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WO1988003782A1 - Procede et dispositif pour eliminer les effets traumatiques dus a la destruction de calculs renaux - Google Patents

Procede et dispositif pour eliminer les effets traumatiques dus a la destruction de calculs renaux Download PDF

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Publication number
WO1988003782A1
WO1988003782A1 PCT/DE1987/000526 DE8700526W WO8803782A1 WO 1988003782 A1 WO1988003782 A1 WO 1988003782A1 DE 8700526 W DE8700526 W DE 8700526W WO 8803782 A1 WO8803782 A1 WO 8803782A1
Authority
WO
WIPO (PCT)
Prior art keywords
foam
pass filter
plate
shock wave
filter
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.)
Ceased
Application number
PCT/DE1987/000526
Other languages
German (de)
English (en)
Inventor
Eberhard HÄUSLER
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.)
HOFFMAN MEDIZINISCHE TECHNIK GmbH
Original Assignee
HOFFMAN MEDIZINISCHE TECHNIK GmbH
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 HOFFMAN MEDIZINISCHE TECHNIK GmbH filed Critical HOFFMAN MEDIZINISCHE TECHNIK GmbH
Publication of WO1988003782A1 publication Critical patent/WO1988003782A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A61B17/225—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2251—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
    • 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
    • G10K11/02—Mechanical acoustic impedances; Impedance matching, e.g. by horns; Acoustic resonators
    • G10K11/04—Acoustic filters ; Acoustic resonators

