RU2155542C2 - Underwater arrester unit for crushing of concrements - Google Patents

Abstract

FIELD: medical equipment for remote shock-wave lithotripsy, holelithotripsy. SUBSTANCE: the underwater destruction unit has an arrester body with high- and low- potential current conductors and electrode holders with rod electrodes and a device for monitoring and adjusting the interelectrode gap in the form of at least one TV camera. Each low-potential and high-potential section of the current conductors adjoining the electric motors has a current conductor holder movable relative to the body. The electrode holders are secured for adjusting movement of each electrode holder in the direction, and vice versa, of the interelectrode gap. EFFECT: provision of continuous contactless monitoring of the state of electrodes of the underwater arrester and their adjustment without replacement of the arrester when conducting the lithotripsy procedure. 8 cl, 4 dwg

Description

 The invention relates to medical equipment, in particular to lithotripter technology.

 A well-known block of an underwater arrester, including a housing of a spark gap with low potential and high potential current leads with pin electrodes forming an interelectrode gap axial relative to the housing of the spark gap (US 5094220 A6, 03/10/1992).

 During the lithotripsy procedure and the development of the electrode life, the arrester is removed from the reflector, the electrodes are replaced, and then the arrester is reinstalled in the reflector.

 The position of the interelectrode gap relative to the discharge focus of the ellipsoid reflector is established only by landing.

 The disadvantage of the underwater arrester unit is the inability to adjust the gap during the procedure, as well as the inaccuracy in determining the production of electrodes, which is determined only by the sound of the discharge.

 Closer in technical essence and the achieved result to the proposed invention is an underwater arrester unit, including an arrester housing with low potential and high potential current leads and electrode holders with pin electrodes, devices for monitoring and adjusting the electrode gap (EP 0457037 A1, 11.21.1991).

 In this block of the underwater arrester, it is possible to adjust the gap during the procedure by moving the electrodes with the electrode holders towards each other, since the low-potential and high-potential current conductors are located coaxially from different sides of the ellipsoid reflector.

 The disadvantage of the underwater arrester unit is that the gap setting is monitored before the procedure, and the gap adjustment during the procedure is carried out visually (by the absence of discharge sound during electrode production).

 In addition, the design of the oppositely installed linear current leads, holders and parts of the arrester housing from the different sides of the reflector leads, on the one hand, to significant distortions when the wave is reflected from the walls of the reflector, to a decrease in the real focusing efficiency, and, on the other hand, to a significant increase in the discharge inductance contour (i.e., an increase in the duration of the shock wave impulse and, accordingly, to a decrease in the quality of crushing and an increase in the likelihood of injury to the patient’s tissues). In addition, there is the possibility of an inaccurate setting of the gap relative to the focus due to uneven erosion of the positive and negative electrodes.

 The essence of the present invention is to make the electrode holders movable with the possibility of adjusting the interelectrode gap remotely under the supervision of TV cameras. As a result of this solution, a technical result is achieved in the form of the possibility of continuous non-contact monitoring of the state of the electrodes of the underwater spark gap and their adjustment without replacing the spark gap during lithotripsy.

In FIG. 1 shows a general view of an underwater arrester unit;
in FIG. 2 - underwater arrester with hinged current holders;
in FIG. 3 - underwater arrester with movable current holders in the grooves of the housing;
in FIG. 4 - underwater arrester with pin electrodes and eccentrics.

 The block (see Fig. 1) of the underwater arrester for crushing calculi consists of directly the underwater arrester 1, on the cylindrical body 2 of which are fixed electrode holders 3 and 4 with pin electrodes 5 and 6, devices 7 for adjusting the interelectrode gap (MEZ) 8 and devices 9 for monitoring the MEZ 8 in the form of TV cameras 10, 11 with a power supply (not shown) and a monitor 12.

