EP0133665A2 - Appareils pour détruire les calculs à distance - Google Patents

Appareils pour détruire les calculs à distance Download PDF

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Publication number
EP0133665A2
EP0133665A2 EP84108750A EP84108750A EP0133665A2 EP 0133665 A2 EP0133665 A2 EP 0133665A2 EP 84108750 A EP84108750 A EP 84108750A EP 84108750 A EP84108750 A EP 84108750A EP 0133665 A2 EP0133665 A2 EP 0133665A2
Authority
EP
European Patent Office
Prior art keywords
shock wave
wave tube
converging lens
tube
lens
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
EP84108750A
Other languages
German (de)
English (en)
Other versions
EP0133665A3 (en
EP0133665B1 (fr
Inventor
Karlheinz Dr. Pauli
Helmut Dr. Reichenberger
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
Siemens Corp
Original Assignee
Siemens AG
Siemens Corp
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, Siemens Corp filed Critical Siemens AG
Publication of EP0133665A2 publication Critical patent/EP0133665A2/fr
Publication of EP0133665A3 publication Critical patent/EP0133665A3/de
Application granted granted Critical
Publication of EP0133665B1 publication Critical patent/EP0133665B1/fr
Expired legal-status Critical Current

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Classifications

    • 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
    • G10K9/00—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers
    • G10K9/12—Devices in which sound is produced by vibrating a diaphragm or analogous element, e.g. fog horns, vehicle hooters or buzzers electrically operated
    • 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
    • G10K11/30—Sound-focusing or directing, e.g. scanning using refraction, e.g. acoustic lenses

