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EP4267021A1 - Dispositif de lithotripsie, système de lithotripsie et procédé de fonctionnement d'un dispositif de lithotripsie - Google Patents

Dispositif de lithotripsie, système de lithotripsie et procédé de fonctionnement d'un dispositif de lithotripsie

Info

Publication number
EP4267021A1
EP4267021A1 EP21843914.9A EP21843914A EP4267021A1 EP 4267021 A1 EP4267021 A1 EP 4267021A1 EP 21843914 A EP21843914 A EP 21843914A EP 4267021 A1 EP4267021 A1 EP 4267021A1
Authority
EP
European Patent Office
Prior art keywords
probe
lithotripsy
force
deflection
converter unit
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.)
Pending
Application number
EP21843914.9A
Other languages
German (de)
English (en)
Inventor
Marius Funder
Bernhard Glöggler
Thomas Hinding
Florian Huber
Beat Krattiger
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.)
Karl Storz SE and Co KG
Original Assignee
Karl Storz SE and Co KG
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 Karl Storz SE and Co KG filed Critical Karl Storz SE and Co KG
Publication of EP4267021A1 publication Critical patent/EP4267021A1/fr
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005—Effects, e.g. on tissue
    • A61B2017/22011—Combined types of vibration, e.g. ultrasonic and electrohydraulic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320098—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with transverse or torsional motion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2503/00—Evaluating a particular growth phase or type of persons or animals

Definitions

  • the present invention relates to a lithotripsy device according to the preamble of claim 1, in particular a device for intracorporeal lithotripsy by means of ultrasonic vibrations, and a lithotripsy system and a method for operating a lithotripsy device.
  • an ultrasonic transducer is connected to a catheter via a coupling part, a longitudinal movement being converted into a transverse movement by means of a laterally arranged screw or a lateral introduction of the catheter into the coupling part.
  • an ultrasonic therapy device has an ultrasonic vibrator for generating ultrasonic vibrations in the axial direction of the device and in a direction different from the axial direction, with piezoelectric elements of the ultrasonic vibrator having an uneven thickness or pretension .
  • the device described in EP 0421 285 A1 for breaking up concretions in body cavities consists of at least one piezoelectric transducer element between a reflector and a horn, ultrasonic waves being directed to the concretions from the horn by means of a sonotrode.
  • the horn is provided with indentations on its surface that run non-parallel to its axis of symmetry.
  • a device for breaking up a body stone is known from WO 2019/141822 A1, which comprises a probe and a drive unit for deflecting the probe or for introducing a shock pulse into the probe along its length, the drive unit having a first drive device for periodically deflecting the probe and a second drive device for pulse-shaped deflection of the probe.
  • the first drive device acts on the probe via an oscillating part.
  • the second drive device comprises an electromagnet, which accelerates a projectile along a longitudinal axis onto a impact body, which transmits the impact impulse to a collar element of the probe. The periodic and the pulsed deflection can be superimposed.
  • a device for transmitting ultrasonic vibrations comprises a horn, which receives vibrations from an actuator, and an ultrasonic waveguide which is firmly coupled to the horn and on which a stop and two shock pulse masses, each with a circular cross section, are arranged.
  • the shock pulse masses are movably mounted on the ultrasonic waveguide.
  • the devices mentioned are not always satisfactory with regard to the removal or fragmentation effect.
  • the effect of the probe may diminish after some time or come to a virtual standstill, thereby prolonging the operating time, and/or the body stone may escape from the surgical field, requiring the probe to be relocated and realigned, resulting in the operating time can also be extended.
  • some of the devices mentioned have a high level of complexity and are not optimal in terms of cleaning and sterilization.
  • the invention relates to a lithotripsy device, in particular a device for intracorporeal lithotripsy using ultrasonic vibrations.
  • a device according to the invention is designed for destroying calculus within a human or animal body, in particular for breaking up and/or removing a bodily stone by means of a probe introduced to it through a natural or artificial body opening.
  • body stones can be kidney stones, ureter stones, bladder stones, gallstones or salivary stones. By crushing or removing the body stone, it can be broken up in such a way that the resulting fragments can be easily removed from the body, for example by rinsing and suction.
  • the device according to the invention can also be used to remove and/or break up other calculi or solid objects inside or outside a body.
  • the lithotripsy device comprises an elongate probe that can be inserted into an interior of a human or animal body.
  • the probe is designed in such a way that it can be inserted into the interior of the body and brought into contact with the body stone when using the device.
  • the probe is designed to transmit ultrasonic vibrations and is preferably made of a metallic material, for example stainless steel.
  • the probe can be excitable to transmit ultrasonic waves, for example in the form of standing waves.
  • the probe can be rigid, semi-rigid or flexible.
  • the probe is preferably rigid and dimensioned for insertion through the shaft of an endoscope, for example a nephroscope, which can have a corresponding channel for this purpose.
  • the probe can be solid or designed as a hollow probe, with a hollow probe also enabling fragments of a bodily stone processed with the probe to be suctioned off. Such a probe is in particular also referred to as a sonotrode.
  • a drive arrangement is arranged on a proximal portion of the probe, ie one close to the user.
  • the proximal portion may be a proximal end portion of the probe.
  • the proximal section of the probe is in particular a section of the probe which, together with the drive arrangement, remains outside the body or outside the endoscope shaft when the probe is inserted into the interior of the body.
  • the proximal portion of the probe may be, for example, about half the length, or a quarter, or a tenth of the length of the probe, or less, each measured from a proximal end of the probe.
  • the drive arrangement is designed to deflect the probe, in particular to generate deflections of the probe from a resting state in the proximal section of the probe, with the deflections being caused by the probe to a distal, ie remote end of the probe can be transmitted.
  • the drive assembly can be designed as a handpiece that can be held by a user when using the device.
  • the drive arrangement includes an ultrasonic converter unit, which is arranged and designed to excite ultrasonic vibrations of the probe in the direction of a longitudinal extension of the probe.
  • This direction which is usually the direction of a longitudinal axis of the probe, is referred to below as the longitudinal direction; in this case, in the case that the probe is curved or flexible, the longitudinal direction is the direction of the longitudinal extension or the longitudinal axis of the probe in its proximal section.
