U.S. patent number 3,823,717 [Application Number 05/351,140] was granted by the patent office on 1974-07-16 for apparatus for disintegrating concretions in body cavities of living organisms by means of an ultrasonic probe.
This patent grant is currently assigned to Reimar Pohlman. Invention is credited to Manfred Cichos, Reimar Pohlman.
United States Patent |
3,823,717 |
Pohlman , et al. |
July 16, 1974 |
APPARATUS FOR DISINTEGRATING CONCRETIONS IN BODY CAVITIES OF LIVING
ORGANISMS BY MEANS OF AN ULTRASONIC PROBE
Abstract
An ultrasonic probe for disintegrating concretions e.g. urinary
calculus, in body cavities comprises a probe tube, ultrasonically
vibrated in a longitudinal direction, having at one end a tubular
impact element loosely coupled to it in the direction of vibration.
The impact element is provided on its free end with a cutting edge,
preferably formed by a plurality of teeth. The disintegrated
concretions are continuously evacuated through the tubular impact
element and the tubular probe.
Inventors: |
Pohlman; Reimar (Aachen,
DT), Cichos; Manfred (Aachen, DT) |
Assignee: |
Pohlman; Reimar (Aachen,
DT)
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Family
ID: |
5842932 |
Appl.
No.: |
05/351,140 |
Filed: |
April 16, 1973 |
Foreign Application Priority Data
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Apr 22, 1972 [DT] |
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2219790 |
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Current U.S.
Class: |
606/128; 604/22;
606/169; 601/4 |
Current CPC
Class: |
A61B
17/22012 (20130101); B02C 19/18 (20130101); A61B
2017/320073 (20170801) |
Current International
Class: |
A61B
17/22 (20060101); B02C 19/00 (20060101); B02C
19/18 (20060101); A61B 17/32 (20060101); A61b
017/32 () |
Field of
Search: |
;128/303,24A,305,276,328,319 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Claims
We claim:
1. An apparatus for disintegrating concretions in body cavities in
living organisms, comprising a tubular probe adapted to be
ultrasonically vibrated longitudinally and a tubular impact element
loosely coupled in the direction of vibration to one end of said
tubular probe whereby the ultrasonic vibrations transmitted to the
impact element are transformed into shock forces.
2. An apparatus as claimed in claim 1, wherein the end of the
tubular impact element remote from said coupling is constructed as
a cutting edge.
3. An apparatus as claimed in claim 2, wherein the cutting edge is
constituted by a plurality of teeth.
4. An apparatus as claimed in claim 3, wherein the teeth are of an
undercut, trapezoidal construction so that their cutting surfaces
are larger than their root surfaces.
5. An apparatus as claimed in claim 3, wherein the teeth are
arranged mutually joggled or twisted so that a line connecting the
outer edges of the teeth has a greater diameter than the external
diameter of the impact element and a line connecting the inner
edges of the teeth has a smaller diameter than the internal
diameter of the impact element.
6. An apparatus as claimed in any of the claim 2, wherein the
impact element is guided loosely with slight radial and axial play
on the end of the tubular probe.
7. An apparatus as claimed in claim 6, wherein the impact element
is prevented from dropping out of the tubular probe by retaining
pins which engage in slots provided in the impact element.
8. An apparatus as claimed in claim 6, wherein the impact element
is loosely supported by a cap sleeve secured to the tubular
probe.
9. An apparatus as claimed in claim 6, wherein the impact element
is supported by a helicoidal spring contacting the tubular probe
and the impact element.
10. An apparatus as claimed in claim 6, wherein the impact element
is supported by a resilient tube contacting the tubular probe and
the impact element.
11. An apparatus as claimed in claim 6, wherein those parts of the
ultrasonic probe tube and of the impact element where the two
components are in mutual contact during their axial movement caused
by the ultrasonic vibrations are of rounded tapered construction of
at least one of said parts.
12. An apparatus as claimed in claim 1, wherein the ultrasonic
probe tube is adapted to be connected to an exhaustor device.
Description
BACKGROUND OF THE INVENTION
This invention relates to an apparatus for disintegrating
concretions in body cavities of living organisms by means of an
ultrasonic probe.
It is known to treat hard and brittle materials by means of
ultrasonic vibrations. In this case a tool profiled in any desired
manner and excited to longitudinal vibrations is lowered into the
material to be treated with interposition of a boron carbide
suspension. By this means perforations, dies etc. can be made in
hard and brittle materials.
The present invention pursues a totally different purpose, namely
to produce brittle fractures in hard and brittle bodies in order to
destroy the said bodies, e.g. urinary calculus. By this means it is
desired to destroy or disintegrate a urinary calculus present in
the human bladder to such an extent that the debris can be
exhausted or removed from the bladder through natural channels
without difficulty.
Now when it is attempted to obtain brittle fractures by means of
ultrasonic vibrations, although e.g. in the case of disintegration
of urinary calculus, relatively soft types of calculus such as
phosphate calculus, can be reduced fairly rapidly by ultrasonic
vibrations; on the other hand harder types, such as urate calculus,
oxalate calculus, can only be disintegrated into small debris
extraordinarily slowly, or even not at all.
