Surgery – Truss – Pad
Patent
1992-01-30
1993-05-11
Smith, Ruth S.
Surgery
Truss
Pad
128 24FL, A61B 1722
Patent
active
052092348
DESCRIPTION:
BRIEF SUMMARY
This invention relates to an apparatus for the non-intrusive fragmentation of renal calculi, gallstones or the like.
It is well known that the conventional method of removing renal calculi, gallstones or the like is by surgery.
Recently however, much effort has been dedicated to the search for non-sanguinary and in particular non-intrusive techniques for fragmenting renal calculi in such a manner as to disintegrate their structure and break them down into particles which can be eliminated naturally without inconveniencing the patient.
In this respect, the "sanguinary" method is of known inconvenience in terms of hospitalization and its associated cost, plus the inevitable surgical shock. The latter in particular can be intolerable to debilitated, elderly, diabetic and other patients, so making the operation impraticable because of the increased risk factor. This and the other said inconveniences should in all cases be avoided, and this has lead to the search for other techniques. Up to a short time ago these were of intrusive character, using special active and/or passive catheters because of the traumatic side effects.
An intermediate method between the completely surgical and the catheter methods has been used in recent years. In this method, a metal probe is brought into contact with the calculus by surgical incision and then transmits to it an ultrasonic mechanical action by the effect of an ultrasonic exciter to which said probe is connected. The technique has proved effective in the fragmentation of and their succesive "natural" elimination with adjuvant clinical intervention. However, although substantially reduced, the inconvenience of even a minor surgical operation still exists.
The non-sanguinary non-intrusive techniques used up to the present time are based on the use of a field or beam of mechanical energy waves generated outside the patient's body, to interact with the constituent concretions of the calculus and cause its fragmentation by "brute force".
The mechanical energy used, which is in the form of ultrasonic or shock waves generated external to the patient, is liberated during the process of their absorption by him, and preferentially by the calculus itself (this selectivity being the distinguishing merit of these techniques) to lead to disintegration of the constituent polycrystalline concretions of the renal calculus.
The ultrasonic techniques of the known art use so-called "brute force", with peak powers reaching 100 kW. In this context, the term "brute force" is used in relation to known techniques because the apparatus concerned relies wholly on the power density applied to the constituent crystalline concretion of the renal calculus, whether it is of semi-fine or fine structure and whatever its size. This approach, especially in the case of shock waves, carries the danger of damaging other biological structures besides the renal calculi themselves, and has numerous disadvantages such as the need to totally anesthetize the patient, the need to completely immerse the bound patient in water or the like, etc.
For example, EP-A-0 133 665 cites as known art certain methods using ultrasonic waves which reach a peak power of 100 kW. The apparatus of that invention, which comprises a spark shock wave generator with wave guides and a focusing lens, certainly applies "brute force".
EP-A-0 133 946 describes a structure for disintegrating renal calculi by means of a plurality of shock wave generators which converge at a common focal point. The technique is again a shock wave and therefore "brute force" technique.
EP-A-0 162 959 describes the generation of shock waves for disintegrating renal calculi by means of an electromechanical structure comprising a pulse-energised electromagnetic coil. "Brute force" is again applied in this case.
EP-A-0 167 670 describes a system for generating shock waves by interaction between electromagnetic microwaves and the structures to be demolished. Fragmentation is thus again by "brute force".
The most recent known art, exemplified by the aforesaid patent refe
REFERENCES:
patent: 4315514 (1982-02-01), Drewes et al.
patent: 4803995 (1989-02-01), Ishida et al.
Lara Consultants s.r.l.
Smith Ruth S.
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