  • the ultrasonic converter unit is thus designed to excite longitudinal ultrasonic oscillations of the probe and is connected to the probe for this purpose.
  • the ultrasonic converter unit can comprise an ultrasonic transducer for generating ultrasonic vibrations and a coupling device, such as an ultrasonic horn, which is designed for coupling the ultrasonic vibrations generated by the ultrasonic transducer into the proximal section of the probe.
  • the probe is preferably firmly but detachably connected to the ultrasound converter unit; for example, the probe can be screwed into a corresponding hole in the ultrasound horn and a collar can rest against a distal end of the ultrasound horn.
  • the ultrasonic vibrations generated by the ultrasonic transducer and coupled into the probe via the ultrasonic hom can be passed on to a distal end of the probe and thus to a site of action located inside the body.
  • the ultrasonic vibrations introduced into the probe by the ultrasonic converter unit have a frequency above about 15 kHz or above 18 kHz, for example in the range between 20 kHz and 30 kHz, with a longitudinal deflection of the distal end of the probe having a double (peak-to- -peak) can reach an amplitude of, for example, 40 pm and more.
  • the ultrasonic converter unit can also be designed to excite transversal ultrasonic vibrations of the probe.
  • the drive arrangement also comprises a deflection device for deflecting the probe by exerting a force on the probe that varies over time a direction transverse to the length of the probe.
  • the direction perpendicular to the longitudinal extent of the probe ie perpendicular to the longitudinal direction of the probe, is also referred to below as the transverse direction.
  • the force is thus exerted in particular in a direction that lies in a plane perpendicular to a longitudinal axis of the probe, for example in a radial or tangential direction, based on the longitudinal axis of the probe in the proximal section.
  • the force can be variable in terms of magnitude and/or direction.
  • the time-varying force can in particular be a temporary but repeatable force exerted on the probe, the force being able to be exerted, for example, intermittently or also over a limited period of time in terms of amount and direction; however, the time-varying force can also be a force exerted on the probe continuously, but with a variable magnitude and/or variable direction, with the term “continuous” also including, for example, a sinusoidally variable force that is temporarily zero.
  • the probe can be deflected in the proximal section by the action of the time-varying force in the transverse direction.
  • the deflection device is thus designed and arranged in particular in such a way that the probe can be deflected transversely to the longitudinal direction of the probe, which is also referred to below as lateral deflection.
  • the deflection means is arranged such that the time-varying force can be applied to the probe at such a position, relative to the longitudinal direction of the probe, as to maximize deflection in the transverse direction; for example, the force can be applied to the probe at a predetermined or adjustable distance from a distal end of the ultrasound converter unit.
  • the probe can be excited to oscillate, in particular, in the transverse direction, ie lateral oscillations.
  • the deflection of the probe or the vibrations excited in the proximal section can be transmitted through the probe in the distal direction and cause a lateral deflection of the distal end of the probe.
  • a lateral deflection of the distal end in the range of approximately 20 to 300 ⁇ m (peak-to-peak) can be achieved.
  • the deflection device can be permanently or detachably connected to the ultrasonic converter unit.
  • the force can be exerted by the deflection device directly, in particular on a lateral surface of the probe, or indirectly on the probe.
  • the device can be connected to or include a control device for controlling the drive arrangement.
  • the control device can be designed to control the ultrasonic converter unit to excite the longitudinal ultrasonic oscillations and to control the deflection device to deflect the probe by the action of a force on the probe in the direction transverse to the longitudinal extent of the probe and thus to generate the lateral deflection of the probe.
  • the control device can be designed to operate the ultrasonic converter unit and the deflection device in a coordinated manner and/or independently of one another.
  • the control device can include operating means for operation by the user of the device, so that the operator can control the device to excite the longitudinal ultrasonic oscillations and to deflect the probe in the transverse direction coordinated therewith, for example simultaneously, or also independently of this.
  • the drive arrangement comprises a deflection device for deflecting the probe by the action of a variable force in a transverse direction on the probe
  • the probe can be excited to perform transverse movements which lead to a transverse movement of the distal end. It has been observed that this can increase the ablation or fragmentation effect of the probe. It is assumed that the removal or shattering effect of the probe is essentially due to the longitudinal ultrasonic vibrations of the probe, however, due to the transverse movement, the point at which the probe acts on the body stone is changed and the effect of the ultrasonic vibrations can thereby be improved.
  • a stationary state which can occur after some time when treating a body stone solely with longitudinal ultrasonic vibrations and in which the removal practically comes to a standstill, can be prevented or eliminated.
  • continuous processing and rapid removal or comminution of the bodily stone can be achieved through a continuous but variable or a temporarily recurring force on the probe in the transverse direction with simultaneous operation of the ultrasonic converter unit.
  • the drive arrangement comprises a deflection device for exerting a variable force in the transverse direction on the probe that can be controlled independently of the ultrasonic converter unit
  • the generated transverse movement of the distal end of the probe can be controlled independently of the longitudinal ultrasonic vibrations of the probe and in particular is not firmly coupled to a movement of the probe in the longitudinal direction.
  • the transverse movement can be optimally dosed and adapted to the requirements of the surgical situation and, for example, a stone can be prevented from escaping from an operating field observed with an endoscope due to excessive transverse movement and then having to be searched for and sighted again, which is disadvantageous.
  • the deflection device is designed or can be controlled in such a way that a frequency and/or an intensity of the time-varying force that is exerted on the probe can be adjusted.
  • “intensity” means in particular an amount or an amplitude of the force exerted or the force impact, ie an impulse transfer to the probe caused by the time-varying force, or an impact strength when an impact is exerted on the probe.
  • the adjustable frequency can be the frequency of a periodic change in the force exerted, for example in the event that the force is exerted on the probe continuously but with a periodically changing amount and/or changing direction.
  • the adjustable frequency can be a repetition frequency of the exertion of force.
  • the frequency or the repetition frequency can be adaptable to a natural frequency of the ultrasonic transducer, the probe or the entirety of the probe and ultrasonic transducer or ultrasonic converter unit, possibly including the body stone, and can be chosen, for example, approximately equal to such a natural frequency or deliberately unequal to the natural frequencies will.
  • the frequency or repetition frequency can be adapted to a resonant frequency of the probe with regard to transverse or bending vibrations.
