LITHOTRIPTER WITH TWO LOCALIZATION DEVICES IN AN ISOCENTRIC SYSTEM

Abstract: A lithotripter (13), and a device for the localization of calculi (11), are mounted on radially moving slides attached to the supporting ring (10). In this manner, their longitudinal axes lie in the same diametric vertical plane, and pass through the center of the supporting ring. The angular distance between the longitudinal axes of the two devices is fixed, as determined by their mounting on the ring. An echograph, with its illustrated free floating probe (19), is interfaced with a computer. The origin of the echograph coordinate system corresponds to both the center of the rotating ring, and to the calculus (16), in the patient's body (14).

Description: "LITHOTRIPTER WITH TWO LOCALIZATION DEVICES IN AN ISOCENTRIC SYSTEM" This present invention concerns an assembled lithotripter with two localizat devices for the calculi, interfaced with a computer in an isocentric system, that allows the 5. simultaneous identi ica ion and control of the f gmentati n of a calculus without the need to move the patient. Ac rding the present n ledge the technique, lithotripters are machines that 10. generate shock waves, which are focused on a cal ulus through a se iellipsoid reflector, causing the fragmenta ion of the calculus in a line f progression that begins at he surface of the Shockwave entry and ends at the point of 15. shoc wave exi . Acc rding to the present owledge of the techniqu , the p siti f the calculus is determined with the aid of a radiological device by echography. Subsequ n ly, the 20. l i h t ipter i used for the fragmen i n. - S - One of the main objects of this present invention is to be able to use a li hotrip er in combination with two localization devices, radiological and echographic, in real time, utsed 5. individually or simultaneously, without moving the patient, by viewing either the radiology or the echography screen. This results in maximum precision in the localization of the calculus, eliminates 10. possible errors of the single system of localization, and allows 1 cal ization of the entire spectrum of the renal and biliary calculi . Another object of this present invention is 15. to be able to isocentricly vary the direction of the sh waves of the lith tripter, changing its delivery angle in the desired direction, without having the calculi move from the position defined by the focus of the ellipsoid, 20. and without the need to move the patient. These and other objects that will appear in more detail later on, have been achieved according to the present invention, by an assembled lithotripter with two localization 25. devices for the calculi, interfaced with a computer in an isocentric system. For the purpose of attaining these objects described, and to achieve an isocentric system, the lithotripter and one of the l calizati n devices for the cal uli, in this parti ular instance the radiological device, have been mounted on radially moving slides attached to a component in the shape of a ring. In this 5. manner, their longitudinal a s lie in the same diametric vertical plane, and pass through the center of the supporting ring. The angular distance between the longitudinal axes of the two devices is fixed, as determined by their 10. mounting on the ring. The echograph, instead, is interfaced with a computer, in which the origin of the coordinate system corresponds to the center of the supporting ring. Consequently, with this present invention a 15. device is obtained which, on the whole, is far more efficient. It may also be used for other types of operations, for example endour 1 og ica1 , or traditional diagnostic procedures, which can be performed simultaneously, without the need to 20. move the patient. These and other features and advantages of the present invention will become apparent with reference to the accompanied drawings, that ar e enclosed only for illustrative purposes and 25. not restrictive , in which: Fig. 1 illustrates a drawing of the assembly of a lithotripter with lo alizatio devices f r calculi, according to the presen invention; Fig. 2 illustrates an assembly of a lithotripter with localization devices for calculi according to fig. 1, in a rotated position of 9O° ; _ Fig. 3 illustrates an assembly of a lithotripter with localization devices for calculi according to figure 1, in a rotated position of IB0°; Fig. is the schematic representation of 10. how a calculus can be reached from two different di ections; Fig. 5 illustrates how easily the calculi can be fragmented, with a lithotripter according to present invention; 15. In the different drawings the same numerals 3mi-e used for the corresponding parts. Referring to the drawings, a radiological tube (11), is mounted on the supporting ring (lO) , with an associated luminance amplifier 20. (IS) , which is connected to a computer not shown in the drawing. In the middle position between the radiological tube (11), and the luminance amplifier (IS) , a lithotripter (13) is mounted. The patient's body ( 1 * ) , is positioned on the 25. bed (15) , and is introduced inside the supporting ring. The bed (15) on which the patient's body rests and the ring (10) supporting the two components, known as the radiological tube (11) and the luminance amplifier (IS) , are ved until the calculus (lό) ispositi ned e actly at the center o the supporting ring ( 1O ) , and lies in the z ne that is reated by the rays (17) , 5. (Fig . Ξ) . The radiological device (11 and 12) provide the computer with the x, y, and z coordinates of the calculus to be treated. The same coordinates can be provided by an 10. echograph, (whose monitor is not illustrated) , by means of a free floating probe ( 19) . The echograph is connected to a computer, which calculates the position of the calculus and provides the requi ed table position (x, y, and 15. z as above) which will cause the position of the calculus to coincide with the center of the supporting ring (10 . The lithotripter (13) , lies on the same plane as the radiological device (11 and 12) , 20. and points directly to the center of the ring (10 , in which the lithotripter is mounted at a fi ed ngle o the direction f the ray's a is (17) , and can be shifted along its own radial axis (18) , to bring it as close as necessary to 25. the patient's body ( 1<+ ) , in order to focus the shod-. aves on the cal ulus t be fragmented (Fig. 1 and 3) , which have been identified by the c uter, by radiological me s, or by echograph ica1 ones. Once the calculus is positi ned at the center of the device, sh uld one verify that another solution would be preferable, with respect to the one chosen originally, and that eventually it would be more 5. expedient to fragment the calculi with waves that originate from different directions, as illustrated in Fig. 4-, the supporting ring (10), and the lithotripter (13), may be rotated to the desired position without any need to move the 10. patient, since once localized by the current invention the calculus will always remain centered . This is especially useful in the case of big calculi, whose f agmentation is easier when 15. the delivery angle of the waves comes from different directions (Fig. 5) . Figures 1, 2, and 3 show three different positions of the supp rting ring (10) , that carry the radiological device (11) , and the 20. lithotripter (13) . These drawings show various delivery angles, to illustrate the versatility of the assembly of the components according to the present invention. The lithotripter (13) and the radiological 25. device (11) can be si ultaneously rotated in a range of appro ima ely 260°, remaining centered on the same fo us. Maximum precision and minimal trauma to the pa ent results from the precise lo alizati n o the calculus, the is centric nature of the system, and the subsequent visu lization of the fragmentation process in real time. Du t the simultaneous use of the radiological and 5. echographic devices, the isocentric system, according to the present invention, is particularly versatile, and usable for any type of l calization and cal uli. According to a preferred embodimen of the 10. invention, the size of the minor diameter, of the semiellipsoidal reflector used to focus the shock waves is greater than that of other known 1 i hotr ipterε , which decreases the algogenic stimuli caused by the sho k waves on the ski ; 15. this is very beneficial in the range of about 30 cm . With the lithotripter m unted n a supp rting ring, maintenance and electrode changing becomes more efficient in respect to 20. other known lithotripters due to the accessibility of the lithotripter on this present inv ntion.

