatment device which, for example, in orthopedics or in lithotripsy, i. in the fragmentation of concretions such as bile, ureteral and kidney stones.
  • Another application for shock wave treatment is pain therapy.
  • the shock waves used are medium-bound longitudinal waves, which as a rule have an ultrasonic frequency range.
  • the extracorporeal shock wave therapy (ESWT) or extracorporeal Stoßwel ⁇ lenlithotripsie (ESWL) is used.
  • the Stoßwel ⁇ len means of a different executable shock wave source generated in the shockwave head, then coupled into a water reservoir also located in the shockwave head and introduced from there by means of a coupling bellows in the object under investigation.
  • the shock waves are previously focused by means of a focusing device onto a focus area whose position substantially coincides with the position of the treatment zone or the concretion in the examination object.
  • shock waves different energies per unit time are coupled into the examination subject by means of the shock waves.
  • high energy and high amplitude shock waves are coupled into the subject to be examined in order to focus the structures in focus, e.g. Ureteral stones or kidney stones, smash or fragment.
  • An orthopedic application in which the energies of the shock waves used lie between those of the lithotriptic application of shock waves and the pain therapy application of shock waves is, for example, the calculus shoulder. Attempts to remove limescale in the shoulder joint to maintain the mobility of the shoulder. Pain therapy uses lower energies.
  • the aim here is to achieve a compressive and tensile loading of the aching tissue by means of the shock waves in order to stimulate the metabolism at these sites and to relieve pain.
  • the treatment zone of the examination subject which is intended for treatment with shock waves, is usually located by means of an ultrasound imaging device or an X-ray device.
  • the be ⁇ is rich adjusted emanating from the shock wave source shock waves into the treatment zone of the object such that it is located in the treatment zone.
  • the emitted shock waves are bundled in the treatment zone, where ⁇ can be achieved by, for example, a fragmentation of a calculus.
  • shock wave heads usually only the amplitude of the shock waves is changed, which correlates directly with the introduced into the examination subject Ener gy ⁇ .
  • Ultrasonic and shock wave methods are technically related. Both methods use medium-bound longitudinal waves in order to bring about an examination success or treatment success.
  • the longitudinal waves used for the ultrasonic methods differ from the longitudinal waves used in shock wave methods.
  • the pressure amplitudes of the longitudinal waves for ultrasound methods are significantly lower than in shockwave methods, and on the other hand, longitudinal waves for ultrasound methods usually have periodic oscillations with limited frequency bandwidth and time duration.
  • a shock wave usually consists of a single pressure pulse, which is composed of frequencies of a few kilohertz to megahertz.
  • the pressure components and tensile components of the pressure pulse are strongly divergent.
  • the pressure component in a shock wave is significantly greater than the tensile component, while they are approximately equally distributed for an ultrasonic wave or for ei ⁇ nen ultrasonic wave train.
  • the maximum positive pressure generated by the shock wave and the pressure load of the fabric is dependent on the shock wave source and is of the order of et ⁇ wa 50 to 100 megapascals, in shorthand 50 to 100 MPa, or 500 to 1000 bar.
  • the ma ⁇ ximum negative pressure generated by the shock waves or the tensile stress caused by the pressure pulse of the tissue is approximately ten percent of the maximum pressure load of the pressure pulse and thus in-called Example at about 5 to 10 MPa.
  • the time period for ⁇ nde ⁇ tion of the pressure from the maximum of the positive pressure to the amount ⁇ moderate maximum of the negative pressure is in the order of a few microseconds.
  • the amount of tensile or compressive stress of the tissue in ultrasound procedures is usually below 1 MPa, to avoid mechanical or thermal damage to tissue.
  • the cavitation erosion is to be called a fragmentation object which gently on the Doomed from the pressure pulse ⁇ tensile load of the tissue is due.
  • the tensile load generated by the pressure pulse leads to a cavitation of water in the focus area, ie bubble formation in the form of water vapor.
  • the collapse of cavitation bubbles near a fragmentation object leads to a strong erosion of Oberflä ⁇ che fragmentation of the object and contributes significantly to decomposition or fragmentation of the fragmentation comminution object at.
  • the cavitation-based effects ie the fragmentation of a fragmentation object on the one hand, and the damage to the tissue surrounding the fragmentation object, on the other hand, can be influenced by following a second shock wave with a short time interval, which is referred to as a tandem pulse, to a first shock wave.
  • the first shock wave subsequent shock wave can collapse the energy of the shock wave formed by the first Kavi ⁇ tationsblasen near a fragmentation object are set depen ⁇ gig from the shock wave parameters of the first and / or second shock wave.
  • the relevant shock wave Para ⁇ meter are, inter alia, the time interval of at ⁇ the shock waves in the treatment zone, spatial displacement of the two shock wave profile or the respective focus zones to each other, the amplitudes of the first and second shock wave, etc.
  • a shock wave lithotripter comprising a first shock wave source with a focusing sier worn, a plurality of piezoelectric elements and a delay device for adjusting the time period between a first and a second shock wave.
  • the disadvantage of this device is that the carrying out of further examinations, for example, imaging examinations, is possible only by means of at least one additional device.
  • the arrangement in connection with further advantages is compact and space saving devices what the Offense ⁇ and restricts freedom of movement of medical personnel and brings additional risks to the object under examination and the device used with it.
  • the invention is based on the object len a gattungsgemä ⁇ SEN shockwave head of the type initially presszustel ⁇ mentioned that in a compact training provides a plurality of unskilled tersuchungs- and / or treatment options. It is another object of the invention to provide a generic method of the type mentioned, which allows an improved control of a fragmentation process or a shock wave treatment.
  • the object is achieved according to the invention in that the shockwave head has at least one opening in which at least one replaceable module device is used for treatment and / or examination of an examination object can be arranged.
  • a removable arrangement of at least a Moduleinrich- tung for the treatment and / or investigation of an examination object the function can extend a shock wave head much ⁇ TION CAREFULLY and inexpensive. It may, for example. Treatmen ⁇ averaging module devices or examination module devices with different functions, function parameters, etc. are provided, which can be arranged interchangeably in the opening and operated there. The operation of the respective module device can be made possible by at least one interface for data exchange and / or energy supply, which can be provided at the boundary of the opening of the shockwave head.