Definitions

  • the invention relates to a device for the contactless smashing of a concrement located in the body of a living being with a shock wave generator which can be aligned with a target area in the body.
  • Devices of this type are used in medicine, e.g. to destroy stones in the kidney of humans. They are particularly beneficial because they avoid any intervention in the body. It is not necessary to operate surgically. There is also no need to bring probes and devices to the concrement. A risk from infection or injury, e.g. when inserting the probe or operations, can not occur in contactless smashing.
  • a device of the type mentioned is described in DE-AS 23 51 247.
  • a spark discharge is brought about between two electrodes in a first focal point.
  • This causes a shock wave, the wavefront of which extends in all directions, ie spherically.
  • the waves are reflected on the wall of the ellipsoid of revolution. They collect in the second focal point of the ellipsoid of revolution.
  • the reflected waves arrive at the same time.
  • the concrement is destroyed under the collision of the shock waves.
  • the coupling between the one half of the ellipsoid and the body in which the concretion is done via a thin film, which lies against the body without an air gap.
  • the focus chamber is filled with water.
  • This device has the disadvantage that changes in the shock wave energy are possible only within small limits and only with considerable expenditure on equipment by changing the distance between the underwater electrodes.
  • a further disadvantage is that the mutual distance between the electrodes for generating high-intensity shock waves generally has to be a few millimeters, as a result of which the shock wave source has no punctiform geometry and imaging errors can occur during focusing.
  • the underwater electrodes wear heavily with each discharge, so that their life is limited, which necessitates regular maintenance of the facilities.
  • the device according to DE-AS 23 51 247 also brings with it the fact that the patient's body is separated from the high-voltage spark gap only by the coupling film which is in contact with the body and by the water in the device. Damage to the coupling foil carries a certain risk for the patient.
  • DE-OS 29 02 331 describes a device for transcutaneous, bloodless obliteration of small reticular and spider vein varices.
  • controllable ultrasound elements are used as the wave generator, which are arranged parabolically so that their sound energies meet at a focal point in which the varice to be destroyed is placed.
  • the entire arrangement of the ultrasonic elements is longitudinally displaceable by means of a worm drive and an adjusting screw. This allows different distances of the focal point from the applicator end to be set.
  • the power of the ultrasound crystals is not sufficient to crush stones in the deep interior of a human body.
  • the exact setting of the individual ultrasonic vibrators with regard to both the location and the energy is therefore not critical. Switching off individual ultrasonic crystals for the purpose of adjusting the ultrasonic energy in the focal point is not provided.
  • DE-OS 31 19 295 describes a device for destroying concrements in body cavities with the aid of a large-area ultrasound transducer as a vibration generator. It is coming. a focusing ultrasonic transducer with a pulse peak power of at least 100 kW for use. Here it is possible to hide different zones of the body, which lie on the sound path to the concrement and interfere with it, by changing the radiation area.
  • An embodiment is also shown in which individual ring-shaped ultrasound elements, which form the transducer, on a spherical surface are arranged. None is said about a change in performance according to the type and depth of the concretion. In addition, the effort for such a device, particularly with regard to the formation of the ring-shaped ultrasonic elements, should be considerable.
  • shock wave tube As used in principle in the present invention, the structure of a so-called "shock wave tube", as used in principle in the present invention, is described.
  • a copper membrane is located in front of a flat coil, separated by an insulating film.
  • a tube filled with water connects to this copper membrane.
  • a voltage in the range of 2 - 20 kV to the flat coil, a magnetic field is induced in the copper membrane, which causes repulsive forces that suddenly push the membrane away from the coil.
  • Such a shock wave tube is used e.g. for substance studies in chemistry.
  • the object of the present invention is to ensure reliable operation of a device of the type mentioned in the introduction increase, to get an image of a target area with the smallest possible imaging error and to reduce maintenance work.
  • this object is achieved in that a shock wave tube known per se, which essentially produces a plane shock wave, is provided as shock wave generator, and in that the shock wave tube is assigned a lens arrangement which focuses the shock wave on a focal point in the target area.
  • this device uses a shock wave generator that generates plane waves, the shock waves coming from only one direction have to be bundled and focused.
  • imaging errors are less likely than if spherical waves proceeding from a spark gap and traveling in all directions have to be focused.
  • the temporal and spatial reproducibility of the shock wave is significantly improved when generated with a shock wave tube compared to the generation with a spark gap.
  • there is no maintenance work due to wear and tear of the electrodes of a spark gap. Because a shock wave tube generates the shock waves with the help of electromagnetic forces and does not require a spark gap.
