Surgery: kinesitherapy – Kinesitherapy – Contact-free comminution of concretion
Patent
1998-03-19
2000-05-09
Lateef, Marvin M.
Surgery: kinesitherapy
Kinesitherapy
Contact-free comminution of concretion
A61B 1722
Patent
active
060597410
DESCRIPTION:
BRIEF SUMMARY
DESCRIPTION
1. Technical Field
The present invention relates to a device for treating corporal tissue and/or for crushing corporal concretions by means of acoustic energy, by way of illustration by means, of shock, pressure or ultrasonic waves according to the generic part of claim 1.
2. State of the Art
A device on which the wording of the generic part of claim 1 is based is known from EP-A-0 369 177. This printed publication, to which including the state of the art of the Search Report cited therein reference is explicitly made with regard to the explanation of all details not mentioned or described closer herein, describes a device which, e.g. can be utilized as an extracorporal lithotriptor.
The known devices of this type are provided with a sound generating unit which generates a plane, a cylindrical, an approximately ball-shaped or an already focused wave field in a transmission medium. If the generated wave field does not have the desired "bundling" respectively focusing, a bundling unit for the acoustic waves is disposed downstream of the sound generating unit. The bundling unit may be a reflector with a, depending on the design of the sound generating unit, paraboloid or elliptical cross section, shock wave tube and/or an acoustic lens, etc.
In the known processes of extracorporally induced lithotripsy or ultrasonic thermotherapy, the sound generating unit and, if need be, the provided bundling unit are disposed outside the human body, i.e. extracorporally. Depending on the treatment procedure to be carried out, continuous, pulsed or repetitive acoustic wave fields (pressure, shock, pulsed or unpulsed ultrasonic fields) are generated outside the body, coupled into the body via a coupling-in surface and concentrated at a target site in the body.
In the present commercially available lithotriptors, the acoustic waves are generated in water and then are coupled into the body via a water cushion or also in an open water bath. For good coupling-in, water seems to have much to recommend it as the transmission medium, because with good approximation it can be assumed that the corporal tissue and water have similar acoustic impedance. In this way the acoustic energy is transmitted into the body without major reflection losses. Water also has much to recommend it because it is easy to handle. This is the reason that today all known lithotriptors and ultrasonic thermotherapy devices work with water as the transmission medium.
In doing so the following has been assumed:
The acoustic impedance Z is defined by the product of the density and the sound propagation velocity c. If the impedance Z of the transmission medium is the same as or at least is approximately the same as the impedance of the corporal tissue, low loss energy coupling-in is ensured. This goal is also achieved even if the values for the density and the sound velocity differ distinctly in the two media as long as only the product of the respective values of the two media are at least approximately the same.
DESCRIPTION OF THE INVENTION
The present invention is based on understanding the following:
For the therapeutic effect of pressure, shock or ultrasonic waves not only the amount of the coupled-in energy is of significance but rather the concentration of energy is important for the actual action area. The focal energy density that can be reached in the body is decisively influenced by whether the waves can propagate without hindrance or whether they are deflected from the intended propagation direction by obstacles, i.e. refracted, scattered or bent. The deviations from the desired propagation direction are so much larger the farther they occur before the zone of action.
Obstacles at which the deviation from straight propagation occurs are, e.g. interfaces of organs where refraction and reflection occur due to a change in the propagation velocity. By way of illustration, the ultrasonic wave propagation velocity in the kidneys or in the liver differs partly by more than 50 m/s from in water.
An element of the present invention is that it w
REFERENCES:
patent: 5060634 (1991-10-01), Belikan et al.
patent: 5144953 (1992-09-01), Wurster et al.
patent: 5305731 (1994-04-01), Buchholtz
patent: 5810748 (1998-09-01), Ueberle
Lateef Marvin M.
Patel Maulint
Storz Medical AG
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