Known apparatusses operate on the principle that a concretion
present in a body cavity is touched by a rod-shaped ultrasonic
probe introduced through natural channels, whereupon by pressing
the concretion against the wall of the body cavity the ultrasonic
vibrations are transmitted to the concretion and the latter is
thereby destroyed. Because the pressure forces required in this
case are relatively powerful, there is a risk, more particularly
with small smooth concretions, that the sonic probe may slip off,
so that the wall of the body cavity may become damaged. Moreover,
if such small smooth concretions are also extremely hard, then in
the majority of cases they cannot be disintegrated at all by this
procedure, because they move away at the very first contact by the
ultrasonic probe.
Furthermore, the known apparatus suffers from another disadvantage.
When it is actually possible to disintegrate a concretion, then in
every case initially the disintegrated debris of the calculus and
the stone dust suspended in the liquor are left behind in the body
cavity. This gives rise to on the one hand to a visual obstruction
for the optical examination instrument (endoscope) introduced with
the ultrasonic probe, and on the other hand to the necessity of
removing the stone residues from the body cavity by a separate
operation, which furthermore can no longer be performed under
visual control. For this purpose the ultrasonic probe must be
removed out of the body cavity and another instrument, for example
a so-called suction syringe, must be used.
SUMMARY OF THE INVENTION
The invention aims at providing an apparatus for disintegrating
concretions in body cavities by means of an ultrasonic probe,
whereby the disadvantages of the apparatusses of this type hitherto
known are obviated.
To this end, the present invention consists in an apparatus for
disintegrating concretions in body cavities in living organisms,
comprising a tubular probe ultrasonically vibrated longitudinally
and a tubular impact element loosely coupled in the direction of
vibration to one end of said tubular probe whereby the ultrasonic
vibrations transmitted to the impact element are transformed into
shock forces.
Due to the interposition of the impact element, the shattering
effect of the ultrasonic vibrations is increased by orders of
magnitude. The impact element should be as hard and highly elastic
as possible, and is arranged loosely between the ultrasonic probe
and the body to be disintegrated. This unyielding element is
capable of "collecting" impulse shocks statistically from the
ultrasonic vibrations acting periodically upon it, and to transmit
them in very brief and highly intensive impact shocks to the body
to be disintegrated. It has been found that these "collected"
highly intensive impulse shocks can achieve orders of magnitude and
can initiate percussive forces which exceed many times the pressure
peaks transmitted periodically by the ultrasonic probe tube and are
capable of causing the desired brittle fractures. Even the hardest
types or urinary calculus (urate and oxalate calculus) can be
destroyed by this means.
By virtue of the tubular construction of the impact element and of
the ultrasonic probe tube, it becomes possible to exhaust the
fragments of calculus continuously by an exhauster device as they
are detached during the actual disintegration operation, so that it
is unnecessary to use additionally a further apparatus to exhaust
them after the disintegration of the concretion. Furthermore, the
continuous exhaustion of the fragments of calculus and of the stone
dust produce the further advantage that no obstruction of vision
for the optical observation instrument (endoscope) occurs. And
lastly, the exhaustion of the fragments of calculus also sucks the
calculus itself towards the front end of the tubular impact
element, so that on the one hand it centres itself automatically
upon the impact element, so that the latter is largely prevented
from slipping off, while at the same time a certain contact
pressure is generated whereby the contact force against the wall of
the body cavity which was hitherto necessary is substantially
reduced. Since furthermore the shocks of the impact element only
have a destructive effect when they strike hard bodies, no injury
to the soft wall of the body cavity occurs even if the latter is
accidentally touched.
The characteristic property of the impact element to transform the
ultrasonic vibrations transmitted to it into powerful shock forces
of low frequency produces a number of advantages:
Only a much weaker contact pressure is required to achieve the
desired effect, compared to the apparatusses hitherto known.
Furthermore, it is possible to destroy with ultrasonic vibrations
of hitherto customary amplitude and power, concretions which would
have withstood destruction without the interposition of an impact
element.
Preferably, the end of the tubular impact element remote from said
coupling is constructed as a cutting edge which may advantageously
be constituted by a plurality of teeth. The efficacity of the
destruction of concretions is increased by these measures.
It is furthermore advantageous to make the teeth of undercut
trapezoidal construction so that their cutting surfaces are larger
than their root surfaces, since in this manner the disintegrated
culculus material can easily be discharged by the exhaustion
operation. Furthermore, if the teeth are arranged mutually joggled
or twisted, so that their cutting edges project partly beyond the
outer circumference of the tube supporting them and into the
interior space of the said tube, then on the one hand the risk of
the impact element seizing in the calculus is reduced, while on the
other hand it has the effect that the diameter of the hole
generated is greater than the diameter of the impact element
carrying the teeth, and the stone fragments are smaller than the
internal diameter of the impact element and of the tubular
ultrasonic probe. In this way a clogging of the entire instrument
by the disintegrated stones is reliably obviated. Furthermore the
advantage is obtained that with this mode of construction the
tubular impact element tends to "dance" in the peripheral
direction, so that it repeatedly strikes fresh points of the
concretion to be destroyed.