  • a module device arranged in the opening of the shockwave head can be operated independently of a data connection and power supply connection to the shockwave head.
  • the module device has its own energy supply and / or control device.
  • the shape of the opening of the shockwave head can be designed almost arbitrarily.
  • the opening of the shockwave head on the side facing away from the coupling bellows, so the back of the shockwave head be arranged.
  • a front-side arrangement of the opening, that is incorporated in the coupling bellows is conceivable.
  • this embodiment he ⁇ calls for a much higher design effort and has other disadvantages, for example.
  • the opening is arranged ro ⁇ tationssymmetrisch to a central axis of the shock wave head.
  • a plurality of operating stations assigned to specific module devices may be provided in the opening, so that, if appropriate, interfaces are adapted to the requirements of the respective module device.
  • the module devices can be connected via locking devices, in particular plug-in connections, latching connections, clamping devices. bonds, etc. are interchangeably locked in the opening of the shockwave head.
  • the connecting means for locking the module device are preferably simultaneously interfaces for data traffic with a control device and, if appropriate, for supplying power to the module device.
  • the shock wave head according to the invention comprises at least one shock wave source, which is arranged on the shock wave head or within the shock wave head, that the shock waves are ⁇ out towards the coupling face of the Koppelbalgs.
  • the shockwaves emitted by the shockwave source can be focused with different focussing devices.
  • focusing devices can be provided which superimpose a plurality of shock waves originating from different shock wave sources in the respective focus area.
  • at least one shock wave is focused or concentrated on the treatment zone, for example a concretion, or a partial area of a concretion.
  • the shock waves can be generated, for example, electro-hydraulically.
  • a high-voltage discharge is carried out in a water reservoir.
  • Such a spark discharge taking place under water leads to the generation of a shockwave in the water reservoir.
  • an electro-hydraulic ar ⁇ beitende shock wave source has a number of disadvantages, un ⁇ ter alia, a high wear, a bad adjustment ⁇ bility of the amplitude of the shock wave fluctuations in the Entste- hung location of the shock waves, among other things, however, the resulting from the processing performed underwater spark discharge Stoßwel ⁇ le be well focused with a rotational elliptical focusing, the shock wave source is disposed in the first focus of the ellipsoid and the treatment zone in the second focus of the ellipsoid.
  • the piezoelectric shock wave generation can be applied.
  • a plurality of piezoelectric arranged electrical elements on a spherical cap or on a spherical surface element By an application of a voltage of several kilovolts disposed on the spherical cap piezoelectric elements undergo simultaneous deflection which is specific as a convergent sphäri ⁇ wave in the water reservoir and the inspection object propagates.
  • the energy density of the shock waves is increased so that a fragmentation of a concretion is made possible.
  • the focusing device forms a device unit with the shockwave source.
  • shockwaves Another possibility for generating shockwaves is the electromagnetic shock wave generation.
  • magnetic induction is used to generate a membrane movement in a water reservoir, wherein the arrangement of coils and at least one membrane is optimized in such a way that strong and short deflection movements occur. It can be distinguished thereby two arrangements, on the one hand a flat coil arrangement, whereby a focusing by an acoustic lens is provided, on the other hand a cylindrical coil with a paraboloid reflector.
  • At least one module device is displaceable and / or rotatable by means of a drive relative to the first shockwave source.
  • the module device can be moved independently of their training relative to the first shock wave source or the shockwave head, whereby a variety of settings is possible. This can lead to different effects of success or investigation.
  • At least one module device has at least one function for action of an examination subject and / or at least one function for examining the examination subject.
  • a module device may comprise a plurality of subassemblies, each of which contributes, for example, to the therapy and / or to the performance of diagnostic procedures on the examination subject. As a result, a number of ausutau ⁇ shear module devices can be reduced.
  • the subassemblies of a module device can be operated independently or simultaneously.
  • the module device may comprise a carrier, on or on which the subassemblies are preferably also arranged interchangeably, wherein the carrier, for example, may have a node for data traffic and / or for supplying energy to the various subassemblies.
  • Such a combined module device facilitates the replacement, ie insertion and removal, of the module device on the shockwave head and possibly the operation of the module device, since data interfaces and / or power supply interfaces for a combined module device can be performed together and are not separately required for each module device with a subunit function ,
  • a first module device and a second module device are arranged concentrically, at least partially within the opening.
  • the module devices can advantageously be cylindrical or hollow-cylindrical in shape.
  • At least ei ⁇ ne module means is provided as at least one second shock wave source formed.
  • a rotatable relative to the first shock wave source and / or slidable storage of the second shock wave source can be used to achieve a spatial displacement of the second shock wave relative to the first shock wave.
  • the shockwave profile effective in the treatment zone can be adapted to the requirements of the treatment.
  • several shock wave profiles derived shock waves, a treatment adapted to the individual total shock wave profile are produced from the sum of from different? ⁇ chen shock wave sources.
  • the second shock wave source can be with ⁇ voted shock wave parameters, be exchanged for another shock wave source with other shock wave parameters from ⁇ such as depth of focus.
  • a module device, which shock wave source as formed, are elements on Kugelobervidele ⁇ or arranged on a paraboloid surface elements piezo-zo-electric elements advantageously applicable.
  • a plurality of shock wave sources having formed ⁇ th module devices are driven as a loading in the opening of the shock wave head having different shock wave parameters, such as position of the focus area have.
  • a spatial distribution of shock wave which tion of a fragmentation object to improved Fragmentie ⁇ , eg. A calculus leads.
  • Another possibility for focusing shock waves can be effected by means of piezoelectric elements, which are formed as a phased array.
  • ultrasound signals are emitted by a piezoelectric array, wherein the signals emitted by a respective piezoelectric element have a fixed phase difference from one another.
  • the maximum shock wave energy can be adjusted in any direction, in particular on the treatment zone.