  • This resonant frequency can be the fundamental frequency of a bending vibration of the probe, at which the length of the probe, measured between a connection of the probe to the ultrasound converter unit, ie in particular the distal end of the ultrasound horn, and the distal end of the probe, is a quarter wavelength, or the frequency of corresponding harmonics.
  • the frequency or repetition frequency is in a low-frequency range in relation to the excitation frequency of the ultrasonic transducer, for example in a frequency range from 3 to 300 Hz, particularly preferably in a range from approx. 15 to approx. 35 Hz, or is in the said range Adjustable frequency range.
  • the control unit of the device can be designed for the user to set the repetition frequency.
  • a frequency or a repetition frequency of the exertion of the force on the probe can be set and, in particular, can be selected to be equal to or different from a natural frequency, a lateral deflection of the distal end of the probe can be maximized and/or the occurrence of a stationary state with a low removal effect in particular sure to be avoided. Because the intensity of the exertion of the force on the probe can be adjusted, a lateral deflection of the distal end of the probe can be adapted to an operation situation, for example to prevent the body stone being worked on from moving out of the operation field.
  • a frequency of the time-varying force in particular a repetition frequency of the temporary exertion of force in the transverse direction on the probe, can be fixed, for example equal to one of the natural frequencies mentioned or different from it, in which case the control device can be preset accordingly, and/or it an intensity of the time-varying force can be fixed.
  • the device or the control device can be designed for non-periodic repetition of the exertion of the force in the transverse direction on the probe, for example for triggering individual temporary force effects on the probe that can be controlled by the user.
  • the deflection device is designed to exert the time-varying force on the probe by an impact exerted on the probe in the proximal section by means of at least one impact element; “Blow” refers here in particular to a shock or impulse-like force that can be exerted directly or indirectly on the probe by a shock or impact.
  • the time-varying force acting on the probe in the direction transverse to the longitudinal extent of the probe and a lateral one causes deflection of the probe, thus generated by an impact of at least one impact element on a lateral surface of the probe in the proximal portion of the probe.
  • the at least one impact element is arranged so that it can move, for example in relation to the longitudinal axis of the probe so that it can move in the radial or tangential direction, so that it can be moved to apply the impact to the lateral surface of the probe.
  • the side or lateral surface is, in particular, an approximately cylindrical surface that is symmetrical to a longitudinal axis of the probe, but can also be a differently configured surface of the probe that is suitable for impact in the transverse direction.
  • the at least one impact element can preferably be moved in a plane perpendicular to the longitudinal axis of the probe or transverse to the longitudinal extent of the probe in the proximal section.
  • the deflection device is designed in such a way that repeated impacts can be exerted on the probe by means of one or more impact elements. Because the deflection device is designed to exert one or repeated impacts on a lateral surface in the proximal section of the probe, a lateral deflection of the probe can be generated in a simple and effective manner, which causes a lateral deflection of the distal end of the probe. The impact usually causes the probe to oscillate laterally with the fundamental and several upper frequencies. As a result, the effect of removing or crushing a stone in the body can be further improved.
  • an area of the surface of the probe in which the at least one impact element touches the surface of the probe during impact and which is also referred to here as the "impact area” is preferably linear or planar, with the linear or planar extent of the impact area being determined is to minimize wear on the probe.
  • the at least one impact element can be designed as a ram or hammer that can be moved by means of a drive device in order to impact the probe.
  • the ram or hammer is mounted so that it can move in particular in a radial direction, based on a longitudinal axis of the probe, and can be driven by the drive device to strike a lateral surface of the probe on one side.
  • a lateral deflection of the probe can be generated in a simple and reliable manner.
  • the at least one impact element can also be designed as a frame or as a slotted disc, which can be moved by means of a drive device, for the one-sided or alternating impact on the probe.
  • the frame or the slotted pane can, for example, be guided so as to be displaceable in the transverse direction or be mounted so as to be rotatable about a pivot axis which is approximately parallel to the longitudinal axis and is spaced apart from it.
  • the probe runs through the interior of the frame or through the slot in the disc, which is wider than a diameter of the probe.
  • the end points of a reciprocating movement of the frame or the slotted disc are thereby positioned such that the striking element can strike a first area of the lateral surface of the probe by moving in the transverse direction with a first inner side of the frame or the slot; more preferably, the impact element can strike a second area of the surface radially opposite the first area by moving in the opposite direction with an opposite, second inner side.
  • the frame or the slot of the pane can be closed on all sides or open on one side.
  • a closed design has the advantage of increased stability and durability, while a frame open on one side or an open slot allows for easier assembly and disassembly of the deflection device without having to pull the probe longitudinally through the frame or slot.
  • the drive device is in the form of a linear drive which drives the impact element in order to impact the probe.
  • the drive device can be designed as a pneumatic drive comprising a pneumatic cylinder, as a linearly operating piezo motor or as an electromagnetic linear drive, for example with a magnetic coil and a displaceable iron core.
  • a linear drive can act directly or indirectly, for example via a linkage, on the striking element.
  • the impact element is designed as a ram, hammer or movable frame
  • the linear drive can be transverse to the longitudinal direction be arranged on the probe and act directly on the striking element. This enables a particularly simple design of the deflection device, which also makes cleaning and sterilization easier.
  • the drive device for driving the striking element can be designed, for example, in the manner of a Wagner hammer.
  • a Wagnerian hammer can be operated without electronic control and be designed without bearings to be lubricated and corresponding seals, with the necessary electromagnet being able to be sealed off in a simple manner from the hammer or the probe. This can facilitate cleaning and sterilization.
  • the drive device comprises a cam disk acting against a spring force.
  • the striking element can be displaced, preferably in the radial direction, and is pretensioned by a spring against the cam disk.
  • the cam rotates, the striking element performs a reciprocating movement.
  • the drive device can comprise a crank, which acts on the impact element and also sets this in a reciprocating motion.
  • the cam disk or the slider crank can be driven in particular by an electric motor, a pneumatic motor, a rotary piezo motor or a turbine.
  • the drive arrangement can comprise an electric motor which can be driven to move back and forth, which is coupled to the impact element and can also set this to move back and forth, preferably with an adjustable frequency. A lateral deflection of the probe can also be achieved in this way in a simple manner.
