GB2199249A - Apparatus for clinical performance of extracorporeal lithotripsy - Google Patents

Apparatus for clinical performance of extracorporeal lithotripsy Download PDF

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Publication number
GB2199249A
GB2199249A GB08725273A GB8725273A GB2199249A GB 2199249 A GB2199249 A GB 2199249A GB 08725273 A GB08725273 A GB 08725273A GB 8725273 A GB8725273 A GB 8725273A GB 2199249 A GB2199249 A GB 2199249A
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GB
United Kingdom
Prior art keywords
water
reflector
spark gap
elliptical reflector
elliptical
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.)
Granted
Application number
GB08725273A
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GB8725273D0 (en
GB2199249B (en
Inventor
Jiri Benes
Pavel Sunka
Vaclav Kordac
Zbysek Barta
Cestmir Stuka
Zdeno Figura
Milan Jirsa
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Karlova Univerzita v Praze
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Karlova Univerzita v Praze
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Publication of GB8725273D0 publication Critical patent/GB8725273D0/en
Publication of GB2199249A publication Critical patent/GB2199249A/en
Application granted granted Critical
Publication of GB2199249B publication Critical patent/GB2199249B/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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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
    • A61B17/2255—Means for positioning patient, shock wave apparatus or locating means, e.g. mechanical aspects, patient beds, support arms, aiming means
    • 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
    • G10K11/35—Sound-focusing or directing, e.g. scanning using mechanical steering of transducers or their beams
    • G10K11/352—Sound-focusing or directing, e.g. scanning using mechanical steering of transducers or their beams by moving the transducer
    • 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
    • G10K15/00—Acoustics not otherwise provided for
    • G10K15/04—Sound-producing devices
    • G10K15/06—Sound-producing devices using electric discharge