  • at least one module device is designed as an ultrasonic device. This allows for a Fragmen ⁇ tation of a fragmentation object success the Fragment istser- or watching fragmentation process.
  • ⁇ given case can further designed as a shock wave source module means are provided to improve the fragmentation of the fragmentation object based on the ultrasonic control of at least fragmentation.
  • images of the treatment zone or the fragmentation object are obtained by means of the ultrasound device, wherein the ultrasound used to display the examination subject penetrates the same tissue as the shockwave on the way to the treatment zone.
  • more than ultrasonic devices formed module means may be provided, so that a spatial representation of theomme ⁇ monitoring object, in particular the treatment zone, can be determined from the ge ⁇ wonnenen ultrasound data.
  • the ultrasonic means is rotationssymmet ⁇ driven to the symmetry axis of a shock wave profile of an outgoing from a first shockwave source shock wave angeord ⁇ net, wherein the axis of symmetry of the shock wave profile is identical with the axis of symmetry of the ultrasound device.
  • at least one further shock wave source can be arranged concentrically with respect to this axis of symmetry.
  • At least one module device is designed such that it can be operated as an ultrasound device and as a shockwave source.
  • the operation of the module device as an ultrasonic device and as a shock wave source can be made possible by subassemblies of the module device. Since however lerdings the generation of ultrasonic and shock waves are used together, it is also possible to module ⁇ means so to design that can be generated as well as ER- ultrasonic waves by means of the same device both shock waves.
  • the shock wave source or ultrasonic wave source can also be used as a shock wave receiver or ultrasonic wave receiver for the ultrasonic waves or shock waves reflected by the examination object.
  • Control device which controls an operation of at least one module device and / or at least one first shock wave source.
  • a control means controls advantageous ⁇ adhesive enough, at least a first shock wave source and at least one module means.
  • the control device of the module device also includes the adjustment of the position and / or position of the module device, ie in particular the displacement and / or rotation or inclination of the module device relative to the first shockwave source, which can be effected by a drive device, as well as the control of the function of the module device.
  • a particular time interval can a first shock wave to a second, formed from an extended as a second shock wave source ⁇ module means outgoing shock wave can be set, and thus the intensity of the cavitation erosion in the fragmentation of a fragmentation object or the large ⁇ SSE of Cavitation-induced tissue damage.
  • a spatial offset of a shockwave profile of a first shockwave relative to a shockwave profile of a second shockwave can be controlled by adjusting the position and / or position of the second shockwave source of relatively first shockwave source by means of the control device.
  • the amplitudes and optionally the be ⁇ rich at least one shock wave source via the Steuerein ⁇ direction as with a conventional shock wave head, for example. Be set to the shock waves induced dy- namic fragmentation ⁇ ren a fragmentation object to steu.
  • a setting of a time interval be- see at least a first in the treatment zone eintref ⁇ fenden shock wave which lenán derived from at least a first Stoßwel ⁇ , and at least a second in the treatmen ⁇ lung zone incoming shock wave, which is derived from at least ei ⁇ ner second shock wave source, by means of an adjustment of a spatial distance between the first shock wave source and the second shock wave source feasible.
  • the setting of a time interval over a spatial distance between at least a first shock wave source and at least a second shock wave source based on the propagation time difference between first and second shock wave due to the spatial separation of the first and second shock wave source ⁇ . Since first and second shock wave in the shockwave We ⁇ sentlichen have an identical propagation path, the resulting time differences are not taken into account in the control.
  • the spatial distance between the first and second shock wave source can be easily provided by means to see ⁇ ner means be adjusted.
  • shock waves time interval can be supplied via an input / output device of the control device, which then the Shock wave generation of at least the first shock wave source and the second shock wave source controls such that the shock wave generated by the respective shock wave source with the desired time interval to each other shock wave in the treatment zone or the Fragment istsêt a ⁇ applies.
  • the control device can be supplied by the medical staff with a fragmentation rate or shockwave profile via the input / output device, whereupon the control device determines an associated time interval for a first and a second shockwave, and the shockwave ⁇ sources controls such that the predetermined Fragmentie ⁇ rate is achieved or the predetermined shockwave profile is generated.
  • the use of a controller allows to adjust the treatment of the object to be examined individually to the present fragmentation object and fibers to verbes ⁇ .
  • an X-ray source to determine the treatment zone of the object is at least partially within the Publ ⁇ voltage of the shockwave head arranged.
  • the X-ray source has spatial dimensions, which allow the Rönt ⁇ gene source in the aperture of the shock wave head to arrange.
  • the X-ray source is rotationally symmetrical to
  • Shock wave profile of a shock wave emitted by a first shock wave source can be arranged.
  • inline X-ray examinations can be implemented on the examination object, which illuminates the path of the shock waves coupled into the examination subject and by means of which a localization of the treatment zone can be carried out.
  • the X-ray source By introducing the X-ray source into the shockwave head, the acquisition area can be increased, since a larger X-ray opening angle can be realized.
  • the x-ray source can be designed as a module device.
  • the X-ray source by means of a drive device rela- tiv to the shockwave head displaced and / or rotatable.
  • An adjustment of the position and / or position of the X-ray source by means of the drive device preferably takes place via a control device, which may be identical to the control device for controlling the module devices. This allows an accurate, fast, repeatable and secure adjustment of the position and / or location of the X-ray source.
  • the object is achieved in that during an interaction of the at least one shock wave fragmentation object with the fragmentation of Fragmen ⁇ t ists réelles, by means of a shock wave from the head ⁇ interchangeable module device is controlled.
  • the progress of a fragmentation of the fragmentation object is controlled by means of a sequence of image representations of the fragmentation object.
  • it can be checked whether, for example, a change in the focus adjustment or an adaptation of the amplitude of the shock waves to improve the fragmentation is required, whether the fragmentation object has particularly resistant areas, whether an improvement in cavitation erosion is possible.
  • image-based control of fragmentation other methods can also be used.