  • the end points of the reciprocating movement are determined so that the striking element can strike the surface of the probe.
  • the intensity or strength of the impact which is determined in particular by the speed, mass and material of the impact element, is selected in such a way that wear on the probe and repulsion of the machined body stone can be minimized and at the same time stone removal can be maximized.
  • the impact element is preferably made of a metallic or other hard material, such as stainless steel.
  • the at least one impact element is designed as a mass body which can be moved by means of a drive device on a circular path in order to impact the probe.
  • the mass body can be arranged, for example, on a circumference of a rotatable disk that can be driven by the drive device, so that the mass body touches the lateral surface of the probe when the circular movement is carried out and the impact is thereby exerted on the probe.
  • the mass body is mounted with play or at least in a radial direction relative to an axis of rotation of the disc, so that after the impact has been exerted it can deviate by touching the surface of the probe during the further circular movement and then again by centrifugal force position to touch the probe during the subsequent rotation of the disc.
  • the mass body can be rotatably mounted on the disk, for example in the form of a ball bearing, the outer ring of which can hit the probe and be set in rotation, thereby reducing friction and wear when touching the probe.
  • the mass body can be held on a rotatable shaft with a flexible holding means, such as a thread or a chain, which can be driven by the drive device, and when the shaft rotates by centrifugal force on a circular path to touch the lateral surface of the probe and thus forced to deliver the shock.
  • the axis of rotation of the disk or shaft is preferably directed essentially parallel to the longitudinal direction of the probe, so that the at least one mass body is moved approximately tangentially, relative to the longitudinal axis of the probe, when the impact is exerted.
  • the deflection device can also comprise a plurality of mass bodies which are arranged on the rotatable disc or on the rotatable shaft held to apply repeated blows to the probe.
  • the intensity of the time-varying force or the strength of the impact can be adjusted in an advantageous manner by a position of the axis of rotation and the radius of the disk or the length of the flexible holding means.
  • the repetition frequency of the impacts is determined by the speed and the number of masses held on the disk or the shaft.
  • the materials of the probe and the mass body can be designed for low wear, for example, the probe can be made of stainless steel and the mass body can be made of brass or of a lubricious plastic.
  • the disk can also be made of plastic and be designed in one piece with the mass bodies, for example in the manner of an impeller with elastic arms. As a result, a particularly simple embodiment can be created which can be intended for single use, for example.
  • the deflection device can advantageously be used to exert the force on the probe by means of an imbalance that can be driven by means of a drive device or by an imbalance that can be driven by means of a drive device be eccentric.
  • This imbalance or eccentric drive is coupled to the probe in the proximal section thereof, so that the rotating imbalance or rotating eccentric can also exert a force on the probe in a direction transverse to the longitudinal direction.
  • a repeatable force action on the probe for the lateral deflection of the probe can also be achieved in a simple manner in this way.
  • the drive device which is used to move the mass body on a circular path or to drive the imbalance or eccentric drive, can include an electric motor, a piezo motor, a pneumatic motor or a turbine. Alternatively, an electric motor that can be driven to move back and forth can be provided. As a result, the deflection device can be driven in a simple and reliable manner.
  • the drive device comprises an electric motor
  • this is preferably a brushless electric motor, in particular with an adjustable speed.
  • a brushless electric motor has the particular advantages of high speeds, high power and a simple structure that facilitates cleaning and sterilization.
  • the drive arrangement includes a piezo motor, this can enable a particularly compact design and a large dynamic range.
  • the drive arrangement comprises a pneumatic motor, a pneumatic cylinder or a turbine, the particular advantage can be achieved in this way that the deflection device can be operated without electrical lines; furthermore, operation with a vacuum or negative pressure can be possible, as a result of which increased security against contamination can be achieved.
  • the deflection device can include the drive device described above, which can form a unit with the deflection device. However, it can also be provided that the drive device is arranged separately from the deflection device or is only partially encompassed by it.
  • a motor of the drive device such as an electric motor, a piezoelectric motor, a pneumatic motor or a turbine, which, as mentioned above, is used to drive the cam disc, the slider crank, the rotatable disc or shaft to move the mass body a circular path or the imbalance or eccentric drive is used, is arranged separately from the deflection device and drives it via a flexible shaft.
  • the flexible shaft can be permanently or detachably connected to the deflection device.
  • the deflection device can be made particularly compact and the handling of the device according to the invention can be improved.
  • the deflection device is arranged in such a way that the time-varying force acts on the probe in the direction transverse to the longitudinal extent of the probe on the distal side of the ultrasound converter unit.
  • the deflection device can be designed and arranged in order to exert the impact exerted by means of the at least one movable impact element on the lateral surface of a section of the probe that lies on the distal side of the ultrasound converter unit.
  • This embodiment has the particular advantage that a distance between an area affected by the impact and the ultrasound converter unit can be adjusted in such a way that a lateral deflection of the distal end of the probe is at a maximum.
  • the deflection device can be connected to the ultrasonic converter unit in such a way that the distance between the impact area of the impact and the ultrasonic converter unit can be adjusted; this allows adaptation to different probes and/or different endoscopes in order to maximize the lateral deflection of the distal end of the probe.
  • the probe extends in the proximal direction beyond the ultrasound converter unit and that the deflection device is arranged in such a way that the time-varying force in the direction transverse to the longitudinal extent of the probe acts proximally on the ultrasound converter unit or at least on the proximal side of a connection of the Probe with the ultrasonic converter unit acts on the probe.
  • the probe can extend through a bore in the ultrasonic converter unit, in which case the ultrasonic vibrations can be coupled into a collar of the probe, for example.
  • the probe can be designed as a hollow probe, for example, and can be provided with a suction connection at its proximal end. In this way, a particularly compact and easy-to-handle configuration can be achieved; in particular, the deflection device can form a unit with the ultrasound converter unit and can be integrated, for example, in a housing of the ultrasound converter unit designed as a handpiece.
  • the deflection device can be designed and arranged in such a way that in order to exert the time-varying force on the probe in the transverse direction Longitudinal extension of the probe standing direction the deflection device exerts a force on the ultrasound converter unit, whereby a time-varying force acts on the probe via the connection of the probe to the ultrasound converter unit in order to deflect it laterally; for example, the force can be exerted on a distal end of the ultrasonic horn or on an attachment of the probe to the ultrasonic horn.