  • a shock wave tube is constructed so that it contains a copper membrane at one end of a tube filled with liquid, preferably water, which is separated by an insulating film and arranged in front of a flat coil. Due to a current pulse in the flat coil, the copper membrane is repelled by it and thereby generates the shock wave in the liquid.
  • the copper membrane itself and the pipe section connected to it are usually based on a common reference potential, ie they are grounded. There is therefore no high voltage at the coupling medium conducting the shock wave, which increases the electrical safety of patient and staff.
  • a shock wave tube 1 known per se, consisting of a jacket 2, a flat coil 3 with two electrical connections 5 and 7, an insulating film 9, a copper membrane 11 and a metallic tube piece 13, in front of an acoustic converging lens 15 , which has a focal point F placed.
  • the pipe section 13 is filled with a liquid 14, e.g. B. filled with water.
  • the shock wave tube 1 is coupled to a body 19 via a coupling medium 17 with water-like acoustic properties.
  • the body 19 e.g. a patient has a concrement 23 in his kidney 21 e.g. a kidney stone.
  • the converging lens 15 can be displaced relative to the jacket 2 of the shock wave tube 1 via a fine adjustment 24 with a bolt 24a and a locking wheel 24b in the direction of a double arrow 25.
  • the bolt 24a is guided in a slot-shaped recess 24c in the casing 2.
  • the shock wave tube 1, the converging lens 15 and the fine adjustment 24 are mounted on a common frame, tripod or a mounting plate 26.
  • This mounting plate is mounted on a bearing 26a which can be pivoted on all sides and is displaceable in all spatial directions. As a result, the shock wave tube 1 can be aligned with the concretion 23 such that the focal point F lies in the concretion 23.
  • the copper membrane 11 and the pipe section 13 are electrically connected to a protective potential such as earth 27, as is the connection 7 of the flat coil 3.
  • the other connection 5 of the flat coil 3 is via a switch 29, which comprises an auxiliary contact 31, in a supply and control unit 33 out.
  • a high voltage U is generated in the supply and control unit 33 via a capacitor / resistance circuit (not shown). This can be several kilovolts, for example 20 kV. The voltage U can be adjustable.
  • a control signal which is supplied by the supply and control unit 33 via a control line 35 to the auxiliary contact 31, causes the switch 29 to close.
  • a part of the energy stored in the capacitor (not shown) of the supply and control unit 33 is discharged abruptly into the flat coil 3, which builds up a magnetic field very quickly.
  • a current is induced in the copper membrane 11, which is opposite to the current in the flat coil and generates an opposing magnetic field.
  • the copper membrane 11 is knocked away from the flat coil 3 by the force of the opposing field.
  • This knocking away of the copper membrane 11 creates a flat shock wave, ie an abrupt compression in the liquid 14 upstream of the membrane 22.
  • This shock wave shows a steep pressure increase, for example 200 bar.
  • the pressure wave gains steepness in its course through the pipe section 13, the converging lens 15 and the patient's body 19.
  • the shock wave After passing through the converging lens 15, the shock wave is shaped to converge at the focal point F.
  • the concrement 23 is placed there, and the focused shock wave releases part of its energy content to the concrement 23, which is brittle compared to the environment, by means of tensile or compressive forces. These forces break up the concrement 23 into several parts and thus cause it to be broken up.
  • This explained smashing device offers the considerable advantage that the grounded copper membrane 11 and the grounded pipe section 13 do not represent a source of danger for the patient 19 or the operating personnel.
  • the electrical safety of the device can be improved for the operating personnel by an additional insulating sheath (not shown), e.g. in the form of a plastic coating on the outer surface of the jacket 2, can be increased.
  • an additional insulating sheath e.g. in the form of a plastic coating on the outer surface of the jacket 2
  • the patient 19 has double security against the high electrical voltage. This security is determined on the one hand by the insulating bag wall and on the other hand by the insulating film 9 in front of the flat coil 3.
  • the switch 29 can also be integrated in the supply and control unit 33. It can also be located away from the shock tube assembly. Since a spark gap does not necessarily have to be used for triggering, for example vacuum or more recently SF6 switches in question, there is no need for complex maintenance and operating work that would be associated with the spark gap.
  • FIG. 2 shows a shock wave tube 1 known per se, to which a system 40 acoustic lenses for imaging a flat shock wave onto a concrement 23 in the body of a patient 19 is assigned.
  • the system 40 acoustic lenses consists of a diverging lens 42, a capacitor 44 and a converging lens 46 with a focal point F.
  • the preferred material for the system 40 of the acoustic lenses is acrylic glass or polystyrene.
  • the plane shock wave generated in the shock wave tube 1 is widened in its cross section by the diverging lens 42.
  • the shock wave is directed in parallel by the capacitor 44 and focused on the focal point F by the converging lens 46.
  • the configurations of the shock wave tube 1 and the holding device described for FIG. 1 also apply to this embodiment of the imaging system.
  • the entire system 40 of acoustic lenses can be displaced relative to the shock wave tube 1 in the axial direction of the double arrow 25.
  • the advantage of this embodiment is that the shock wave enters the patient's body 19 over a larger cross-section of the body surface. This makes it possible to keep the energy density in the patient's tissue low, in particular on the body surface 48.