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

Description

2199249 m j J APPARATUS FOR CLINICAL PERFORMANCE OF EXTRACORPOREA1
LITHOTRIPSY The invention relates to an apparatus for clinical performance of extracorporeal lithotripsy by a focused shock wave, comprising an elliptical reflector in which a spark gap is provided, further a current source and locating or aiming means. - From the Czechoslovak Inventor's Certificate No /Appln.No. PV 4066-85/ there is known an apparatus for experimentally performing lithotripsy or disintegrating-gallstones by a focused shock wave. The focused shock wave has already been, applied to the treatment of renal'calculy. The pressure wave is generated by an electrical discharge in water., such discharge being a spot source of a spherical pressure wave. In order to obtain the desired effect, viz. disintegration of calculus with minimum damage on adjacent tissues, the shock wave energy has to be focused. The focusation is carried out by means of an elliptical cavity which is able to concentrate a pressure impact from the original focus where a spark gap, is situated, by reflexion into a second focus of a circular ellipsoid. The second focus is situated into the point of calculus location so that a half of the ellipsoid is used for the focusation. This known apparatus has been examined by disintegrating human calculi implanted into swine. However, this apparatus has been found.unsuitable for clinical applications since it does not allow a reliable stability of water spark gap, a perfect location of calculi and easy manipulation.
It is an object of the present invention to eliminate the disadvantages of prior art as hereinabove set forth and to provide an improved apparatus-for clinical performance of extracorporeal lithotripsy by a focused shock wave, comprising an
2 - elliptical reflector in which a spark gap is provided, a current source and locating or aiming means.
According to the invention, the elliptical reflector in which a water spark gap is provided, which gap is connected to a pulse condenser charged by pulses through a one-way switch, is supported by a manipulator having several degrees of freedom, a patient's bed being disposed above said elliptical reflector.
Alternatively, the elliptical reflector is arranged fixedly, and the bed is mounted for movement along axes x, y and z.
According to another aspect of the invention, the elliptical reflector is providdd with a water bag attached to the bearing portion of said reflector.
According to another embodiment of the invention, the patient's bed is provided with a water bath with a sealing collar.
Another embodiment consists in that the tips of water spark gap are connected to electrodes of two series-connected condensers which are parallel-charged.
Further it is preferred that the water spark gap has one tip situated in a plane passing through the plane of optical reflector while the second tip is in the direction of the main reflector axis.
Alternatively, the tips of water spark gap are disposed in the plane of focus of the optical reflector, said plane being perpendicular to the main relector axis.
The essential advantage of the apparatus according to the invention resides in the possibility 1 - 3 i -T 1 of generating reproducable shock waves, the possibility of continuously adjusting the distance between tips of electrodes, which leads to a considerable prolongation of their lifetime, and-in an enhancement of reliability of lithiasis treatment, due to a perfect location of calculi and a correct adjustment of the relative positions of the patient and the elliptical reflector. This adjustment is enabled by using the manipulator allowing several degrees of-'freedom. The patient's bed provides for a perfect acoustic contact between the elliptical reflector an_d the patient. Electrical appliances are connected to a control unit enabling an optimum timing of the shock wave release. 15 In order that the invention be better understood and carried into practice, some preferred embodiments thereof will hereinafter be described with reference to.the accompanying schematic drawings in which: 20 Fig. 1 is an elevation view of the complete apparatus for treating cholelithiasis; Fig. 2 shows an arrangement of water spark gap; Fig. 3 is an alternative arrangement of water spark-gap; Fig. 4 is wiring diagram showing the circuitry for generating a shock wave; and Fig. 5 is a variant of the wiring diagram shown in Fig. 4.
As can be seen in the drawings, and particularly in Fig. 1 thereof, the apparatus comprises an elliptical reflector I supported on a manipulator 2 with six degrees of freedom. At a suitable place, the manipulator 2 carried a two- dimensional locating and imaging probe 3, and 4 particularly in such a manner that the focal point of the elliptical reflector 1 is permanently situated in the image plane of said probe 3. The structure of the elliptical reflector 1 makes it possible to vary the ellipse eccentricity by changing the lengths of half-axes. Thereby the shock wave can be focused onto deeply situated calculi such as, for instance, when they block the bile ducts.
The elliptical reflector 1 is coaxially connected with a pulse condenser 5.
The manipulator 2 is embodied by a spacer block 6 allowing the movement along axes x and y. To the spacer block 6 there is attached a lift jack 7 which carries an arm 8. The arm 8 is fixed onto the lift jack 7 for oscillation allowing the motion within the range of an angle alpha in the direction of axis z. The arm 8 supports the elliptical reflector 1 which is rotatable within the range of an angle gamma. The orifice of the elliptical refl-3ctor 1 is open upward to the patient's bed 4 which is formed by a water bath. The walls of the bath are attached water-tightly onto upper edges of the elliptical reflector 1.
Alternatively the water bath can be replaced by a water bag which can be attached directly to the upper aperture of the elliptic reflector.
Fig. 2 shows an embodiment of a water spark gap 9 installed in the elliptical reflector 1 in such a way that its tips are comprised in the plane of focus of the elliptical reflector. The condenser 5 is situated at the side of the elliptical reflector 1.
Fig. 3 shows an alternative embodiment of the water spark gap 9. One tip of the water spark 11 cl - 1 gap 9 lies in the plane passing through the reflector focus while the other extends in the direction of the main reflector'axis. In this case the condenser 5 is provided within the axis of the elliptical reflector 1, in its bottom part. In the two cases shown in Figures 2 and 3 the distance between tips of the water spark gap 9 can be adjusted.
Fig. 4 shows a circuit of the shock wave generator-. From a high-voltage DC source 10 there is charged, over a resistor 13, an auxiliary condenser 11 from which an operating condenser 5 is charged by pulses via inductor 12. The water spark gap 9 generating a pressure wave is connected to said condenser 5. In the charging circuit of the operating condenser 5 there is interconnected a oneway switch 14 which allows a unidirectional current passage only.
An alternative wiring diagram of pressure wave generator is shown in Fig. 5. In this embodiment there is used a circuit with doubled input voltage. A condenser 15 is charged via first inductor 18 from another high-voltage current source 19. Another condenser 16 is charged through the inductor 18 and impedance 17. After closing the oneway switch 14 the over-poling of the condenser 15 and the other condenser 16 occurs so that between tips of the water spark gap 9.a double initial voltage arises.
Apart from this, the apparatus according to the invention is provided with a control unit for ensuring a precipe shock wave course. This control unit is designed not only for synchronizing the shock wave source with electrocardiogram and the respiration cycle but monitors moreover physical parameters of the apparatus such as the distance 6 - 1 between tips of the water spark gap 9.
The apparatus according to the invention operates as follows:
The patient is put on the bed 4. The actual acoustic contact of corresponding patient's body part is provided for by the water bath, or the water bag. In the first case the sealing collar 8 prevents the water leakage. The water bath is present in the application region only while the upper part of patient's body and limbs are beyond contact with water. The sealing collar-8 enables a good fixation of organs in the abdominal cavity. In the second case the water bag is immediately drawn over the upper aperture of the elliptical reflector 15 1 - After these preparing steps, the calculi are located by means of the probe 3. A correct adjustment of the elliptical reflector 1 is carried out by moving the entire system of the manipulator 2 or, alternatively, by moving the patient's bed. If using the water bath, the locating probe 3 is fixed to the elliptical reflector 1 so that the plane to be imaged intersects the main axis of the elliptical reflector 1 just in the focus averted from the water spark gap 9. In the event of transmitting the shock wave by means of transmission water bags, the location is effected alternatively by means of a locator system on the basis of two crossed X- ray projections. In this case it is necessary to use a precisely defined motion in order that the monitor may always show the position of focus of the elliptical reflector 1 averted from the water spark gap 9. The command for releasing the shock wave is given by the operating surgeon as soon as he ascertains the correctness of the location. However, the discharge is released at the moment okayed by the d k t 1 i 7 - control unit. The apparatus according to the invention makes it possible to either completely disintegrate the calculi, or to partially dilapidate them by small impact doses.
The second treatment, however, should be appropriately combined with a dissolution pharmacotherapy.
14 n 8 - 3235