Definitions

  • the invention relates to a method for eliminating traumatic effects in extracorporeal kidney stone destruction with focused fluid shock waves, which are supplied to the body via a water bath.
  • the invention also relates to an apparatus for carrying out the method with a water column with a soft sound and serving as a waveguide.
  • shock waves For the destruction of kidney stones in particular, it is known to use focusing shock wave generators, the shock waves having to be focused on the location of the kidney stone in order to have the mechanical energy required for the destruction available at the respective location.
  • a water reservoir or water bath is used to transmit the focused shock wave.
  • Various methods are known for generating the shock wave.
  • the shock waves generated with these methods have different spectral components.
  • low-frequency spectral components may also be excited.
  • These low-frequency spectral components are not only therapeutically ineffective, they are even associated with harmful side effects. For example, hematomas can arise in the vicinity of the body surface penetrated by the shock wave, which result from the sudden load caused by these low-frequency components.
  • the invention is based on eliminating the task of round, di ered frequency shock wave components from the shock wave field in such a way that only the high frequency components are focused.
  • the object is achieved in that the shock wave is passed through a high-pass filter before entering the human body.
  • the high-pass filter eliminates the low-frequency components without significantly affecting the effectiveness of high-frequency components.
  • shock wave field it may make sense to filter the shock wave field before it is focused by an elliptical reflector or a sound lens by passing it through channels delimited by foam strips that are arranged in the immediate vicinity of the shock wave enquell e. In this way, it is possible to create channels with soft edges that provide the desired barrier damping.
  • Such a high-pass filter that is to say a water column with a soft edge
  • a high-pass filter is expediently realized by providing an air-filled foam plate, preferably a foam rubber plate, with a bore.
  • the bore can be dimensioned according to the desired channel cross-section and thus the respective cut-off frequency.
  • the size of the cutoff frequency depends on the cross section of the liquid waveguide. With a diameter of the waveguide channel of 10 mm, the cut-off frequency is around 200 kHz in water, whereby it decreases with increasing diameter.
  • the damping of the foam plate for low-frequency spectral components is 40 d B / cm.
  • shock waves In the therapeutic application of shock waves, it can happen that in obese patients the shock wave amplitude on the way through the body happens so that it is no longer sufficient for stone crushing.
  • you can by using a high pass Filters with a low cut-off frequency can be remedied because the low-frequency spectral component is weakened less. In this way, a compromise between the therapeutic and traumatic effects of the shock waves can be achieved.
  • the invention provides that several high-pass filters combined to form a filter plate are arranged side by side and in a correspondingly shaped channel cross section in the foam plate.
  • the individual channels are arranged as closely as possible next to one another, so that a perforated plate which is as flat as possible or which is adapted to the wavefront is obtained.
  • This filter plate is parallel to the wavefront normal and the axes of the individual channels are arranged perpendicular to it. In this way there is an optimal transmission loss, the transmission loss of the entire filter plate being given by the cross section of the sum of the channels, based on the total cross section of the wave field.
  • the high-pass filter As a replacement for the filter plate, it is appropriate, depending on the application, for the high-pass filter to be arranged in the immediate vicinity of the shock wave source, preferably a spark gap, and to be formed by foam strips delimiting the channels. These foam strips also act as high-pass filters, but here the cut-off frequency and blocking attenuation are not as easy to calculate as with the filters or filter plates mentioned earlier. Due to the early filtering, however, there are advantages, which can be seen in particular in the structure of the overall device but also in the more targeted damping of the waves to be damped.
  • the shape of the respective channels can be influenced in particular by the fact that the foam strips are arranged in the longitudinal and circumferential directions, which preferably results in rectangular or strip-shaped channels with soft edges.
  • the design of a device is particularly advantageous if the filter system formed by the foam strips and the shock wave generation system form a structural unit, because then the distances which are predetermined once are to be adhered to even during a long period of operation.
  • a particularly expedient embodiment of the foam strip forming the high-pass filter is that in which the sheet metal webs serving as the power supply line of the spark gap are covered with foam strips and arranged symmetrically to the axis and connected via zi rkumferenti al arranged foam rings. This results in a particularly stable design and a possibility of adapting the shape of the channels with soft edges to the circumstances.
  • the sheet metal webs carrying the foam strips are detachably connected to the holder of the spark gap. In particular, these are inserted into the holder, so that a. easy connection and detachment is possible.
  • the foam strips can be replaced after a long period of operation by removing the entire cage or the entire scaffold with the foam strips and replacing them with a new one. This is also facilitated by the fact that, after a further development, the foam strips are assigned to a cage-like support, preferably a plastic tube frame.
  • the high-pass filter preferably in the form of the foam strips and foam rings, be designed to have the necessary stability against the shock waves. To do this, it is possible to wrap them with a film or to use foam strips and foam rings with a coated surface.
  • Foam rubber is well suited as a high-pass filter due to the high proportion of air bubbles. But it can also be advantageous that the high-pass filter is a dimensionally stable plastic plate with a high proportion of air bubbles. In terms of dimensional stability, such a plate has advantages over foam rubber.
  • the invention additionally provides that the high-pass filter or the filter plate has a stiffening insert, preferably a thin sheet. This plate is inserted approximately in the middle of the filter plate.
  • Gas bubbles arising during shock wave excitation are advantageously prevented from getting stuck in the channels or the bore, in that the high-pass filter or the filter plate is covered by a film, the foam plate itself being filled with liquid.
  • the invention is characterized in particular in that a method and a device are specified with which the disadvantageous low-frequency shock wave components are effectively eliminated, so that no harmful side effects can be caused in the patient.
  • complete elimination is not advisable because otherwise the high-frequency shock waves will not reach their destination, the sudden loading of the low-frequency waves is reduced to such an extent that a significant reduction in the traumatic effects can still be achieved.
  • 1 is a schematic, perspective view of a high-pass filter
  • FIG. 2 is a top view of a foam sheet
  • FIG. 3 shows a filter plate made of several high-pass filters
  • Fig. 4 is a section through that shown in Fig. 3
  • FIG. 5 a section through a stabilized high-pass filter
  • FIG. 6 a further embodiment of the spark gap
  • FIG. 7 a cage-like design of the spark gap.
  • Fig. 1 shows a water tank (1) with a high-pass filter (3) and the center of the high-pass filter through the bore (4) provided there running water column (2) as a waveguide.
  • the water column (2) fills the bore (4) in the foam plate (5) designed as a foam rubber plate, the waveguide being delicately delimited by the foam rubber end.
  • the water tank (1) is divided into two areas by the foam plate (5) designed as a foam rubber plate.
  • a flat shock wave incident on the foam rubber plate from below is reflected on the foam plate (5), except for the area delimited by the bore (4). Only the low-frequency components of the shock wave are reflected in this area.
  • the higher-frequency spectral components pass through the water column into the area above the foam plate (5).
  • Fig. 2 shows a foam sheet (5). with a bore (4) for a waveguide, while the top view according to FIG. 3 provides a filter plate (76) with a plurality of bores, that is to say a filter plate (6) consisting of a plurality of high-pass filters (3).
  • This filter plate (6) thus has a number of wavy conductors or water columns (52) with soft edges.
  • Fig. 4 shows a section through the high-pass filter (3) shown in Fig. 3 or the filter plate (6).
  • a few channels (9, 10) are shown, the axes of which are perpendicular to the wavefront normal (11).
  • the number of corresponding channels (9, 10) can be considerably higher.
  • the shape of the filter plate (6) adapted to the wavefront normal (11) can be clearly seen here in FIG. 4.
  • the shown shock wave front (13) corresponds to a snapshot shortly after the shock wave excitation in the area of the spark gap (14) and within the ellipsoidal reflector (12). The focus is denoted by (15).
  • FIG. 4 shows a section through the high-pass filter (3) shown in Fig. 3 or the filter plate (6).
  • FIG. 5 shows a section through a foam sheet (5) which is equipped with an insert (7) designed as a thin sheet to improve the dimensional stability and is enclosed by a film (8).
  • This film (8) prevents the gas bubbles generated during shock wave excitation from settling in the channels (9, 10) or in the bore (4).
  • FIG. 6 shows a longitudinal section through a spark gap (14) serving as a shock source.
  • channels (9 ', 10') are subdivided by circumferentially arranged foam rings (24, 25) and a high-pass filter (3 ') is created, the cut-off frequency of which is determined by the cross section of the individual channels (9', 10 ') and its blocking attenuation by the expansion of the foam strips (22, 23) is given in the radial direction.
  • a system placed on the spark gap (14) and provided with foam strips (22, 23) in the axial and circumferential direction has similar properties (FIG. 7).
  • the strip elements with sound-proof edges are fastened to a carrier (26), here a plastic tube frame (27).
  • This plastic tube frame (27) sits around the two electrodes (2o, 21) and thus forms uniform channels (9 ', 10') on all sides, which are edged with a correspondingly soft sound.

