Abstract:
A reflector ( 14 ) reflects energy emitting from an energy source ( 16 ) and focuses and directs it to a target. An aperture stop or suppressor disk ( 18 ) is positioned between the energy source ( 16 ) and target. The outer periphery of the aperture stop or suppressor disk ( 18 ) is an irregular curve (FIGS.  12  and  13 ). This shape of the periphery prevents diffraction enhancement to the direct wave. In another emobidment, the suppressor disk ( 18 ) is replaced by a suppressor member ( 18′ ) that is directly mounted on a frame portion of the energy source ( 16 ). This energy source ( 16 ) includes a spark-gap, or the like, and an open frame ( 36 ) that surrounds the spark-gap ( 52 ) or the like. This frame ( 32 ) includes a pair of laterally spaced apart frame members ( 42, 44 ) on the side of the frame ( 36 ) that faces the target (F 2 ). The suppressor member ( 18′ ) is connected to these frame members ( 32, 44 ). It may have longitudinal grooves ( 48, 50 ) in its side edges into which the frame members ( 42, 44 ) snap-fit.

Description:
RELATED APPLICATION  
       [0001]    This application is a continuation-in-part of application Ser. No. 10/266,874, filed Oct. 8, 2002, and entitled Direct Wave Cavitation Suppressor For Focused Shock-Wave Devices. 
     
    
       [0002] The subject invention was made under DARPA contract no. N00014-99-1-0793, managed by ONR, and developed under NIH grant P01 DK 43881-09. 
     
    
     
       TECHNICAL FIELD  
         [0003]    This invention relates to shock-wave focusing devices, e.g. electrohydraulic and electromagnetic lithotripters. More particularly, it relates to a method and apparatus for making the focused shock-wave more efficient, enabling it to perform its function in a shorter period of time.  
         BACKGROUND OF THE INVENTION  
         [0004]    Shock-wave devices are commonly used clinically for therapeutic treatment. For example, an electrohydraulic shock-wave lithotripter is a device that generates a focused shock-wave and directs it onto a clinical target, such as a kidney stone. An electrohydraulic shock-wave lithotripter is only one example of the shock-wave devices that can benefit from the present invention. This device is characterized by a focusing reflector having spaced-apart first and second foci. A shock-wave generator is positioned substantially at the first foci and is adapted to discharge shock-wave creating energy outwardly from itself to the focusing reflector. The focusing reflector is configured to receive shock-wave energy and focus it and direct it as a focused wave to a target (e.g. kidney stone) at the second foci.  
           [0005]    One use of a shock-wave focusing device is to fragment kidney stones into small pieces that can then be safely removed from a patient via the urinary tract. There is evidence that normal tissue can at the same time be damaged. Several thousand shock-wave generations are necessary to fragment a kidney stone. The clinician takes care to operate the lithotripter at the highest safe rate of operation. Currently, the instrument is operated typically at 0.5-2.0 Hz pulse repetition frequency (PRF). There is a need to decrease the total number of shock-waves that are delivered to the kidney stone to cause its comminution, in order to reduce the unwanted and unhealthy bioeffects on healthy tissue.  
           [0006]    A principal object of the present invention is to increase the efficiency of a focused shock-wave device so that it can perform its function satisfactorily by use of a reduced number of focused shock-waves or by an increased PRF.  
         BRIEF SUMMARY OF THE INVENTION  
         [0007]    The invention includes the discovery that the effectiveness of focused shock-waves is decreased by direct waves emanating from the shock-wave generator. The shock-waves diverge spherically from the shock-wave generator. Those shock-waves that strike the focusing reflector are focused by the reflector to form the focused shock-wave that is then directed to a target, e.g. a kidney stone. The direct waves are those shock-waves that miss the reflector and move directly to the target. It has been observed that direct waves cause a premature growth of preexisting bubbles on and near the target. These bubbles can act as a protective membrane around the region of target, decreasing the efficiency of the focused shock-wave. It has been discovered, by removing or decreasing the effect of the direct wave, premature bubble growth is reduced.  
           [0008]    One embodiment of the present invention is basically characterized by providing a direct-wave cavitation suppressor and positioning it between the first and second foci of the focusing reflector, in a position to block direct shock-waves from traveling from the shock-wave generator directly to the second foci. The direct-wave cavitation suppressor has a periphery spaced inwardly from the focusing reflector. The outer periphery is shaped to substantially prevent diffraction enhancement of the direct waves as it moves around the direct-wave cavitation suppressor.  
           [0009]    Typically, the focusing reflector includes a reflecting surface of at least near elliptical shape. Typically also, the shock-wave generator is an electric spark discharge device. In preferred form, the direct-wave cavitation suppressor is generally in the form of a disk having an irregular periphery.  
           [0010]    Another aspect of the invention is to provide a method of producing a focused shock-wave and delivering it to an object. This method is basically characterized by providing a shock-wave generator and a focusing reflector positioned to direct a focused shock wave on an object. A direct-wave cavitation suppressor is positioned between the generator and object in a position to block direct waves from traveling directly from the generator to the object. The shock-wave generator is operated to discharge shock-wave creating energy outwardly from itself. The focusing reflector is used to receive shock-wave energy and focus it and direct it as a focused wave on the object. The direct-wave cavitation suppressor is configured to substantially block the direct shock waves from traveling directly to the object. The direct-wave cavitation suppressor is also configured to prevent diffraction enhancement of the direct waves as they move around the direct-wave cavitation suppressor. In preferred form, the direct-wave cavitation suppressor is generally in the shape of a disk having an irregular periphery. In one form, the focusing reflector is shaped substantially like an end portion of an ellipse. An electrical spark discharge device or an electromagnetic generator is used for the shock-wave generator.  
           [0011]    Another object of the invention is to provide a shock-wave device characterized by a focusing reflector configured to receive shock-wave energy and focus it and direct it on a target. The shock-wave generator includes a frame portion that surrounds the location where the shock-wave energy is generated. A direct cavitation suppressor is mounted on this frame portion of the shock-wave device, on the target-side of the device, in a position to block direct shock-waves from traveling from the shock-wave generator directly to the target.  
           [0012]    In preferred form, the shock-wave device comprises an electric spark discharge device surrounded by a frame that includes a pair of laterally spaced apart frame members on the side of the shock-wave device that faces the target. The direct-wave cavitation suppressor is mounted on these frame members. The direct-wave cavitation suppressor may have a pair of longitudinal edges, each including a longitudinal groove in which one of the frame members is received. The frame members are snap-fittable into the grooves. 
       