  • the method according to the invention allows observation of a fragmentation of a fragmentation object, which as a rule takes place within an examination subject.
  • the control by means of at least one interchangeable arranged on the shock ⁇ wave head module device allows for a use of various control methods by replacing the module devices. Furthermore, in the event of a defect of the module device, replacement with another module device can be carried out quickly. Furthermore, an inline arrangement of the module device can be made so that at least the projection of the fragmentation object in the propagation direction of the shockwaves can always be detected. Thus, for example, depending on the state of the fragmentation Fragmentie ⁇ changed approximately object of focus range, for example, be expanded or tightened in order to focus on a specific area of the fragmentation object. A setting of Fo ⁇ kus Schemes depending on the progress of the Fragmentie ⁇ insurance process can also be done in terms of prevention of damage to the environment of the fragmentation object.
  • the fragmentation means of an ultrasonic process formed by ei ⁇ ne as an ultrasonic device module means is controlled.
  • Ultrasonic methods are implemented by means of a rapid rapid-action device. Ultrasonic devices are relatively inexpensive, have no damaging effect on tissue, such as ionizing radiation, and are easy to handle. Therefore, ultrasonic methods for controlling the fragmentation of a fragmentation object are advantageously applicable.
  • One possible method uses ultrasound to control the fragmentation no self-generated ultrasonic waves ⁇ but detects the light reflected by a shock wave in the direction of the shock wave head portion of the shock wave. As a result, it is possible to control the fragmentation of the fragmentation object by means of ultrasound waves without additional loading of the examination subject. In this case, shock waves can be alternatelyStekop ⁇ pelt in the object to be examined and reflected portions of the shock waves are detected at Fragment réelle Meeting.
  • an ultrasonic device emits ultrasonic waves and detects the light reflected from the structures of the sec ⁇ monitoring object ultrasonic waves.
  • an ultrasound wave filter device which, for example, allows only those ultrasound waves to be taken into account for further processing into image datasets. have significant the frequency and the amplitude of the ultrasonic waves emitted by the ultrasonic device.
  • the fragmentation of the fragmentation object ilias controlled by we ⁇ a first module means, and currency ⁇ rend the control emits at least one second processing by at least one second formed as a shock wave source Moduleinrich ⁇ generated shock wave, focused and in the Un - Test object coupled, wherein the at least first
  • the method for fragmenting the fragmentation object can be improved, for example by using ultrasound images to set a time interval between a first shock wave and a second shock wave in such a way that the kavation activity is improved.
  • the improvement can, for example, in an increased rate of fragmentation Fragmentie ⁇ approximately object consist or in reducing damage to the surrounding tissue by the fragmentation object occurring cavitation.
  • the cavitation activity by means of a second shock wave, which follows a first shock wave in a short time interval.
  • E- b a focal region of the first shock wave, and the focus area, the second shock wave can be set such that a spatial position of the be ⁇ realm of the first shock wave does not coincide with the spatial position of the focus of the second shock wave together.
  • the position of the focus areas of the first and second shockwaves may be determined by displacement and / or rotation of the Shock wave sources are changed relative to each other.
  • shock wave sources can be provided whose emitted shock waves can be superimposed temporally and spatially in the treatment zone with the shock waves of the other shock wave sources. This allows larger fragmentation objects to be fragmented with high efficiency.
  • the second shock wave is spatially offset and / or temporally spaced coupled to the first shock wave in the Untersu ⁇ monitoring object.
  • a localization of the treatment zone and / or an inspection is made of fragmentation of the fragmentation object by means of Wenig ⁇ least a second shock wave source.
  • the second shock wave source By means of the second shock wave source, a shock wave reflected by the fragmentation object is detected.
  • the ultrasound receiving device may be identical to the shockwave source, for example in the case of electromagnetic shock sources or piezoelectric elements. Due to the reflected portion of the shock wave striking the membrane, the membrane is deflected. The deflection can be detected and converted into an electrical signal.
  • the recording of the temporal Chen the course of the incoming reflected portion of the previously irradiated to the fragmentation shock wave.
  • a control of the fragmentation is a Fragmentie ⁇ approximately object a setting of at least one Stoßwellenpa ⁇ rameters provided at least one shock wave source currency rend.
  • the effect of a shock wave with changed Stoßwellenpa ⁇ rametern the fragmentation object immediately monitored or observed.
  • the medical Per ⁇ can personnel will assess the change in Fragment istspro ⁇ zesses. This makes it possible to improve the setting of the shockwave parameters during the treatment and, if appropriate, to shorten the treatment time or to make the treatment for an examination object more pleasant.
  • FIG. 1 shows a sectional view of a side view of a shockwave head according to the invention
  • FIG. 2 shows a shockwave head operated on an examination object as part of a shockwave treatment device
  • FIG. 3 shows a sectional view of a side view of a shockwave head with two concentrically arranged
  • FIG. 1 shows a shockwave head 10 with a first shockwave ⁇ lenán 11, wherein the first shockwave source 11 is formed as elekt ⁇ romagnetician shockwave source.
  • the first shock wave source 11 therefore has a vibration diaphragm 12 and a coil carrier 13. It is a flat coil arrangement. If an electric current flows through the coil carrier 13, the magnetic field caused by the electric current causes an induction current in the diaphragm 12 and, as a consequence, an opposing force which causes a deflection of the diaphragm 12.
  • the membrane 12 is arranged in a water reservoir 16 so that the deflection of the membrane 12 propagates as a shock wave in the water reservoir 16.
  • the generated shock wave is then focused by means of a focusing device 14, which is designed as an acoustic lens.
  • the acoustic lens 14 is also disposed in the water reservoir 16.
  • the water reservoir 16 between the first shock wave source 11 and the focusing device 14 and between the focusing device 14 and a coupling bellows 15 are in the
  • the volume of the water reservoir 16 is adjustable.
  • the water reservoir 16 is surrounded by an elastic coupling bellows 15, which serves to couple the shockwave into an examination object (not shown in FIG. 1).
  • the coupling bellows 15 is pressed when performing ei ⁇ ner treatment or investigation of the examination subject, wherein between coupling bellows 15 and Informsob ⁇ jekt yet another unillustrated coupling medium may be provided, for example in the form of a gel pad. That investigation object and the shock wave head 10 are ⁇ during the ban deviation in physical contact.