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  • Physics & Mathematics (AREA)
  • Engineering & Computer Science (AREA)
  • Acoustics & Sound (AREA)
  • Multimedia (AREA)
  • Surgical Instruments (AREA)
EP84108750A 1983-08-03 1984-07-24 Appareils pour détruire les calculs à distance Expired EP0133665B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE3328051 1983-08-03
DE19833328051 DE3328051A1 (de) 1983-08-03 1983-08-03 Einrichtung zum beruehrungslosen zertruemmern von konkrementen

Publications (3)

Publication Number Publication Date
EP0133665A2 true EP0133665A2 (fr) 1985-03-06
EP0133665A3 EP0133665A3 (en) 1985-04-03
EP0133665B1 EP0133665B1 (fr) 1988-06-22

Family

ID=6205689

Family Applications (1)

Application Number Title Priority Date Filing Date
EP84108750A Expired EP0133665B1 (fr) 1983-08-03 1984-07-24 Appareils pour détruire les calculs à distance

Country Status (3)

Country Link
US (1) US4674505A (fr)
EP (1) EP0133665B1 (fr)
DE (2) DE3328051A1 (fr)

Cited By (19)

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DE3545381A1 (de) * 1985-12-20 1987-06-25 Siemens Ag Ultraschallwandler zur messung der schalleistung eines fokussierten ultraschallfeldes
EP0229981A1 (fr) * 1985-12-20 1987-07-29 Siemens Aktiengesellschaft Procédé pour contrôler les caractéristiques du foyer d'un champ ultrasonique et dispositif de sa mise en oeuvre
JPS62155819U (fr) * 1986-03-25 1987-10-03
EP0240797A1 (fr) * 1986-04-01 1987-10-14 Siemens Aktiengesellschaft Générateur d'ondes de choc à rendement amélioré
EP0243650A1 (fr) * 1986-04-01 1987-11-04 Siemens Aktiengesellschaft Générateur d'ondes de choc à focalisation améliorée
EP0253053A1 (fr) * 1986-07-14 1988-01-20 Siemens Aktiengesellschaft Générateur d'ondes de choc pour un dispositif de désintégration à distance des concrétions dans un organisme vivant
EP0254104A1 (fr) * 1986-07-16 1988-01-27 Siemens Aktiengesellschaft Générateur d'ondes de choc pour la production d'une onde de choc acoustique impulsionnelle
EP0256438A1 (fr) * 1986-08-18 1988-02-24 Siemens Aktiengesellschaft Détecteur pour enregistrer les impulsions d'ondes de choc
EP0258561A1 (fr) * 1986-07-08 1988-03-09 Siemens Aktiengesellschaft Générateur d'ondes de choc, utilisé en particulier pour la lithotripsie
EP0263349A1 (fr) * 1986-10-06 1988-04-13 Siemens Aktiengesellschaft Générateur d'ondes de choc
AU572027B2 (en) * 1985-06-26 1988-04-28 Yachiyoda Kogyo Co. Ltd. Apparatus for disintegrating calculus by underwater shock wave from outside human body
EP0266538A1 (fr) * 1986-10-06 1988-05-11 Siemens Aktiengesellschaft Générateur d'ondes de choc
EP0275460A1 (fr) * 1986-12-22 1988-07-27 Siemens Aktiengesellschaft Tête émettrice d'ondes de choc pour la fragmentation à distance de concrétions
EP0328943A1 (fr) * 1988-02-16 1989-08-23 Siemens Aktiengesellschaft Générateur d'ondes de choc pour la désintégration à distance des concrétions
EP0441997A1 (fr) * 1990-02-12 1991-08-21 Siemens Aktiengesellschaft Applicateur médical ultrasonore pour utilisation dans un milieu de propagation acoustique transmettant des ondes de choc
US5056069A (en) * 1989-02-10 1991-10-08 Siemens Aktiengesellschaft Ultrasonic sensor
EP0461287A1 (fr) * 1990-06-13 1991-12-18 Siemens Aktiengesellschaft Générateur d'ondes de choc entraîné électriquement
EP0486815A1 (fr) * 1990-11-22 1992-05-27 Dornier Medizintechnik Gmbh Dispositif de focalisation acoustique
DE19723499C1 (de) * 1997-06-05 1998-08-13 Dornier Medizintechnik Stoßwellenquelle nach dem elektromagnetischen Prinzip

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DE3328051A1 (de) 1985-02-14
EP0133665A3 (en) 1985-04-03
EP0133665B1 (fr) 1988-06-22
DE3472209D1 (en) 1988-07-28
US4674505A (en) 1987-06-23

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