  • This can be particularly advantageous in the case that the deflection device for exerting the force on the probe is designed by an unbalanced or eccentric drive. A particularly compact configuration can also be achieved in this way.
  • the ultrasonic converter unit is movably mounted in a surrounding housing, it also being possible for the deflection device to be accommodated in the surrounding housing.
  • the surrounding housing can be designed as a handpiece.
  • the deflection device can be arranged to exert a force on the ultrasonic converter unit and have a drive device designed as described above, for example a linear drive, a piezoelectric motor, an electric motor with a slider crank, an unbalanced drive or an eccentric drive for generating a reciprocating movement of the ultrasonic converter unit transverse direction.
  • the drive device can be supported against the surrounding housing, as a result of which a more efficient application of force to the ultrasonic converter unit and thus to the probe is made possible.
  • the ultrasonic converter unit can be resiliently mounted in the surrounding housing, in particular elastically, for example by means of a membrane.
  • the surrounding housing can advantageously be mechanically decoupled from the lateral deflections generated by the deflection device, as a result of which handling can be further improved.
  • the ultrasonic converter unit can be cardanically suspended in the surrounding housing by means of an intermediate ring, as a result of which a particularly extensive decoupling of the surrounding housing from vibrations is made possible.
  • the ultrasonic converter unit can be mounted in the surrounding housing so that it can pivot about a transverse axis, the transverse axis being transverse to the longitudinal direction of the probe.
  • the action of the force the deflection device exerts a force on the ultrasound converter unit in the direction transverse to the longitudinal extension of the probe as a result of which the ultrasound converter unit is set in a pivoting movement and the probe is thereby deflected in the lateral direction.
  • the deflection device can in particular comprise a linear drive, a piezoelectric motor, an electric motor with a slider crank, an unbalanced drive or an eccentric drive. This embodiment can be designed to be particularly compact.
  • the drive arrangement is designed to exert a further force on the probe in a further direction transverse to the longitudinal extension of the probe.
  • a force can thus be exerted on the probe in a number of different directions, each transverse to the longitudinal direction, for example in two directions perpendicular to one another.
  • the drive arrangement can comprise a further deflection device, which is designed to exert a force on the probe in the further direction, which is transverse to the longitudinal direction.
  • the deflection devices can be offset relative to one another by a corresponding angle relative to a longitudinal axis of the probe, for example perpendicular to one another.
  • the deflection devices can each be configured as described above, identical to or different from one another and can be controlled, for example, simultaneously, alternately or independently of one another.
  • a deflection of the probe in a further lateral direction can be brought about by the action of the force in the further transverse direction.
  • a deflection of the probe in different directions, each transverse to the longitudinal direction, can thus be generated, as a result of which the effectiveness for removing or breaking up a bodily stone can be further increased.
  • a lithotripsy system which is in particular a system for intracorporeal ultrasonic lithotripsy, comprises a device for lithotripsy, which is designed as described above, and an endoscope, for example a nephroscope, which has a channel for inserting the probe into the interior of the human or animal body.
  • the channel is dimensioned to enable the deflection of the probe generated by the action of the force in the direction transverse to the longitudinal extent of the probe to be transmitted to a distal end of the probe.
  • the probe when inserted into the channel, has sufficient lateral play within the channel to transmit lateral deflection, caused by the time-varying force exerted on the probe by the deflection means, to the distal end; if necessary, a seal can also be designed accordingly.
  • a length of the channel is dimensioned such that the probe can be passed through the channel and extends beyond the distal end thereof to contact a bodily calculus located in front of the distal end.
  • the probe is excited in a proximal section of the probe to longitudinal ultrasonic vibrations, i.e. to ultrasonic vibrations in the direction of a longitudinal extension of the probe, which is transmitted through the probe to a distal end transferred to the probe.
  • a time-varying force is applied to the probe in a direction transverse to the length of the probe such that the probe is deflected transverse to its length, which deflection of the probe is transmitted through the probe to the distal end.
  • the distal end of the probe can be set into longitudinal ultrasonic vibrations and at the same time be deflected in the transverse direction, for example in the form of lateral vibrations.
  • the force is repeatedly, in particular periodically repeatedly, exerted on the probe in the transverse direction, it being possible for the repetition frequency to be adjustable.
  • the force can be continuous or intermittent on the probe be exercised.
  • an impact can be exerted on a lateral surface of the probe by means of at least one impact element, for which purpose the impact element can be moved by means of a drive device.
  • a force can also be exerted in the direction transverse to the longitudinal direction by means of an imbalance which can be driven by means of a drive device or an eccentric which can be driven by means of a drive device.
  • the lithotripsy device is preferably designed as described above.
  • an ultrasonic converter unit can be provided to excite the probe to produce longitudinal ultrasonic oscillations
  • a deflection device can be provided to exert the force that varies over time in the transverse direction, with the probe, the ultrasonic converter unit and/or the deflection device preferably being designed and arranged as described above and as described above be operated as described.
  • the device according to the invention is designed in particular for carrying out the method.
  • the method according to the invention can be carried out extracorporeally and the lithotripsy device can be operated extracorporeally, with the probe being able to be brought into contact with its distal end with an object which can be processed by the action of the ultrasonic vibrations and the lateral deflection of the probe.
  • the method according to the invention can also be carried out intracorporeally, with the probe being designed for introduction into the interior of a human or animal body.
  • the probe Before carrying out the method, the probe can be introduced, preferably through the shaft of an endoscope, into the interior of the body to a body stone to be destroyed, so that the distal end of the probe touches it.
  • the body stone is removed or shattered.
  • rinsing can be carried out to remove the fragments of the body stone and/or the probe can be removed from inside the body or from the endoscope shaft. The procedure can be carried out repeatedly.
  • the probe of a lithotripsy device configured as described above is inserted into the Inside the body of a human or animal body and introduced to a body stone to be destroyed so that the distal end of the probe touches it, the lithotripsy device is operated as described above and the body stone is removed or smashed, if necessary the fragments can be removed by flushing , and the probe is removed from inside the body.
  • FIG. 1 shows a schematic diagram of the mode of operation of a device according to the invention
  • FIG. 2a and 2b show a first exemplary embodiment of a device according to the invention
  • FIG. 3 shows a second exemplary embodiment of a device according to the invention
  • 4a to 4c show a third exemplary embodiment of a device according to the invention.