Claims: CLAIMS 1. A lithotripter (13), which is differentiated by the fact that it is assembled with two localization devices for calculi (11 and 19) , interfaced with a computer in an 5. isocentric system. 2. A lithotripter (13) , according to Claim 1, which is differentiated by the fact that the localization devices of the calculi consist of a radiological device (11) , and by an echograph 10. device (19) , that can either be used individually or simultaneously, without moving the patient's body (1»^). 3. A lithotripter (13), according to Claims 1 and 2, which is differentiated by the fact 15, that it is mounted on radially moving slides attached to the supporting ring (10) , together with the radiological device (11); the radiological device (11) and the lithotripter (13) are placed, with the axis on the 20. diametrical vertical plane at a fixed angle relative to each other. . A lithotripter (13) , ac ording o the above mentioned claims, which is differentiated by the fact that the echograph 25. (19) , is interfaced with a computer, in which the origin of the coordinate system correspond to the center of the supporting ring (10) . 5. A lithotripter (13) , according to Claim 1 , which is diff r ntiated by the fact that the over all size of the minor diameter of the ellipsoid, which constitutes the reflector 5. of the shock waves of the lith trip er, is about 30 cm. 6. A lithotripter (13) , assembled with two localization devices for calculi (11 and 19) , interfaced with a computer in an isocentric 10. system, substan ially as described to include one or more of the features described or/and illustrated above (Fig.l — 5) .

Inventors: PUPPO PAOLO, PUPPO, PAOLO
Applicants: MEDAS SPA
Application year: 1989
Main classification: A61B17
IPC codes: A61B6, A61B8, A61B17