  • shock waves by means of a first shock wave source
  • other concepts for generating shock waves can also be implemented.
  • the focusing devices specified here also differ from Weil's shock wave source to provide suitable focusing.
  • the shockwave head 10 further has a tube 17, which is rotationally symmetrical to the central axis A of the shockwave head 10 at least partially disposed within the shockwave ⁇ head 10.
  • the tube 17 is substantially a hollow cylindrical structure and provides the opening according to the invention of the shockwave head 10, in which a module device can be arranged exchangeably.
  • the tube 17 is enclosed by the focusing device 14, the first shock wave source 11 and the water reservoir 16.
  • a module means arranged damage to loading has the tube 17, a waterproof sound-trans ⁇ parente Tubusver gleichkappe 18.
  • the tube 17 may ⁇ inner half of the shock wave head 10 relative to the first shock-wave source 11 is displaced by means of a Tubusantriebs 19 and rotates ge ⁇ be.
  • sealing elements 20 are provided which ei ⁇ ne rotary motion of the tube 17 about an axis with a vertical component to the central axis A allow while the water in the water reservoir 16 always keep it from escaping from the water reservoir 16.
  • the expansion of the sealing elements 20 is optionally controllable by means of a control device depending on the position and / or position of the tube 17 in order to always ensure optimal completion of the water reservoir 16 of the shock ⁇ wave head 10 to the environment.
  • the sealing elements 20 can also serve to dampen the motion and pressure between the focusing device 14 and the shockwave source 11 and the tube 17.
  • conventional gaskets may be provided if none
  • the tube 17 is hollow on the inside and optionally provided with locking devices, data line interface and E- nergiemakerssexcellentstellen, so that a module device, not shown in FIG 1 insertable, feststell ⁇ bar and operable without further data line connections or power supply connections are provided on the Modulein ⁇ direction.
  • each module device may have its own data lines and possibly power supply lines.
  • FIG. 2 shows a shockwave head 10 operated on an examination object U as part of a shockwave treatment apparatus.
  • the shockwave head 10 is mounted on a, not shown, movable support arm which is movably arranged on a tripod unit or a trolley, also not shown.
  • the examination object U includes a concrement K which trümmert shock wave zer ⁇ or is to be fragmented.
  • a coupling bellows 15 of the shockwave head 10 is thereby pressed against the examination object U, so that the shock waves generated by a first shockwave source 11 and focused with a focusing device 14 can be coupled into the examination object U.
  • the focus range of the focusing device 14 is DA, selected in such a way that its position substantially i- dentisch is with the position of the concrement K in ban ⁇ monitoring object U.
  • the propagation directions of different shock wave elements of a shock wave after it the focus ⁇ sier worn have happened 14, are denoted by 13 '.
  • the shock waves all converge in the focus area, whereby the energy density of the shock wave per shock wave reaches a maximum in the focus area.
  • the shockwave head 10 shown in FIG. 2 further shows a module device 30, which is inserted into a tube 17.
  • the module device 30 is releasably locked within the tube 17 with a number of latching connections 33.
  • the module device 30 has a rotatably mounted module head 31 on which motor ge by means of a module head drive 32 ⁇ can be rotated.
  • the module head 31 may, for example, be designed as an ultrasound transmitting and ultrasound receiving device, likewise a design as a second shockwave source 35, see FIG. 3, is possible.
  • a superposition of shock wave profile is the first shock ⁇ wave source 11 and the second shock wave source 35, see FIG 3, it is possible with spatial offset in the focus area, so that the overall shock wave profile into the treatment zone ⁇ is adjustable.
  • an off-axis arrangement may be provided for the module device 30 within the tube 17, i. the center axis of the tube 17 does not coincide with the central axis of the module device 30.
  • an off-axis arrangement relative to the central axis of the shockwave head 10 can also be provided for the entire tube 17 with inserted module device 30, i. the longitudinal central axis or the axis of rotational symmetry of the tube 17 does not coincide with the central axis A of the shockwave head 10.
  • relative to the effective range of a first shock wave emitted by a first shock wave source 11 may be simply, e.g. be changed by rotation of the tube 17 with a not-shown off-axis arranged module device about its rotational symmetry axis. This also makes it possible to change the location of the coupling of shock waves into the examination object U, and thus to adjust the energy density during the coupling of the shock waves.
  • FIG. 2 further shows an X-ray device 40, which can be positioned such that an X-ray can be taken through the tube 17 when the module device 30 is removed.
  • the x-ray apparatus 40 is an X-ray source, said x-ray source of the x-ray device inserted into the tube 40 and can optionally be locked.
  • the X-ray source by means of the Tubu ⁇ santriebs 19. within the shock head 10 in a Posi ⁇ tion near the object to be examined U be brought further wherein an X-ray examination is substantially in the direction of the propagation direction of the shock waves can be made.
  • the central axis of the x-rays emanating from the x-ray source of the x-ray device and the central axis of the tube 17 generally coincide substantially.
  • a localization of the calculus K can take place by means of an X-ray image thus carried out and shockwave obstacles in the examination subject U can be detected on the way to the focus area.
  • the X-ray device 40 and an X-ray source having operative part of the X-ray device 40 may be used as a off in the opening of the shock wave head can be arranged and operable interchangeable module means being ⁇ be formed.
  • conventional in-line X-ray devices may be used, for example a C-arm X-ray device.
  • the C-arm X-ray device is positioned in such a way that the X-ray emitter arranged on the C-arm of the C-arm X-ray device passes through the opening of the shockwave head in order to acquire X-ray images in the propagation direction of the shockwaves.
  • the module device 30 is designed as an ultrasound device, so that localization of a treatment zone of the examination object U can be carried out without ionizing radiation.
  • a further advantageous embodiment of the module device 30 is a second shock wave source designed for the detection of ultrasound.
  • the latter thus has a dual function and permits, on the one hand, the fragmentation of a fragmentation object by means of shock waves and, on the other hand, the detection of shock waves reflected and scattered on structures of the examination object U.
  • an ultrasonic device can be saved under certain circumstances.
  • the module device 30 embodied as an ultrasound device is here connected to a programmable controller 50, which also controls further functions of the shock treatment device.