  • 5a and 5b show a fourth embodiment of a device according to the invention.
  • 6a and 6b show a fifth exemplary embodiment of a device according to the invention.
  • FIG. 7a and 7b show a sixth embodiment of a device according to the invention.
  • FIG. 8 shows a seventh exemplary embodiment of a device according to the invention.
  • FIG. 9 shows an eighth exemplary embodiment of a device according to the invention.
  • a lithotripsy device comprises an elongated probe 1, which is also referred to as a sonotrode, and an ultrasound converter unit 2, which is arranged on a proximal section 3 of the probe 1.
  • the probe 1 is designed for insertion into the interior of a human or animal body, so that a distal end 4 of the probe 1, which is also referred to as the probe tip, can be introduced through a natural or artificial body opening to a body stone located inside the body.
  • the probe 1 can be inserted into a corresponding channel of an endoscope, which is passed through the body opening, for example through a nephroscope (not shown) to a kidney stone located in the renal pelvis.
  • the proximal section 3 of the probe 1 with the ultrasound converter unit 2 remains outside the body and possibly also outside the endoscope.
  • the probe 1 is preferably rigid, but may be flexible or semi-rigid, and is typically made of stainless steel.
  • the distal end 4 of the probe 1 can also have a movable crown.
  • the ultrasonic converter unit 2 comprises an ultrasonic converter 5 which is coupled to a horn 6 for the transmission of ultrasonic vibrations.
  • the hom 6 is permanently connected to the ultrasonic converter 5 .
  • the probe 1 is attached to a distal end of the horn 6 .
  • the probe 1 can, for example, be screwed into a through bore 7 of the horn 6 so that a collar 8 of the probe 1 is in firm contact with the distal end of the horn 6 .
  • the probe 1 can extend in the proximal direction through the ultrasonic transducer 5 or end in the area of the horn 6, for example.
  • the hom 6 is used to amplify the ultrasonic vibrations generated by the ultrasonic transducer 5 and to couple the ultrasonic vibrations into the probe 1.
  • the coupled-in ultrasonic vibrations are transmitted as ultrasonic waves through the probe 1 to its distal end 4 and cause it to vibrate accordingly.
  • the ultrasonic transducer 5 is activated to generate standing waves in the probe 1, so that an oscillation amplitude at the distal end 4 of the probe 1 is at a maximum.
  • the probe 1 can be designed as a hollow probe which has a continuous flushing channel 9 .
  • a connection can be provided at a proximal end 10 of the ultrasonic transducer 5 or the probe 1 for connecting a rinsing or suction device in order to remove the fragments of the body stone that have formed.
  • a flushing or suction connection can be provided on the side of the probe 1, on the distal side of the horn 6.
  • the ultrasonic vibrations or ultrasonic waves generated by the ultrasonic transducer 5 and coupled into the probe 1 by the horn 6 are of a longitudinal nature, i.e. the corresponding deflection of the probe 1 takes place in the direction of the longitudinal extent of the probe. This longitudinal direction is indicated by the arrow 11.
  • the generation of lateral ultrasonic waves by the ultrasonic converter unit 2 can also be provided.
  • a transverse force F q which varies over time is exerted on the probe 1 in a direction which is transverse to the longitudinal direction of the probe 1 and causes a lateral deflection of the probe 1 .
  • a deflection device is provided for this purpose, which is arranged in order to exert the variable transverse force F q on the probe.
  • a flexural vibration of the probe 1 can be excited by a temporary, temporally recurring lateral force, which is transmitted from the probe 1 to its distal end 4 .
  • the distal end 4 of the probe 1 thus performs, in addition to the longitudinal ultrasonic vibrations, a lateral movement which is usually of low frequency. Such a lateral movement of the distal end 4 allows a significant improvement in the removal or fragmentation effect of the probe 1.
  • the force F q can occur on the distal side of the ultrasound converter unit 2, but also still in the proximal section 3 of the probe 1, which is outside the body or the endoscope remains, act on the probe 1; alternatively, the force F q acting in the transverse direction can be exerted on the probe 1 within or on the proximal side of the ultrasound converter unit 2 or indirectly via this.
  • a deflection device is provided, which can be designed and arranged, for example, as in the exemplary embodiments explained below.
  • the deflection device comprises a linear drive 12, which can be, for example, a pneumatic cylinder, a linearly operating piezo motor or an electromagnet with a displaceable iron core, which has a frame 13 trained percussion element drives.
  • a linear drive 12 which can be, for example, a pneumatic cylinder, a linearly operating piezo motor or an electromagnet with a displaceable iron core, which has a frame 13 trained percussion element drives.
  • the probe 1 runs through the interior of the frame 13.
  • the frame 13 is guided in a direction transverse to the longitudinal extent of the probe 1 and is guided by the Linear drive 12 driven to a reciprocating movement.
  • the linear drive 12 acts on the frame 13 via a piston rod 15 or via a linkage, possibly with a certain amount of play.
  • the end points of the reciprocating movement are determined so that the inner faces 16, 17 of the frame 13 alternately strike opposing impact areas 18, 19 of the lateral surface of the probe 1; alternatively, the probe 1 can also be hit on only one side.
  • the frame 13 has a thickness in the longitudinal direction of the probe 1 such that the effective areas 18, 19, in which the frame comes into contact with the surface of the probe during impact, have a sufficient longitudinal extent to prevent wear on the surface of the probe 1 to be minimized (see Fig. 2a).
  • the deflection device with the linear drive 12 can include a holder with which it is detachably attached to the ultrasonic converter unit 2 (not shown).
  • a deflection device with a drive device for the lateral deflection of the probe 1, which works in the manner of a Wagner hammer.
  • a hammer 21 is arranged on a leaf spring 20, which is actuated by an electromagnet 22 with an armature and an interrupter contact coupled thereto for a reciprocating movement in the transverse direction, which is indicated by the double arrow 23 in FIG. 3, is driven and hits the lateral surface of the probe 1.
  • the leaf spring 20 can be attached to the ultrasonic converter unit 2 via a holding bracket 24 .
  • the ultrasonic converter 5 also has a supply connection 26 for electrical connection to a control device (not shown).
