JPH0560751B2 - - Google Patents

Description

[Detailed description of the invention] [Industrial application field]

This invention involves generating acoustic (vibration) energy such as shock waves and ultrasonic waves outside the body, and concentrating it on the stone as energy for crushing the stone formed in the body, thereby crushing the stone. Regarding equipment.

[Conventional technology]

In order to crush a calculus in a living body using a lithotripter, it is necessary to effectively focus crushing energy on the calculus. To this end, we use a stone detection device such as an ultrasound diagnostic device to accurately locate the stone.
The crushing energy is focused on that position. In order to perform this positioning accurately, conventionally,
The treatment bed, a crushing energy generator such as an ultrasonic pulse generator, and a stone detection device are integrally formed. This is because it is possible to accurately and easily detect the calculus position and position the focal point to that position using the bed as a reference. Furthermore, a configuration is known in which only the crushing energy generating device can be separated from the treatment bed and the calculus detecting device integrated therewith.

[Problem to be solved by the invention]

However, when the crushing energy generator and the calculus detector are integrated into a bed as in the past, there is a problem in that the bed cannot be used independently as an operating table. Additionally, if only the crushing energy generator could be separated from the bed, the bed could be used as an operating table.
Another problem arises in that the position of the fracturing energy generator relative to the bed becomes ambiguous, making it difficult to precisely match the focal point of the fracturing energy to the stone location. An object of the present invention is to provide a stone crushing device that allows a bed for performing stone crushing treatment to be used as an operating table, and also allows the focus of crushing energy to be easily aligned with the stone position.

[Means to solve the problem]

In order to achieve the above object, the stone crushing device according to the present invention includes a treatment bed having a notch that can be opened and closed as desired, and a crushing energy generating device that is large enough to fit into the notch when it is opened. A stone detection device is provided integrally with the crushing energy generating device, and a moving device movably holds the crushing energy generating device and the stone detecting device integrated with the crushing energy generating device. It is becoming.

[Effect]

A bed for lithotripsy treatment has a notch that can be opened and closed as desired, and when this is closed, it becomes a normal bed without a notch, so it can be used as a surgical table. When the cutout is opened, a cutout large enough to accommodate the crushing energy generator is formed. The crushing energy generating device has a calculus detection device integrally therein, and is movably held by a moving device. Therefore, the notch can be opened and the crushing energy generator can be inserted into the notch. In this state, the patient is made to lie down on the bed and lithotripsy treatment is performed. At this time, the crushing energy generating device is movable relative to the bed, and its position relative to the bed cannot be determined accurately, but since it has an integrated device to detect the stone of the patient on the bed, it generates crushing energy. It is possible to have a precise knowledge of the location of the stone relative to the device, based on which the fragmentation energy can be focused precisely on the location of the stone.

【Example】

Next, an embodiment of the present invention will be described with reference to the drawings. In FIG. 1, a treatment bed 1 is provided with a notch 2. As shown in FIG. This notch 2 is provided at a position corresponding to the abdomen of a patient when lying on this bed 1. A shock wave generator 3 is inserted into this notch 2. The shock wave generator 3 integrally includes an ultrasonic tomographic probe 4 held by a link mechanism 41, and is mounted on a movable table 5. When the moving table 5 is moved to move the shock wave generator 3 away from the bed 1, a notch 2 remains, but this notch 2 can be closed by fitting a bed top plate (not shown). When closed in this way, it becomes a normal therapeutic bed. Therefore, in this state, it can be used as an operating table. As shown in FIG. 1, the shock wave generator 3 is inserted into the open cutout 2 to perform stone crushing treatment. At this time, the shock wave generator 3 is positioned under the abdomen of the patient lying on the bed 1. This shock wave generator 3 is held by a moving table, and as shown in FIG. 2, this moving table 5 has a moving mechanism 51 with wheels and is movable by itself.
In addition, the movable table 5 can move the shock wave generator 3 up and down, as well as move it freely in a horizontal plane (see the two-dot chain line in Fig. 2), and furthermore, the movable table 5 can move the shock wave generator 3 up and down. It can be rotated arbitrarily using the central axis. Therefore,
The shock wave generator 3 can be moved arbitrarily and set at the most appropriate position and direction for the patient. The ultrasonic tomographic probe 4, which is integrally attached to the shock wave generator 3 via a link mechanism 41, is used to obtain a tomographic image of the patient's body, and is designed to inject an ultrasonic beam into the body and to emit a reflected ultrasonic beam. Receive waves. This received echo signal is sent to the main body of the non-sushi ultrasound diagnostic apparatus, and an ultrasound tomographic image is displayed. Since the link mechanism 41 is provided with angle encoders 42 at various locations, information regarding the position of the probe 4 can be obtained, so that it is possible to know where an ultrasound tomographic image has been obtained. Therefore,
If a stone image is found in the ultrasonic tomographic image, the position of the stone relative to the shock wave generator 3 is known, and accordingly the shock wave generator 3 is moved to the position closest to the stone, and the shock wave generator 3 is moved to the position above the shock wave generator 3. The water bag 31 provided in the patient's body can be brought into close contact with the patient's body. Then, the focal position of the shock wave generated from the shock wave generator 3 is electronically controlled to finely adjust the focal position so that the focal point of the shock wave accurately matches the calculus position captured on the ultrasonic tomographic image. In this case, the focus position is adjusted using the shock wave generator 3 and the ultrasonic tomography probe 4 which is mechanically integrated with the shock wave generator 3 and whose position relative to the shock wave generator 3 can be accurately determined, making it easy to perform highly accurate positioning. It can be carried out. When such adjustment of the focal position is completed, if the shock wave generator 3 is driven and the shock waves are made to enter the patient's body from below to above through the water bag 31, the shock waves will be accurately focused on the stone. Become. NAO, in this example ultrasonic tomographic probe 4
is held by a link mechanism 41 outside the shock wave generator 3, but it goes without saying that it can also be incorporated inside the shock wave generator 3.
In this case, the ultrasonic beam transmitted and received from the ultrasonic tomographic probe 4 is transmitted to or received by the patient from below to above, similar to shock waves. Furthermore, although a shock wave generator is used as the stone crushing energy generator in the above description, it is possible to use an ultrasonic pulse generator or other acoustic (vibration) energy generator. Furthermore, stone detection devices other than ultrasonic diagnostic devices can also be used.

Effects of the Invention According to the stone crushing device of the present invention, since the stone crushing energy generating device can be separated from the treatment bed, this bed can be used as a surgical table. Moreover, even if the crushing energy generating device can be separated from the bed in this way, the accurate positioning of the crushing energy focus on the stone can be easily performed.

[Brief explanation of the drawing]

FIG. 1 is a perspective view of one embodiment of the present invention, and FIG. 2 is a front view showing only the shock wave generator, ultrasonic tomography probe, and moving table shown in FIG. 1. DESCRIPTION OF SYMBOLS 1... Treatment bed, 2... Notch, 3... Shock wave generator, 31... Water bag, 4... Ultrasonic tomographic probe, 41... Link mechanism, 42... Angle encoder, 5... Movement Table, 51...Movement mechanism.

Claims (1)

[Claims] 1. A treatment bed having a notch that can be opened and closed at will, a crushing energy generator large enough to fit into the open notch, and a stone integrally provided with the crushing energy generator. A stone crushing device comprising: a detection device; and a moving device that movably holds the crushing energy generating device and a stone detection device integrated therewith.