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

Abstract

Pour éliminer les effets traumatiques ressentis lors de la destruction extracorporelle de calculs rénaux par concentration d'ondes de choc dans un liquide, ces dernières passent à travers un filtre passe-haut avant de pénétrer dans le corps humain. Ce filtre passe-haut est avantageusement configuré comme un guide d'ondes liquide à marge acoustique faible. On utilise à cet effet une plaque en mousse (5) avec une proportion élevée de bulles d'air, dans laquelle on pratique un alésage (4) destiné au guide d'ondes. Ce procédé et ce dispositif permettent d'éliminer du champ d'ondes de choc les composantes basse fréquence de ces dernières, de manière à concentrer les seules composantes haute fréquence. Il s'ensuit une thérapie par ondes de choc indolore et rendant superflue l'anesthésie du patient.
PCT/DE1987/000526 1986-11-29 1987-11-17 Procede et dispositif pour eliminer les effets traumatiques dus a la destruction de calculs renaux Ceased WO1988003782A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DEP3640899.9 1986-11-29
DE3640899 1986-11-29
DEP3723815.9 1987-07-18
DE19873723815 DE3723815A1 (de) 1986-11-29 1987-07-18 Verfahren und vorrichtung zur eliminierung traumatischer effekte bei der nierensteinzertruemmerung

Publications (1)

Publication Number Publication Date
WO1988003782A1 true WO1988003782A1 (fr) 1988-06-02

Family

ID=25849871

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1987/000526 Ceased WO1988003782A1 (fr) 1986-11-29 1987-11-17 Procede et dispositif pour eliminer les effets traumatiques dus a la destruction de calculs renaux

Country Status (4)

Country Link
EP (1) EP0334859A1 (fr)
JP (1) JPH02500720A (fr)
DE (1) DE3723815A1 (fr)
WO (1) WO1988003782A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0300315A1 (fr) * 1987-07-23 1989-01-25 Siemens Aktiengesellschaft Générateur d'ondes de choc pour un appareil de destruction sans contact des calculs, présents dans un corps
US7988631B2 (en) 2005-08-05 2011-08-02 Dornier Medtech Systems Gmbh Shock wave therapy device with image production

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030199857A1 (en) * 2002-04-17 2003-10-23 Dornier Medtech Systems Gmbh Apparatus and method for manipulating acoustic pulses
DE10234144A1 (de) 2002-07-26 2004-02-05 Dornier Medtech Gmbh Lithotripter
JP4804906B2 (ja) 2004-12-15 2011-11-02 ドルニエル メドテック システムズ ゲーエムベーハー 循環器および神経疾患の患者における細胞治療および組織再生の衝撃波による改良方法

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1253221A (fr) * 1958-04-14 1961-02-10 Pittsburgh Corning Corp Filtres acoustiques pour conduits d'air
US4168482A (en) * 1977-04-04 1979-09-18 The United States Of America As Represented By The Secretary Of The Navy Combination acoustic filter plate and liquid lens
DE3320998A1 (de) * 1983-06-10 1984-12-13 Dornier System Gmbh, 7990 Friedrichshafen Stosswellenadapter
EP0196353A2 (fr) * 1985-04-04 1986-10-08 DORNIER SYSTEM GmbH Dispositif pour empêcher ou diminuer la douleur durant une lithotripsie extracorporelle

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1253221A (fr) * 1958-04-14 1961-02-10 Pittsburgh Corning Corp Filtres acoustiques pour conduits d'air
US4168482A (en) * 1977-04-04 1979-09-18 The United States Of America As Represented By The Secretary Of The Navy Combination acoustic filter plate and liquid lens
DE3320998A1 (de) * 1983-06-10 1984-12-13 Dornier System Gmbh, 7990 Friedrichshafen Stosswellenadapter
EP0196353A2 (fr) * 1985-04-04 1986-10-08 DORNIER SYSTEM GmbH Dispositif pour empêcher ou diminuer la douleur durant une lithotripsie extracorporelle

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0300315A1 (fr) * 1987-07-23 1989-01-25 Siemens Aktiengesellschaft Générateur d'ondes de choc pour un appareil de destruction sans contact des calculs, présents dans un corps
US4972826A (en) * 1987-07-23 1990-11-27 Siemens Aktiengesellschaft Shock wave generator for an extracorporeal lithotripsy apparatus
US7988631B2 (en) 2005-08-05 2011-08-02 Dornier Medtech Systems Gmbh Shock wave therapy device with image production

Also Published As

Publication number Publication date
EP0334859A1 (fr) 1989-10-04
JPH02500720A (ja) 1990-03-15
DE3723815A1 (de) 1988-06-09

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