  • the ultrasonic converter unit 2 of the other exemplary embodiments can be constructed in a corresponding manner.
  • the probe 1 is subjected to impacts acting on one or both sides by means of a frame 27 that can be displaced in the transverse direction, for which purpose the probe 1 runs through the frame 27 and a displacement path of the frame 27 is dimensioned in such a way that at least one of the inner sides 16, 17 of the frame 27 hits against a corresponding area of influence of the lateral surface of the probe 1 during the displacement.
  • the deflection device also includes a cam disc 28 which acts on a roller 29 which is rotatably mounted near an upper edge of the frame 27 .
  • the frame 27 is slidably mounted in a guide unit 30 .
  • the frame 27 is biased by a spring 31 in the direction of the cam 28 (s. Fig. 4a).
  • the cam disk 28, which is shown in FIG. 4c in an oblique view seen from the distal direction, has a control surface 32 over which the roller 29 rolls when the cam disk 28 rotates.
  • the control surface 32 occupies an angular range of approximately 90° in relation to an axis of rotation of the cam disc 28; The roller 29 is not in contact with the cam disk 28 in a remaining angular range.
  • the cam disk 28 is fastened to a motor shaft 33 of an electric motor 34, for example with a clamping screw, and can be set in rotation by this.
  • the cam disc 28 rotates clockwise, seen from the proximal direction, the roller 29 rolls along the control surface 32 in the direction of its tip 35, so that the frame 27 is displaced downwards against the force of the spring 31.
  • An end point of this movement can be determined such that the frame 27 strikes an upper surface of the probe 1 with an upper inside 17 .
  • the roller 29 resting on the control surface 32 exceeds the tip 35 thereof, the frame is pushed upwards by the spring 31, with the lower inner side 16 of the frame hitting a lower surface of the probe 1.
  • the frame 27 By driving the cam disk 28 by means of the electric motor 34, the frame 27 can be set in a reciprocating motion, impacts being exerted on one or both sides of the probe 1 in the transverse direction, which lead to a lateral deflection of the probe.
  • the mass of the frame can be, for example, 16 g and the speed with which the lower inside 16 of the frame 27 strikes the lower surface of the probe 1, for example 2.4 m/s or more, in order to have a sufficient impact effect for the lateral deflection of the probe to achieve.
  • FIG. 4a shows that the electric motor 34 and the ultrasonic converter unit 2 are arranged parallel to one another and are each firmly mounted in a surrounding housing 36 .
  • the surrounding housing 36 can be designed as a handpiece.
  • the surrounding housing 36 comprises a closure plate 37 on the distal side, on which the guide unit 30 and a cover 38 of the cam disk 28 are held, and a closure plate 39 on the proximal side, through which the hose connector 25 and a connection socket 40 for connecting the electric motor 34 to a control device protrude .
  • the closure plates 37, 39 are screwed to a body 41 of the surrounding housing 36.
  • FIGS. 5a and 5b show a fourth embodiment of the device according to the invention in a lateral and an axial view.
  • an electric motor 34 is provided here, which is mounted parallel to the ultrasonic converter unit 2 in a symbolically indicated surrounding housing 36 .
  • the electric motor 34 drives a slider crank mechanism 42 which includes a drive pulley 43 fastened to the motor shaft 33 and a slotted pulley 44 which is pivotably mounted on the surrounding housing 36 and is connected to the drive pulley 43 via a connecting rod 45 .
  • a rotation (arrow 46) of the drive disk 43 is converted into a reciprocating pivoting movement (double arrows 47, 48) of the slotted disk 44, with the axis 49 of the pivoting movement being directed parallel to the longitudinal extension of the probe 1 .
  • the starting and end points of the pivoting movement are selected in such a way that the probe 1, which runs through the slot 50 of the slotted disc 44, which is radial in relation to the axis 49, is pushed away from the walls of the slot 50 on one or both sides by a force, in particular a Impact effect is applied. This can also cause a deflection of the probe 1 in the transverse direction.
  • a slotted disc 51 is mounted on the motor shaft 33 of the electric motor 34 instead of a coupling via a crank mechanism. This is arranged in such a way that the probe 1 lies within the radial slot 52 of the slotted disc 51 .
  • the electric motor 34 is controlled in such a way, for example with a square-wave voltage, that the motor shaft 33 with the slotted disc 51 held on it executes a reciprocating movement (double arrow 53), in which the probe 1 is moved from one or alternately from both inner sides 54, 55 of the walls of the slot 52 is touched.
  • a force can be exerted on the probe in the transverse direction, with a corresponding design in particular an impact effect.
  • an electric motor 34 with a motor shaft 33 which runs essentially parallel to the longitudinal direction of the probe 1, is next to the ultrasonic converter unit 2 arranged and can be connected to it in a manner similar to that explained in FIG. 4a.
  • the deflection device comprises a drive disk 56 which is mounted on the motor shaft 33 of the electric motor 34 and near the circumference of which a plurality of striking bodies are arranged.
  • these are six ball bearings 57, each of which is held with play on a bolt 58 which is directed parallel to the axis.
  • impact masses 59 are each held on a rotatable drive disk 61 by means of a thread 60; instead of the thread 60, another flexible holding means, such as a chain, can also be provided. If the drive disk 61 is set in rotation by means of the electric motor, the impact masses 59 follow a circular path, as indicated symbolically by the arrow 62 . The path is laid in such a way that the impact masses 59 strike the surface of the probe 1 in the process.
  • Fig. 9 an embodiment of the invention is shown in a partially sectioned side view, in which the variable force acting in the transverse direction acts proximally of the ultrasound converter unit 2 on the probe 1.
  • the ultrasonic transducer unit 2 includes an ultrasonic transducer 5 and a horn 6.
  • the ultrasonic transducer 5 includes a plurality of piezoelectric elements 63 stacked on one another in the longitudinal direction for generating ultrasonic vibrations.
  • the horn 6 and the ultrasonic transducer 5 have a through-bore 7 which runs through in the longitudinal direction and through which the probe 1 is passed beyond the proximal end of the ultrasonic transducer 5 .
  • a deflection device 64 is arranged proximally to the ultrasonic transducer 5 and is accommodated in a housing 65 into which the probe 1 extends through a bore aligned with the through bore 7 of the ultrasonic converter unit 2 .
