GB2118046A

GB2118046A - Mechanical lithotriptor

Info

Publication number: GB2118046A
Application number: GB08304218A
Authority: GB
Inventors: Ludwig Demling; Kurt Seuberth
Original assignee: Individual
Current assignee: Individual
Priority date: 1982-02-26
Filing date: 1983-02-16
Publication date: 1983-10-26
Also published as: FR2523837A1; GB8304218D0; DE3206846A1; CH658377A5; GB2118046B; DE3206846C2

Abstract

A lithotriptor for the fragmentation of larger-sized concretions in the body of a patient comprises a snare 11 constituted of snaring cables 12 which are retractable into a flexible steel conduit 3, and the snaring cables serve as cutters during the retraction of the snare into the steel conduit. <IMAGE>

Description

SPECIFICATION Mechanical lithotriptor 1. Field of the Invention The present invention relates to a mechanical lithotriptor for the fragmention of larger-sized concretions in the body of a patient.

2. Discussion of the Prior Art A lithotriptor of that type is utilized in conjunction with endoscopes which incorporate an instrumentation passageway. Herein, this can relate to duodenoscopes, gastroscopes or coloscopes, which essentially consist of a glass fiber optic, a tubular light conductor and an instrumentation passageway.

It is already known that, through the intermediary of such instrumentation passageways, there can be introduced into the body of a patient various biopsy forceps, papillotomes and polypectomy slings.

Summary of the Invention Accordingly, it is an object of the present invention to provide an arrangement, through the assistance of which there can be fragmented larger-sized stones in the body of the patient and which, because of their size, cannot be moved safely with a normal stone extraction cage.

The foregoing object, pursuant to the invention, is effected through the assistance of a mechnical lithotriptor of the type referred to hereinabove which provides for a snare constituted of a plurality of snaring cables which are rectractable into a flexible steel conduit, and the snaring cables serve as cutters during the retraction of the snare into the steel conduit.

Further advantageous modifications of the invention may be readily ascertained from the detailed description of the lithotriptor as set forth hereinbelow.

The above-described lithotriptor facilitates the fragmentation of stones in the choledochum and to thereafter extract these with d stone extraction snare to the extent in which the fragmented portions will not readily pass through without additional effort being exerted. Heretofore, for larger stones it was always necessary to undertake an operation entailing the opening of the stomach cavity (laparotomy).

Brief Description of the Drawing Reference may now be had to the following detailed description of a preferred embodiment of the invention, taken in conjunction with the single figure of the accompanying drawing, illustrating a general view, partly in section, of the mechanical lithotriptor.

Detailed Description The inventive arrangement consists of a snare 1 1 which is formed of a plurality of snaring cords 12. The snaring cords 12 are connected to a pulling cable 8 which is guided within a flexible steel conduit or tube 3. The snare 1 1, which can be formed from three, four, or even a larger number of snaring cords 12, can be retracted into the flexible steel conduit 3. When this occurs during the presence of a stone within the snare 11, the snaring cords 12 will then cut into the stone and fragment the latter. A stone which is fragmented in this manner will either pass through spontaneously or can be extracted with the aid of a grappling snare.

In the case where it appears to be necessary, the end of the flexible steel conduit 3 towards the snare 1 1 can be specially reinforced in order to provide structure able to absorb the radial forces.

The flexible steel conduit 3 is introduced into the body of the patient through the instrumentation passageway of an endoscope.

The retraction of the snare 1 1 into the flexible steel conduit 3 is effected through a holder 1 within which there is guided a threaded spindle 4 having an internal bore and an external screw thread. The pulling cable 8 is conducted through the internal bore of the threaded spindle 4 to a protective cap 9 and fastened thereto by means of a clamping screw 7. The protective cap 9 can be connected either directly or indirectly with a handgrip 10. The threaded spindle 4 is encompassed by an adjusting wheel 5 which, in the loaded condition of the snare 11 and thereby that of the pulling cable 8, supports itself against an abutment 6 on the holder 1.

The end of the holder 1 towards the flexible steel conduit 3 is provided with a cap 2 which includes a Luer lock for enabling cleaning of the flexible steel hose 3. The pulling cable 8, as well as the snare 11, consists of stainless-steel wire.

The function of the above-described lithotriptor is as follows: The flexible steel conduit 3 is introduced into the body of the patient through the instrumentation passageway of an endoscope until the leading end of the flexible steel conduit 3 exits from the instrumentation passageway of the endoscope. Thereafter, through inward movement of the handpiece 10 by means of the threaded spindle 4, the pulling cable 8 and, as a result, the snare 11 is extended outwardly. Through the employment of a brief X-ray control, the stone is engaged by the snaring cords 12. Through the exertion of a pull on the handpiece 10, the snare 11 is reduced in size until a resistance can be felt.

The engaged stone is now rigidly encompassed by the snare 1 The adjusting wheel 5, which is mounted on the threaded spindle 4 by means of an internal thread, is rotated relative to the threaded spindle 4 in such a manner whereby, under action of its support against the abutment 7 on the holder 1 , the threaded spindle 4 and the pulling cable which is connected therewith, as well as the snare 1 1, are moved in the desired direction.

Due to the threaded interconnection between the adjusting wheel 5 and the threaded spindle 4 there is produced a force or power transmission ratio which is dependent upon the increase in the screw threading. Whereas for the setting of the adjusting wheel 5 only a small force is required, an extremely large amount of power stands available on the pulling cable 8 and, consequently, on the snare. Under the effect of this power, the snaring cords 12 will cut into the stone and fragment the latter.

Through the utilization of the above-described lithotriptor, any surgery becomes superfluous in most instances. The required stay in a hospital can thus be shortened by up to 14 days. Moreover, a recuperative period is no longer needed. Because of this treatment there are thus obtained significant financial savings.

While there has been shown and described what is considered to be a preferred embodiment of the invention, it will of course be understood that various modifications and changes in form or detail could readily be made without departing from the spirit of the invention. It is therefore intended that the invention be not limited to the exact form and detail herein shown and described, nor to anything less than the whole of the invention herein disclosed as hereinafter claimed.

Claims

1. Mechanical lithotriptor for the fragmenting of large-sized concretions in the body of a patient, comprising a flexible steel conduit; and a snare formed of a plurality of snaring cords being retractable into said steel conduit, said snaring cords each forming cutters during retraction of the snare into the steel conduit.

2. Lithotriptor as claimed in claim 1, wherein the end of the steel conduit towards the snare is reinforced for the absorption of radial forces.

3. Lithotriptor as claimed in claim 2, comprising a holder connected with the opposite end of said steel conduit; and a cap forming a closure on the end of said holder facing towards the steel conduit.

4. Lithotriptor as claimed in claim 3, wherein said cap comprises a Luer lock for facilitating cleaning of the flexible steel hose.

5. Lithotriptor as claimed in claim 3, comprising a threaded spindle axially displaceable within said holder, said spindle having an internal bore for receiving a pulling cable and being provided with an external screw thread.

6. Lithotriptor as claimed in claim 5, comprising a protective sleeve, and a handgrip connected with the free end of said threaded spindle through said protective sleeve.

7. Lithotriptor as claimed in claim 6, said protective sleeve including a clamping screw for gripping engagement of the pulling cable.

8. Lithotriptor as claimed in claim 5, comprising an adjusting wheel having an internal screw thread, said wheel encompassing the threaded spindle so as to engage the external thread on the latter, said adjusting wheel being supported against an abutment on the holder in the load condition of said lithotriptor.