The impact element is preferably guided loosely with slight radial
and axial play on the end of the ultrasonic probe tube. In this
case the impact element can be prevented from falling out by
various measures which later be more fully explained.
It has further been found particularly advantageous to construct
the ultrasonic vibrator tube and/or the impact element coupled to
it, at the mutual contact surfaces, so that a linear or punctiform
contact occurs, since in the case of an areal contact the recoil of
the element is considerably impaired by the adherence layer of
interlying liquid. The elastic shock conditions are also
appreciably improved.
BRIEF DESCRIPTION OF THE DRAWINGS
In order that the invention may be more readily understood,
reference is made to the accompanying drawings which illustrate
diagrammatically and by way of example several embodiments thereof,
and in which:
FIG. 1 shows the front end of an ultrasonic probe with tubular
impact element, partly in section;
FIG. 2 shows the side elevation of the cutting edge of the impact
element with trapezoidal teeth;
FIG. 3 shows the plan of the cutting edge with twisted teeth and of
the impact element (in a section along the line III--III of FIG.
1);
FIG. 4 shows an impact element with rounded and corrugated impact
surface;
FIG. 5 shows an impact element with conical impact surface and cap
sleeve;
FIG. 6 shows an impact element with helicoidal spring retaining
means; and
FIG. 7 shows an impact element with tubular retaining means.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring to FIG. 1, an ultrasonic probe comprises a tube 1 and an
impact element 2. The tube 1 is oscillated longitudinally by an
ultrasonic generator indicated by the double arrow 27. The impact
element 2 is likewise of tubular construction and carries at one
end teeth 7 as a cutting edge. Due to the longitudinal oscillations
of the tube 1, impulses are transmitted to the impact element 2,
which are intensified in the above described manner into very
powerful impulse peaks, because the impact element 2 is supported
loosely in the radial and axial direction in or on the tube 1. The
loose mounting of the impact element is ensured in that a
sufficient tolerance in the radial direction is provided by shank
guide means 4 in the end of the tube 1, whilst axial movement of
the impact element 2 is limited on the one hand by an impact
surface 3 on the element 2 and on the other hand by retaining pins
5, 5' which engage in slots 6, 6' in the impact element 2, so that
the impact element 2 is prevented from dropping out of the tube 1.
The teeth 7 of the impact element 2 constructed as a tube section
are arranged joggled, so that only those fragments of the
concretion treated which have a smaller diameter than that of the
tube can penetrate into the tube 1, so that easy evacuation of the
fragments in the direction of the arrow 27 through the tube 1 is
possible.
As FIG. 2 shows, the teeth 7 are advantageously of trapezoidal
construction with their wide side acting as chisels, so that they
do not jam in the case of a less brittle concretions, but can
automatically bore themselves free. The discharge of the material
to the exhaustor device is furthermore greatly facilitated by this
means.
FIG. 3 illustrates the impact element 2 viewed axially in plan and
partly in section along the line III--III of FIG. 1. The teeth 7
are arranged twisted so that a line connecting the outer edges of
the teeth has a greater diameter than the outside diameter D of the
impact element 2, whilst a line connecting the inner edges of the
teeth has a smaller diameter than the inside diameter d of the
impact element 2.
FIG. 4 shows a construction of the impact surfaces at the front end
of the ultrasonic probe tube 8 and on the impact element 9. The end
of the tube 8 is substantially conically countersunk at its end
face 9a, whereby an automatic centering of the impact element 9 is
created. The impact element 9 is rounded at its contact surface 10,
so that its rests not upon a plane surface but only upon an
encircling line. If desired, the rounded support surfaces 10 may be
corrugated as at 10a, so that only support points remain.
FIG. 5 shows the mode of supporting an impact element 11 on an
ultrasonic probe tube 12 by a cap sleeve 13. In this case, for the
purpose of automatic centering, both the impact surfaces 14, 15 are
conically tapered.
FIG. 6 illustrates an embodiment in which an impact element 16 is
loosely supported on an ultrasonic probe tube 17 by means of a
helical spring 18. The spring is dimensioned so that in the rest
position a small gap 19 remains between the impact element 16 and
the tube 17, which is closed only when the impact element 16 is
pressed against the tube 17, so that energy is transmitted only
then. By virtue of this construction, during idle running, the
excited but inoperative ultrasonic vibrator does not touch the
impact element at all and avoids unnecessary wear of the impact
surfaces and stressing of the support means.
FIG. 7 shows means for supporting an impact element 20 on an
ultrasonic probe tube 21 by means of a soft resilient sleeve 22
which can be adjusted so that again a small gap 23 remains between
impact surfaces 24, 25. The impact surfaces may be rounded and/or
conically tapered.
* * * * *