  • the probe 1 has an axially continuous rinsing channel 9 and is guided to a proximal side of the housing 65, where a hose connector 25 is arranged, which communicates with the rinsing channel 9.
  • An electric motor 66 is accommodated in an interior space of the housing 65, a force acting in the transverse direction being applied by means of an eccentric disc 67, which can be set in reciprocating or continuous rotation by the electric motor 66 and thereby strikes the probe 1 the probe 1 is exercised.
  • the deflection device 64 can instead be designed with a slotted disc or according to another of the exemplary embodiments described above.
  • the through-bore 7 is designed with sufficient clearance so that the deflections of the probe 1 generated in this way can be transmitted in the transverse direction through the ultrasonic converter unit 2 in the distal direction.
  • the rotating eccentric disc can also act as an imbalance or centrifugal mass, which, via the electric motor 66 mounted in the housing 65, generates the deflection device 64 and the ultrasonic converter unit 2 formed unit and thus the proximal portion of the probe 1 in additional vibrations in the transverse direction, which usually represent lower frequency components compared to the impact excitation. These can also be transmitted to the distal end 4 of the probe 1 and deflect it in the transverse direction.
  • the deflection device 64 and the ultrasonic converter unit 2 can be accommodated in a non-illustrated surrounding housing, which can be designed as a handpiece, and can be resiliently mounted therein, for example.
  • the ultrasonic converter unit 2 is replaced by a Drive device 68, which acts between a surrounding housing 69 and the ultrasonic converter unit 2, is set in a reciprocating pivoting movement about an axis 70 which is transverse to the longitudinal axis of the probe 1 and which traverses the ultrasonic converter unit 2 in a central section.
  • the drive device 68 can comprise, for example, a linear drive, such as a magnetic coil with a movable iron core, a piezoelectric motor or an electric motor with a crank drive, as a result of which a transverse force that varies over time is continuously exerted on the ultrasonic converter unit 2, in particular an alternating upward and downward force Power. Due to the pivoting movement of the ultrasonic converter unit 2 that is generated in this way, the probe 1 is deflected in the transverse direction in its proximal section, as a result of which a lateral deflection of the distal end of the probe 1 can also be brought about.
  • a linear drive such as a magnetic coil with a movable iron core
  • top and bottom are to be understood only with reference to the representation in the figures; depending on the orientation of the device, a feature described in this way can also be oriented differently.
  • lateral refer to the longitudinal extension of the probe 1, in particular a lateral surface of a cylindrically designed probe 1 is thereby designated.

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Abstract

La présente invention concerne un dispositif de lithotripsie comprenant une sonde (1) allongée, qui peut être insérée dans un intérieur corporel d'un corps humain ou animal, et une configuration d'entraînement pour dévier la sonde (1), qui est disposée au niveau d'une portion proximale (3) de la sonde (1), la configuration d'entraînement comprenant une unité de conversion ultrasonore (2) pour exciter les vibrations ultrasonores dans le sens d'une extension longitudinale de la sonde (1), et la configuration d'entraînement ayant un dispositif de déflexion (64) pour exercer une force variant dans le temps sur la sonde (1) dans un sens transversalement à l'extension longitudinale de la sonde (1). L'invention concerne également un système de lithotripsie et un procédé de fonctionnement d'un dispositif de lithotripsie.
EP21843914.9A 2020-12-22 2021-12-20 Dispositif de lithotripsie, système de lithotripsie et procédé de fonctionnement d'un dispositif de lithotripsie Pending EP4267021A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102020134602.6A DE102020134602B4 (de) 2020-12-22 2020-12-22 Lithotripsievorrichtung, Lithotripsiesystem und Verfahren zum Betreiben einer Lithotripsievorrichtung
PCT/EP2021/086873 WO2022136311A1 (fr) 2020-12-22 2021-12-20 Dispositif de lithotripsie, système de lithotripsie et procédé de fonctionnement d'un dispositif de lithotripsie

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EP (1) EP4267021A1 (fr)
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WO (1) WO2022136311A1 (fr)

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DE102021131669A1 (de) 2021-12-01 2023-06-01 Karl Storz Se & Co. Kg Lithotripsievorrichtung zum Zertrümmern von Körpersteinen, Lithotripsiesystem, Nachrüstsatz zum Nachrüsten einer bestehenden Lithotripsievorrichtung und Verfahren zum Betreiben einer Lithotripsievorrichtung
DE102022129228A1 (de) * 2022-11-04 2024-05-08 Karl Storz Se & Co. Kg Lithotripsievorrichtung zum Zertrümmern von Körpersteinen mit einem Hebelelement und Nachrüstsatz zum Nachrüsten einer bestehenden Lithotripsievorrichtung
DE102022133521B3 (de) * 2022-12-15 2024-02-29 Karl Storz Se & Co. Kg Haltevorrichtung für eine Lithotripsievorrichtung und Lithotripsievorrichtung zum Zertrümmern von Körpersteinen

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Publication number Priority date Publication date Assignee Title
US3830240A (en) 1972-07-02 1974-08-20 Blackstone Corp Method and apparatus for disintegration of urinary calculi
US4961424A (en) 1987-08-05 1990-10-09 Olympus Optical Co., Ltd. Ultrasonic treatment device
DE3932966C1 (fr) 1989-10-03 1991-04-04 Richard Wolf Gmbh, 7134 Knittlingen, De
EP1380265A1 (fr) * 2002-07-11 2004-01-14 Olympus Optical Corporation Limited Appareil pour le traitement de calculs
JP2005040222A (ja) 2003-07-24 2005-02-17 Olympus Corp 超音波処置装置
US9421023B2 (en) * 2013-06-12 2016-08-23 Cybersonics, Inc. Ultrasonic transducer with shock pulsing masses
DE102018101215B4 (de) * 2018-01-19 2023-09-07 Ferton Holding S.A. Vorrichtung zur Zertrümmerung eines Körpersteins

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CN116867446B (zh) 2024-12-03
DE102020134602A1 (de) 2022-06-23
WO2022136311A1 (fr) 2022-06-30
DE102020134602B4 (de) 2023-11-23
CN116867446A (zh) 2023-10-10

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