 In the housing 2 of the arrester 1 (see Fig. 2), the low-potential 13 and high-potential 14 current leads are located coaxially in the back of the arrester 1, and the low-potential and high-potential moving parts 15 and 16 of the current leads 13 and 14 adjacent to the electrode holders are linearly located in the head part arrester 1. Current-carrying devices 17 and 18 of parts 15 and 16 are pivotally mounted on axes 19 and 20 in the housing 2 with the possibility of installation movement of the upper parts 15, 16 in the direction of the MEZ 8 (and from it).

 The pin electrodes 5, 6 have the possibility of additional installation movement in the clamping elements 60, 61 (see Fig. 3, 4). This is necessary for the initial installation of the MEZ 8 with a maximum divergence of the electrode holders 3, 4 from each other.

 The pusher 21 is attached to the current holder 17, and the pusher 22 is connected to the current holder 18.

 On the lower parts of the pushers 21 and 22, forks 23 and 24 are made, which respectively go into the annular grooves 25 and 26 of the carrier 27 and 28.

 In one of the variants (see Fig. 3) of the arrester 1 in its housing 2, guide grooves 29 and 30 are made perpendicular to the axis 31 of the housing 2.

 In the grooves 29 and 30 on opposite sides relative to the axis 31, the current holders 17 and 18 are placed with the possibility of their installation movement along the grooves 29 and 30 towards (or vice versa) each other. The movable parts 15, 16 of the current leads 13 and 14 pass through the current holders 17 and 18, in which the recesses 32 and 33 are made for the upper parts 34, 35 of the pushers 21 and 22 to enter, and the latter are also pivotally fixed by means of the axes 36 and 37 in the housing 2.

 In another embodiment (see Fig. 4), the pushers 21, 22 are made in the form of pin elements 38, 39 with eccentrics 40, 41 at their ends 42, 43 with the possibility of rotation of the pin elements 38, 39 around their axes 44, 45 and, respectively the interaction of the eccentrics 40, 41 with the current holders 17, 18. The opposite end parts of the pin elements 38 and 39 relative to the eccentrics 40 and 41 can be made with a screw thread 46, 47 interacting with a worm wheel (not shown) or can be articulated with a rotary lever 48, 49 .

 In the operational position (see Fig. 1), the underwater arrester 1 is located in the reflector 50 with an elastic cushion 51 for holding liquid in the reflector 50 and matching the transition between the liquid-patient transition (not shown).

 The spark gap 1 is connected to a pulse voltage generator (GIN) 52, and the device 7 for adjusting the MEZ 8 can be connected via a kinematic (or electric) transmission 53 to the block 54 for turning on the device 7.

 In the position of the lateral input of the spark gap (shown in Fig. 1), the plane of the pin electrodes 5 and 6 can be parallel to the pupil of the TV camera 10, located in the bottom 55 of the reflector 50.

 In this case, two images are displayed on the monitor screen 12: one image 56 from the TV camera 10, and another image 57 from the TV camera 11 located on the side of the reflector 50 along the axis 31 of the arrester 1.

 When the spark gap 1 is positioned vertically by the plane of the pin electrodes 5 and 6 (along the major axis of the reflector 50), the TV cameras 10 and 11 are located on the sides of the reflector 50 perpendicular to each other (one on the axis of the spark gap 1, the other perpendicular to this axis).

 When the arrester 1 is inserted from the bottom 55 of the reflector 50, the TV cameras 10 and 11 are also located on the sides of the reflector 50 perpendicular to each other.

 The operation of the arrester unit 1 is as follows.

 Before starting the crushing procedures by means of a pin template (not shown), an image 56 of the border (usually 0.8-1.0 mm in diameter) is displayed on the monitor 12 of the TV cameras 10, 11. The MEZ 8 by means of a movable cross 58 of the sight is installed on the monitor 12.

 When using two TV cameras 10, 11, two images 56 and 57 are displayed on the monitor 12 and two crosses 58 of the sight are used.

 The spark gap 1 is directly installed in the GIN 52 and, together with the latter along the guides (not shown), moves into the reflector 50.