Claims (8)

1. - An apparatus for clinical performance of extracorporeal lithotripsy by a focused shock wave, comprising an elliptical reflector in which.a spark gap is providea, further a current source and locating or aiming means, wherein the elliptical reflector in which a water spark gap is provided, which gap is connected to a pulse condenser charged by pulses through a one-way switch, is supported by a manipulator, or arranged fixedly, a patient's bed being disposed above said elliptical reflector.
2. An apparatus according to Claim 1, wherein the elliptical reflector is provided with a water bag attached to the bearing portion of the reflector.
3. An apparatus according to Claim 1, wherein the patient's bed is provided with a water bath with a sealing collar.
4. An apparatus according to any one of Claims 1 through 3, wherein the tips of the water spark gap are connected to electrodes of two series-connected condensers which are parallel-charged.
5. An apparatus according to any one of Claims 1 through 4, wherein one tip of the water spark gap is situated in a plane passing through the reflector focus while the other tip thereof lies in the direction of the main reflector axis.
6. An apparatus according to any one of Claims 1 through 4, wherein the tips of water spark gap are situated in the focal.plane of the elliptical reflector, said plane being perpendicular to the main reflector axis.
7. An apparatus substantially as hereinbefore described with reference to Figures 1 to 5 of the accompanying drawings.
Pubils-ted 19B6 at The Patent QMce. State House 6671 RIgh Holborn. London WC1R 4TP Further copies may be obtained frorn 71,e Patent 0 ice Sales B.-ar.ch.
S. CrE, 0-P"ng-cn Men BR5 3P.1) Printel. by Multiplex tecY,=crues M St Mary Cray. Kent Con IT, 1 1j,
GB8725273A 1986-10-29 1987-10-28 Apparatus for clinical performance of extracorporeal lithotripsy Expired - Fee Related GB2199249B (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CS867789A CS261485B1 (en) 1986-10-29 1986-10-29 Device for clinic out-of-body lithotripsy of gall stones

Publications (3)

Publication Number Publication Date
GB8725273D0 GB8725273D0 (en) 1987-12-02
GB2199249A true GB2199249A (en) 1988-07-06
GB2199249B GB2199249B (en) 1991-06-12

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Country Status (4)

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CS (1) CS261485B1 (en)
DE (1) DE3736360C2 (en)
FR (1) FR2605874A1 (en)
GB (1) GB2199249B (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109715079A (en) * 2016-07-21 2019-05-03 索里顿有限责任公司 The electro-hydraulic shock wave generator equipment of fast-pulse with improved electrode life

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CS270064B1 (en) * 1988-07-01 1990-06-13 Pavel Ing Csc Sunka Method of surge generator's spark gap's points regulation for non-invasive lithotrity and device for realization of this method
DE4124259A1 (en) * 1991-07-22 1993-01-28 Wolf Gmbh Richard SOUND WAVE TREATMENT DEVICE
ES2097848T3 (en) * 1992-09-28 1997-04-16 Hmt Ag APPARATUS FOR THE GENERATION OF SHOCK WAVES FOR THE CONTACTLESS DESTRUCTION OF CONCRETIONS IN BODIES OF ORGANISMS.
DE19532219C2 (en) * 1995-09-01 1997-07-31 Tzn Forschung & Entwicklung Energy converter for high-performance pulse generation
DE102007031332A1 (en) * 2007-07-05 2008-05-29 Siemens Ag Lithography device, has X-ray receiver and X-ray source arranged at multi-axle robot and fastened relatively to each other in fixed position at carrier, where carrier is located at robot
DE102007046902A1 (en) * 2007-09-28 2009-04-09 Hochschule Konstanz Technik, Wirtschaft Und Gestaltung Impulse generator for shock-wave therapy device, has capacitors charged by charging units comprising switch such that charging voltages developed at capacitors are partially compensated based on polarity of capacitors by series connection
CN102781350B (en) 2010-01-19 2016-09-14 得克萨斯大学体系董事会 Produce the device of high-frequency percussion ripple and system and using method
AR087170A1 (en) 2011-07-15 2014-02-26 Univ Texas APPARATUS FOR GENERATING THERAPEUTIC SHOCK WAVES AND ITS APPLICATIONS
AU2016261936B2 (en) 2015-05-12 2020-12-17 Soliton, Inc. Methods of treating cellulite and subcutaneous adipose tissue
US11813477B2 (en) 2017-02-19 2023-11-14 Soliton, Inc. Selective laser induced optical breakdown in biological medium