  • the control device 50 controls the function of the ultrasound device, as well as the processing of the received ultrasound signals of the ultrasound device.
  • the control device 50 is further connected to a data processing device 60, which determines an image data record from the ultrasonic signals received by the ultrasound device. Such an image data record is then output on an input / output device 70. This allows the medical staff knowledge about the treatment zone and on the lying between treatment ⁇ zone and shockwave source structures of the sec ⁇ monitoring object can win.
  • the medical staff can communicate with the medical staff. Furthermore, the medical staff can communicate with the medical staff. Furthermore, the medical staff can communicate with the medical staff. Furthermore, the medical staff can communicate with the medical staff. Furthermore, the medical staff can communicate with the medical staff.
  • the inputs of the shock wave parameters are supplied to the controller 50, which thereupon to the ⁇ controlling shock wave source 11 and 35, see FIG 3, controls and adapts to be controlled shock wave parameters corresponding to the input of the medical staff.
  • FIG 3 is a sectional representation of a side view ei ⁇ nes shockwave head 10 is shown having a tube 17 into which a module device 30 with a Ultra ⁇ sound device 34 and a second shock wave source is introduced 35th
  • a module device 30 with a Ultra ⁇ sound device 34 and a second shock wave source is introduced 35th
  • This is a combined Mo ⁇ dul sensible 30, wherein the ultrasonic means 34 and the second source of shock are arranged on a common carrier 36 Toggle 35th
  • the ultrasonic device 34 and the second shock source 35 are connected to each other via a carrier 36 and therefore are also interchangeable, the exchange, especially in concentric arrangement, a first module device, here an ultrasonic device 34, and a second module device, here a second shock wave source 35, facilitated.
  • FIG. 3 as in FIG. 1 and FIG. 2, one is a
  • Membrane 12 and a bobbin 13 having first shock ⁇ wave source 11 is provided, wherein a shock wave emitted from the shock wave source 11 is focused by a focusing device 14 on a focusing, which preferably has substantially the same position as a concretion K in a study object U, which is to be fragmented.
  • the coupling of the shock waves of the first shock wave source 11 into the examination object U er ⁇ follows by means of a water reservoir 16 and a coupling bellows 15, which is pressed against the examination object U.
  • the first shock wave source 11 and the second shock wave source 35 have a distance d, which can be changed by a displacement of the tube 17 relative to the first shock wave source 11. This can be exploited, for example, to control a time interval with simultaneous emission of at least a first and a second shock wave.
  • the transit time difference of the first and second shockwaves via the path difference, ie the distance d of the first shockwave source 11 to the second shockwave source 35 for example. Adjusted by means of ei ⁇ ner control device.
  • the required path difference to provide a specific time difference between a first within the treatment zone incoming shock wave and a second arriving in the treatment zone shock wave may, for example, on the basis of Ausbreitungsgeschwindig ⁇ ness of the shock waves in the examination object U determined ⁇ the.
  • the combined module device 30 which has both an ultrasound device 34 and a second shockwave source 35, the fragmentation rate of Konkre ⁇ ment K and the Fragment istssecures in cooperation of a first, originating from the first shockwave source 11 Shock wave and a second, derived from a second shock wave source 35 shock wave increases or the unwanted side effects are reduced to the tissue.
  • a resul ⁇ advantage a shortened treatment time. Those emitted from the first one emitted from the first shock wave source 13
  • shock wave and the second focused, indicated by the second shock wave source 35 shock wave Ausbrei ⁇ processing direction 13 'and 35' are exemplary in FIG 3 Darge ⁇ represents.
  • ultrasonic means 34 and second shock wave source 35 are used separately ie, are not operated gleichzei ⁇ tig.
  • a ge for performing the method ⁇ suitable device Figures 2 and is already positioned in an object under examination in accordance with U 3, and is aligned with a valve disposed in the examination object calculus.
  • a first shock wave is generated by a ten ers ⁇ shock wave source 11, which propagates in a water reservoir 16 and a kussier sensible Fo 14 applies.
  • the focusing device 14 By means of the focusing device 14, the light emitted from the first shock wave source 11 shockwave in a process step 102 is set to the rich be ⁇ the focusing device 14 focuses, wherein the position of the focus coincides with the position of the concrement K substantially. Subsequently, the focus catalyzed shock wave of the first shock-wave source 11 by means of the water reservoir 16 and the coupling bellow is object in the assayed ⁇ U coupled.
  • a control device 50 controls a second shockwave source 35 such that after a period of time after the first shockwave of the first shockwave source 11 has been emitted, in a method step 101 'a second shockwave of the second shockwave source 35 is emitted.
  • the second Stoßwel- lenario 35 is preferably designed as a number of piezo-electric elements ⁇ with adjustable focus range, wherein the arrangement of the piezo-electric elements generates a focusing of the emitted shock wave. Thus, there is no need for a separate focusing device for focusing the shock waves emitted by the second shock wave source 35.
  • the focusing of a shock wave of the second shock wave source 35 in a method step 102 ' generally takes place simultaneously with the emission of this shock wave in the method step 101'.
  • the shock wave emitted by the second shock wave source 35 propagates in the water reservoir 16, wherein the shock wave previously passes through the sound-transparent tube closure cap 18.
  • the second shock wave emitted by the second shock wave source 35 is also coupled into the examination object U, by means of a method step 103 '.
  • an imaging Ultraschallverfah ⁇ is reindeer, which is referred to in FIG 4 as method step 104, already carried out at the time of emission of the first shock wave from the first shock wave source 11 and at the time of emission of the second shock wave from the second shockwave source 35th
  • the method step 104 of the image-based ultrasound control of the calculus K can also begin with the emission time of a first or a second shock wave. It is expedient that a control method, in particular an ultrasound imaging method, be started at such a time that the interaction of the first shockwave with the concretion K, or the interaction of the second shockwave with the concretion K or the common
  • Interaction of the first and second shock wave with the concretion K can be detected or controlled.
  • fragmentation and in particular the cavitation activity in the treatment zone can be controlled and, if appropriate, adjusted in the desired manner by setting shock wave parameters.
  • a filter device which frequencies of the shock waves from the Ultrasound signal filters out, so that the image quality of the imaging ultrasound examination is increased. If appropriate, a frequency comparison between the frequency range of the shock waves emitted by a shock wave source and the frequency range of the ultrasonic waves detected by the ultrasound device can be carried out. On the basis of the comparison, desired frequency ranges can then be removed from the detected ultrasonic signal and an image determination with the residual signal can be provided.