 When an elastic “cushion” 51 is installed on the reflector 50, water 59 is poured into the cavity of the reflector 50 and the image 56 (or 57) of the MEZ 8 of the electrodes 5, 6 is aligned with the center of the cross 58 of the sight.

 Since the magnification of image 56 (57) is 10 to 30 times relative to the real (0.8 - 1.2 mm) MEZ of 8 electrodes, the process of combining the center of MEZ 8 with the center of crosses 58 of the sight takes 1 to 2 minutes.

 After combining the center of the MEZ 8 with the cross 58 of the sight, the desired MEZ 8 lithotripsy procedure is established (depending on the size, type and location of the calculus, this size varies from 0.4 to 1.2 mm).

 Then, after combining the image of the calculus with the therapeutic focus (not shown) of the reflector 50, the crushing process is carried out and the magnitude of the MEZ 8 is varied by block 54 depending on the generation of electrodes 5, 6, as well as on the necessary characteristics of the shock wave pulse in the therapeutic focus, since these the characteristics depend not only on the choice of capacitance and voltage at the GIN, but also on the magnitude of the MEZ 8.

 Monitoring of the MEZ 8 is carried out on the monitor 12 continuously or periodically (after 100 - 300 pulses).

 In case of failure of the electrodes 5, 6 ("fluffing" or breaking off of the tips of the electrodes 5, 6), the pulses are stopped and the spark gap 1 is changed to a new one, controlling its installation on monitor 12.

 During the production of lithotripsy under tele-observation of the position and condition of the electrodes 5, 6, not only the quality of crushing is improved, but the likelihood of tissue injury due to improper installation of the electrodes 5, 6 or their operation with the "fluffy" tips of the electrodes 5, 6 is also significantly reduced.

 When this unit of the spark gap 1 is operating, there is no need to use a gateway (not shown) of the reflector 50, since remote adjustment of the gap 8 without replacing the spark gap 1 is carried out for 5-6 thousand pulses, which is respectively sufficient for 2 to 3 crushing sessions.

 Replacement of the electrodes 5, 6 in the electrode holders 3, 4 is carried out within 3-5 minutes without a patient, and the absence of the need to replace the arrester 1 "under the patient" speeds up the process of conducting a lithotripsy session.

Claims (8)

 1. Block underwater arrester for crushing stones, including the housing of the arrester with low potential and high potential current leads and electrode holders with pin electrodes, devices for monitoring and adjusting the interelectrode gap, characterized in that each of the low potential and high potential parts of the current conductors adjacent to the electrode holders is equipped with movable current lead parts moreover, the electrode holders on the current leads are fixed with the possibility of installation movement azhdogo of the electrode arms in a direction (and vice versa) of the interelectrode gap, the device for control of the interelectrode gap is in the form of at least one TV-camera.  2. The underwater arrester unit according to claim 1, characterized in that the pin electrodes in the electrode holders are fixed with the possibility of additional installation movement in the direction of the interelectrode gap.  3. The underwater arrester unit according to claim 1, characterized in that the current holders are pivotally mounted in the arrester housing, and the clearance adjustment device is made in the form of pushers, the latter being kinematically connected to the current holders, and the kinematic coupling unit is offset relative to the hinge axes of the current holders.  4. The underwater arrester unit according to claim 1, characterized in that the guiding grooves are made in the arrester housing perpendicular to its axis with the possibility of installation movement of current holders along them.  5. The underwater arrester unit according to claim 1, characterized in that the pushers are made in the form of pin elements with an eccentric at one of its ends.  6. The underwater arrester unit according to claims 1 and 4, characterized in that each of the pushers adjacent to the current holder is pivotally mounted in the housing by axes, and recesses are made in the current holders for the upper parts of the respective pushers to enter.  7. The underwater arrester unit according to claims 1 and 5, characterized in that the end part of each of the pin elements of the pushers, which is opposite with respect to the current holders, has a screw thread.  8. The underwater arrester unit according to claims 1, 4 and 6, characterized in that forks are made on the lower parts of the pushers.

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