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EP0090138A2 (en) * 1982-03-25 1983-10-05 DORNIER SYSTEM GmbH Apparatus for the disintegration of concretions in living bodies
US4570634A (en) * 1982-11-06 1986-02-18 Dornier System Gmbh Shockwave reflector
US4610249A (en) * 1984-05-08 1986-09-09 The Johns Hopkins University Means and method for the noninvasive fragmentation of body concretions
EP0196353A2 (en) * 1985-04-04 1986-10-08 DORNIER SYSTEM GmbH Device for the avoidance or reduction of pain in extracorporal lithotripsy
US4620545A (en) * 1984-10-31 1986-11-04 Trutek Research, Inc. Non-invasive destruction of kidney stones

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DE3220751A1 (en) * 1982-06-02 1983-12-08 Jörg Dr. 8022 Grünwald Schüller Device for crushing concrements, especially renal calculi, in living human or animal bodies
DE3316837C2 (en) * 1983-05-07 1986-06-26 Dornier System Gmbh, 7990 Friedrichshafen Device for generating shock waves by means of a spark gap for the contact-free crushing of concrements in the bodies of living beings
US4595019A (en) * 1984-05-04 1986-06-17 Shene William R Stone disintegrator
DE3417985C2 (en) * 1984-05-15 1986-03-27 Dornier System Gmbh, 7990 Friedrichshafen Device for the contact-free comminution of concretions
DE3444421A1 (en) * 1984-12-04 1986-06-05 Dornier System Gmbh, 7990 Friedrichshafen Device for coupling a treatment apparatus to the human body, especially for the contactless destruction of concrements in the human body
JPS62337A (en) * 1985-06-26 1987-01-06 八千代田工業株式会社 High voltage generator by submerged shock wave
DE3532678A1 (en) * 1985-09-13 1987-03-26 Wolf Gmbh Richard DEVICE FOR LOCATING AND CRUSHING CONCRETE IN BODY CAVES
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Publication number Priority date Publication date Assignee Title
EP0090138A2 (en) * 1982-03-25 1983-10-05 DORNIER SYSTEM GmbH Apparatus for the disintegration of concretions in living bodies
US4570634A (en) * 1982-11-06 1986-02-18 Dornier System Gmbh Shockwave reflector
US4610249A (en) * 1984-05-08 1986-09-09 The Johns Hopkins University Means and method for the noninvasive fragmentation of body concretions
US4620545A (en) * 1984-10-31 1986-11-04 Trutek Research, Inc. Non-invasive destruction of kidney stones
EP0196353A2 (en) * 1985-04-04 1986-10-08 DORNIER SYSTEM GmbH Device for the avoidance or reduction of pain in extracorporal lithotripsy

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109715079A (en) * 2016-07-21 2019-05-03 索里顿有限责任公司 The electro-hydraulic shock wave generator equipment of fast-pulse with improved electrode life
JP2019523057A (en) * 2016-07-21 2019-08-22 ソリトン， インコーポレイテッド Rapid pulse electrohydraulic (EC) shock wave generator with improved electrode life
CN109715079B (en) * 2016-07-21 2023-12-12 索里顿有限责任公司 Fast pulsed electrohydraulic shock wave generator device with improved electrode life

Also Published As

Publication number Publication date
DE3736360A1 (en) 1988-05-05
GB8725273D0 (en) 1987-12-02
DE3736360C2 (en) 1997-02-13
GB2199249B (en) 1991-06-12
FR2605874B1 (en) 1995-03-17
FR2605874A1 (en) 1988-05-06
CS778986A1 (en) 1988-07-15
CS261485B1 (en) 1989-02-10

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PCNP Patent ceased through non-payment of renewal fee

Effective date: 19931028