  • a further representation of the treatment zone is desired.
  • a further check may be made of the treatment zone by means of UIT raschall until the time, for example at the.
  • Medi ⁇ zinisches personnel aware decides to terminate the investigation, eg. By operating the input / output unit, switching off the module device 30 or removing the Module device 30 from the shockwave head 10th
  • a method step 106 the setting of the shockwave parameters, eg amplitudes of the shockwaves used, temporal distance between a first shockwave emitted by a first shockwave source 11 and a second shockwave emitted from a second shockwave source 35, spatial distribution of the effective in the focus area Shock wave profile, etc. then checks whether changed values are provided by the medical staff for the shock wave parameters that have been supplied to the control device by means of the input / output unit 70.
  • the shockwave parameters eg amplitudes of the shockwaves used, temporal distance between a first shockwave emitted by a first shockwave source 11 and a second shockwave emitted from a second shockwave source 35, spatial distribution of the effective in the focus area Shock wave profile, etc.
  • shockwave parameters not shown in FIG. 4 can also be provided which, for example, provide for the stepwise increase of the intensity of the shockwaves or the fragmentation rate, possibly up to a predefinable limit value.
  • the query according to method step 106 preferably does not require regular activities of the medical staff. Rather, the control device 50 checks in the method step 106 whether a change of shock wave parameters by the medical personnel has taken place in a method step 107 by the input / output device 70 or whether the control device 50 provides a stored change of a shock wave parameter. Only if the shock Waveform parameters by medical personnel by means of the input / output device 70 or, for example, by an examination time-dependent, stored in the controller 50 Ver ⁇ change a shock wave parameter is carried out during the next run of the method, an adjustment of the prescribed by the medical staff or the controller values for the change provided shockwave parameters. The change of a shock wave parameter by the medical personnel is usually caused by evaluation of a number of ultrasound images.
  • the treatment of the object U with shock waves dau ⁇ ert usually it up as long ent to the calculus K ⁇ neither is completely fragmented or treatment is stopped by the medical staff.
  • the imaging Ult ⁇ raschalluntersuchung can be used for further examination of the treatmen ⁇ development success after shock wave treatment of the object U.
  • no white ⁇ tere device is required to, it is turned off, only the generation of shock waves of the shock wave head 10 by means of the input / output device, but the ultrasound method further carried out with the arranged inside the shock wave head 10 ultrasonic device 34th
  • Shock wave parameters is possible by, for example, by means of ultrasound or X-ray fragmentation rate for the incorporated ⁇ set is determined shock wave parameters, and then the shock wave parameters are comparable such changes of the control device that the fragmentation rate is increased. Since ⁇ is on the well-being of the object U, insbeson ⁇ particular of a patient during treatment gen to begursichti ⁇ . This can be done by having the patient adjusting the intensity of the shock wave energy to a certain extent, with- means of an appropriate control element, even departmenth can men ⁇ . Basically, the control of the fragmentation process can be controlled with a variety of measures.
  • a control by means of X-rays ⁇ SUC gene wherein while the second shockwave source 35 preferably has a hollow cylindrical shape and no further Modulein ⁇ device 30 in which is arranged by the second shock wave source 35 gebil ⁇ Deten cavity.
  • in-line X-ray imaging may be enabled during an interaction of at least one shockwave with the fragmentation object.
  • the advantage here is that no disturbing superposition of the control signal, so the the object under examination convinced Anlagendrin ⁇ constricting X-rays carried out with the shock waves such as this.
  • With ultrasonic devices can be carried out as a control device for shock wave treatment device.
  • number of Stoßwel ⁇ lenánn to illustrate the invention can be expanded.
  • the number of spatially fixed shock wave sources and the number of relative to a spatially detected shock wave source movable shock wave sources can be significantly increased over the number mentioned in the embodiment.
  • all shock wave sources can be displaceable and / or rotatable relative to one another.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiology & Medical Imaging (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une tête (10) à ondes de choc pour un dispositif de traitement par ondes de choc, la tête (10) à ondes de choc présentant au moins une première source (11) d'ondes de choc pour émettre des ondes de choc ainsi qu'un dispositif (14) de concentration pour concentrer les ondes de choc sur une zone (K) à traiter d'un objet (U) à analyser. Du fait que la tête (10) à ondes de choc présente au moins une ouverture (17), dans laquelle peut être disposé au moins un dispositif (30, 34, 35) modulaire interchangeable destiné à traiter et/ou à analyser un objet (U) à analyser, il est possible de réaliser une tête à ondes de chocs qui, avec une configuration compacte, offre une pluralité de possibilités d'analyse et/ou de traitement. De plus, l'invention concerne un procédé de fragmentation d'un objet (K) à fragmenter disposé dans un objet (U) à analyser au moyen d'ondes de choc et pour contrôler cette fragmentation, au moins une onde de choc étant émise au moyen d'une première source (101) d'ondes de choc disposée sur ou dans une tête (10) à ondes de choc, concentrée (102) sur l'objet (K) à fragmenter au moyen d'un dispositif (14) de concentration et injectée (103) dans l'objet (U) à analyser. Du fait que pendant une interaction de ladite ou desdites ondes de choc avec l'objet (K) à fragmenter, la fragmentation de l'objet (K) à fragmenter est contrôlée au moyen d'un dispositif (30, 34, 35) modulaire interchangeable disposé sur la tête (10) à ondes de choc, il est possible d'obtenir un procédé qui permet un meilleur contrôle d'un processus de fragmentation ou d'un traitement par ondes de choc.
EP07726992A 2006-05-05 2007-03-16 Tete a ondes de choc pour un dispositif de traitement par ondes de choc et procede de fragmentation et de controle de la fragmentation d'un objet a fragmenter dispose dans un objet a analyser Withdrawn EP2015686A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102006021049A DE102006021049A1 (de) 2006-05-05 2006-05-05 Stoßwellenkopf für eine Stoßwellenbehandlungsvorrichtung und Verfahren zur Fragmentierung und zur Kontrolle der Fragmentierung eines in einem Untersuchungsobjekt angeordneten Fragmentierungsobjekts
PCT/EP2007/052513 WO2007128611A1 (fr) 2006-05-05 2007-03-16 TÊte À ondes de choc pour un dispositif de traitement Par ondes de choc et procÉdÉ de fragmentation et de contrÔle de la fragmentation d'un objet À fragmenter disposÉ dans un objet À analyser

