Coaxial location for contact free comminution of concrements

• US 4,705,026 A
• Filed: 05/08/1985
• Issued: 11/10/1987
• Est. Priority Date: 05/15/1984
• Status: Expired due to Term

• Current Assignee: Dornier Medizintechnik GmbH
• Original Assignee: Dornier System GmbH
• Inventors: Chaussy, Christian, Forssmann, Bernd, van Rijn, Dick, Hepp, Wolfgang
• Primary Examiner(s): NOT, DEFINED
• Application Number:
  US06/732,364
• Time in Patent Office: 916 Days
• Field of Search: 128/24 A, 128/33, 128/303 B, 128/660, 128/328, 378/177, 378/180
• US Class Current: 601/4
• CPC Class Codes: A61B 17/2255 Means for positioning patient, shock wave apparatus or locating means, e.g. mechanical aspects, patient beds, support arms, aiming means positioning of patients for radiation diagnosis A61B6/04; positioning of locating means inside shock wave apparatus A61B17/2256
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4417 related to combined acquisition of different diagnostic modalities
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61G 13/12 Rests specially adapted therefor; Arrangements of patient-supporting surfaces rests for the surgeon A61B90/60; restraining devices A61F5/37
• CPC Class Codes: A61G 13/121 Head or neck
• CPC Class Codes: A61G 13/1225 Back
• CPC Class Codes: A61G 13/1235 Arms
• CPC Class Codes: A61G 13/1245 Knees, upper or lower legs
• CPC Class Codes: A61G 13/125 Ankles or feet
• CPC Class Codes: A61G 13/1255 Shoulders
• CPC Class Codes: A61G 2200/325 prone
• CPC Class Codes: A61G 2210/50 for radiography

Abstract

A concrement in a human body is located by an X-ray system establishing an axis through the concrement; ultrasonic equipment determines a depth coordinate value for the concrement on that axis, and a shock gyrator and focusing system is placed on that established axis for obtaining the comminution. A rest is provided for placing the body in the action zone, and for establishing a second axis in a coordinate system; the third axis is perpendicular to the latter and defines locally the direction of position change for the various types of equipment needed to carry out the aforementioned program.

Claims

1. In a device for contactfree comminution of concrements in the body of a living being including a shock wave generating and reflecting system, at least one concrement locating system and a rest for said living being the improvement comprising:

at least one equipment carrier for said shock wave system and said one or more locating systems; and

means for displaceably supporting said equipment carrier for selective positioning said shock wave system or said one locating system in a particular position with respect to said rest to thereby obtain a particular position of either and both said shock wave system and said one locating system with respect to the rest and a body having been placed on said rest, so that the shockwave system can replace said locating system in said one particular position.

2. The improvement as in claim 1 there being a first equipment carrier and a second equipment carrier arranged with respect to said rest such that different pieces of equipment placed on the first and second carrier can be operationally coupled to each other along an axis that traverses the body of said living being when on said rest.

3. The improvement as in claim 2 wherein said first carrier carries at least one source of X-ray, the second carrier carrying an X-ray receiving device.

4. The improvement as in claim 1 said locating equipment including at least one ultrasonic imaging device.

5. The improvement as in claim 1 said rest including frame means and large area pans for providing support surfaces for parts of said living being and having lateral upward extensions for limiting lateral displacements of such parts.

6. The improvement as in claim 5 said pans including means for contour adapting to the contour of the parts of the body.

7. The improvement as in claim 1 said equipment carrier including a carriage said supporting means being provided for displacement of the carriage on the supporting means in the direction perpendicular to a longitudinal axis as defined by said rest in representation of position of the body on said rest, there being means for latching the carriage into particular operating positions.

8. The improvement as in claim 2 wherein one of said carriers is a carriage and holds X-ray receiving means and an accoustic coupling cushion, a second one of the carriers is also a carriage and holds an X-ray source, a shock wave generator and reflector, and an ultrasonic locating device.

9. The improvement as in claim 8 wherein said second carriage is generally below the rest and said first carriage above the rest.

10. The improvement as in claim 1 including a plurality of water cushions for positioning in abutment with said body so as to retain the body in a predetermined position.

11. The improvement as in claim 10 including pressure controlling means for said cushion.

12. The improvement as in claim 1, said carrier being of curved configuration.

13. The improvement as in claim 1, the locating system including pieces of equipment to be placed in physical contact with the living being, said pieces being resiliently mounted.

14. The improvement as in claim 1, including means for gapless contact making by at least one equipment piece on the carrier with the living being.

15. In a device for contactfree comminution of concrements in the body of a living being including a shock wave generating and reflecting system, at least one concrement locating system and a rest for said living being the improvement comprising:

means for positioning the concrement locating system within an X-Y coordinate system, such that a third (Z) coordinate through the origin of the X-Y system runs through the concrement;

means for measuring the Z-coordinate value of the concrement; and

means for positioning the shock wave generating and reflecting system on said Z coordinate for being effective at a depth corresponding to the measured Z-coordinate value.

16. A method for contactless comminution of concrements in the body of a living being, comprising the steps of:

locating a concrement by means of X-rays such that an axis for a beam of X-rays runs through the concrement;

marking a representation of that axis such that subsequently other equipment can be located with respect to said axis;

measuring a depth value for the concrement on the axis under utilization of the representation of the axis;

positioning a shock wave generating and focussing device on said axis under utilization of the representation of the axis and under further utilization of said dept value as measured; and

operating said device for comminution of the located concrement.

17. Method as in claim 16, said measuring step using ultrasonic depth measurement.

18. Method as in claim 16, wherein said locating, measuring and positioning steps are carried out with reference to a rest for said body.