Publications (1)

Publication Number Publication Date
EP2015686A1 true EP2015686A1 (fr) 2009-01-21

Family

ID=38229388

Family Applications (1)

Application Number Title Priority Date Filing Date
EP07726992A Withdrawn EP2015686A1 (fr) 2006-05-05 2007-03-16 Tete a ondes de choc pour un dispositif de traitement par ondes de choc et procede de fragmentation et de controle de la fragmentation d'un objet a fragmenter dispose dans un objet a analyser

Country Status (5)

Country Link
EP (1) EP2015686A1 (fr)
CN (1) CN101437459A (fr)
DE (1) DE102006021049A1 (fr)
IL (1) IL194884A0 (fr)
WO (1) WO2007128611A1 (fr)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE202009012955U1 (de) 2009-09-24 2009-12-10 Ast Gmbh Elektrohydraulische Elektrode
EP2529678B1 (fr) * 2011-05-31 2015-01-28 Storz Medical Ag Appareil à ondes de pression pour le traitement du corps humain ou animal
CN104614100A (zh) * 2014-09-28 2015-05-13 李众利 一种测量扩散式冲击波能量的装置
CN105249995B (zh) * 2015-10-29 2017-10-10 杭州迪比声学技术有限公司 利用超声波定位治疗点的体外震波碎石仪的定位方法
CN105919632B (zh) * 2016-06-21 2018-09-07 深圳市慧康医疗器械有限公司 一种中置b超定位的体外心脏冲击波治疗头
CN107198555A (zh) * 2017-07-07 2017-09-26 北京索迪医疗器械开发有限责任公司 一种复式脉冲体外冲击波碎石系统
DE102018101215B4 (de) 2018-01-19 2023-09-07 Ferton Holding S.A. Vorrichtung zur Zertrümmerung eines Körpersteins
CN108720897B (zh) * 2018-07-09 2023-12-05 北京万孛力医疗器械有限公司 组合波治疗设备及治疗系统
EP3682822B1 (fr) * 2019-01-18 2024-05-08 Storz Medical AG Source combinée d'ondes de choc et d'ultrasons

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3916093A1 (de) * 1989-05-17 1990-11-22 Wolf Gmbh Richard Lithotriptor
DE3932577C1 (fr) * 1989-09-29 1990-11-22 Dornier Medizintechnik Gmbh, 8000 Muenchen, De
US5165412A (en) * 1990-03-05 1992-11-24 Kabushiki Kaisha Toshiba Shock wave medical treatment apparatus with exchangeable imaging ultrasonic wave probe
US5582578A (en) * 1995-08-01 1996-12-10 Duke University Method for the comminution of concretions
DE19644314A1 (de) * 1995-11-23 1997-05-28 Siemens Ag Therapiegerät mit einer Quelle akustischer Wellen
DE19748071A1 (de) * 1997-10-30 1998-10-29 Siemens Ag Therapiegerät mit einer Quelle fokussierter akustischer Wellen
DE10228550B3 (de) * 2002-06-26 2004-02-12 Dornier Medtech Systems Gmbh Lithotripter zur Fragmentierung eines Zielobjekts in einem Körper und Verfahren zur Überwachung der Fragmentierung eines Zielobjekts in einem Körper
US7559904B2 (en) * 2003-07-17 2009-07-14 Moshe Ein-Gal Shockwave generating system
WO2005018469A1 (fr) * 2003-08-14 2005-03-03 Duke University Procede de lithotripsie par onde de choc amelioree a generateur combine d'onde de choc a reseau piezoelectrique annulaire et hydraulique

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2007128611A1 *

Also Published As

Publication number Publication date
CN101437459A (zh) 2009-05-20
DE102006021049A1 (de) 2007-11-08
IL194884A0 (en) 2009-08-03
WO2007128611A1 (fr) 2007-11-15

Similar Documents

Publication Publication Date Title
EP2015686A1 (fr) Tete a ondes de choc pour un dispositif de traitement par ondes de choc et procede de fragmentation et de controle de la fragmentation d'un objet a fragmenter dispose dans un objet a analyser
DE69631555T2 (de) Gerät zum zerkleinern von konkrementen
DE4443947B4 (de) Endoskop
EP0133946B1 (fr) Appareil pour la destruction à distance des concrétions
DE102005037043B4 (de) Stoßwellentherapiegerät mit Bildgewinnung
DE102008038214B4 (de) Verfahren und Stoßwellenkopf zum Erzeugen von fokussierten Ultraschall-Stoßwellen
EP2341835B1 (fr) Dispositif pour la destruction de cellules tumorales et de tissus tumoraux
EP0372174B1 (fr) Lithotripteur
EP0397980B1 (fr) Lithotriteur
WO1994028540A2 (fr) Dispositif pour le traitement de tissus biologiques et de concretions corporelles
DE3119295A1 (de) Einrichtung zum zerstoeren von konkrementen in koerperhoehlen
DE4110102C2 (fr)
DE10140064A1 (de) Vorrichtung zur Behandlung subkutaner Zellbereiche
EP0369177A2 (fr) Dispositif pour générer des ondes de choc acoustiques focalisées
EP2719344A1 (fr) Instrument de chirurgie fluidique avec schéma de pulvérisation variable
EP1151724B1 (fr) Applicateur à ultrason pour la désintegration de tissus
EP0372119B2 (fr) Lithotripteur
EP0355178B1 (fr) Appareil pour la destruction à distance de concrétions dans le corps d'un être vivant
DE3328039A1 (de) Zertruemmerungseinrichtung fuer konkremente im koerper eines lebewesens
DE19548000C1 (de) Vorrichtung zur Ortung von Konkrementen im Körper eines Patienten
DE10394286T5 (de) Vorrichtung für verbesserte Schockwellen-Nierenzertrümmerung (SWL) unter Verwendung eines piezoelektrischen Ringanordnungs- (PEAA) Schockwellengenerators in Kombination mit einer primären Schockwellenquelle
DE3806532C2 (fr)
DE3814743C2 (de) Einrichtung zur Auflösung von Konkrementen in einer Körperhöhle
WO2023099466A1 (fr) Dispositif de lithotritie pour détruire les calculs et procédé de réglage de la trajectoire d'accélération d'un tube d'accélération d'un dispositif de lithotritie
DE19928491A1 (de) Vorrichtung, insbesondere Therapievorrichtung, zum Beschallen von Objekten mit fokussiertem Schall

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20080910

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LI LT LU LV MC MT NL PL PT RO SE SI SK TR

AX Request for extension of the european patent

Extension state: AL BA HR MK RS

17Q First examination report despatched

Effective date: 20110719

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 20111130