    
    
       [0013]    Other objects, advantages and features of the invention will become apparent from the description of the best mode set forth below, from the drawings, from the claims and from the principles that are embodied in the specific structures that are illustrated and described.  
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING  
       [0014]    Like reference numerals are used to designate like parts throughout the several views of the drawings, and:  
         [0015]    [0015]FIG. 1 is a diagram of a shock-wave lithotripter that is in the public domain, such view showing a shock-wave generator and its relationship to a truncated ellipsoidal reflector, direct and focused shock-waves and a second foci at which the focused wave is directed;  
         [0016]    [0016]FIG. 2 is a plot of light-scattered signal level versus relative time, such graph showing the influence of the direct wave precursor on preexisting bubbles that respond to the direct wave before the main shockwave arrives at the second foci;  
         [0017]    [0017]FIG. 3 is a numerical simulation of the relative amplitude and timing of the direct and focused waves;  
         [0018]    [0018]FIG. 4 is a plot of bubble radius versus relative time based on an assumed direct wave amplitude that is a factor of 20× smaller than the focused wave amplitude;  
         [0019]    [0019]FIG. 5 is a graph like FIG. 4 but showing the effect of changing the direct wave prefactor, such view showing a 10× prefactor and a 30× prefactor;  
         [0020]    [0020]FIG. 6 is another graph plotting experimentally measured bubble radius versus relative time, such graph showing a precursor signal corresponding to bubble growth due to the direct wave;  
         [0021]    [0021]FIG. 7 is a plot of the hydro-phone detected direct wave at F 2  and a numerical simulation of the direct wave;  
         [0022]    [0022]FIG. 8 is a plot of precursor amplitude versus relative time and a comparison with a numerical simulation;  
         [0023]    [0023]FIG. 9 is a diagram of a true ellipse, showing that an ellipse is the locus of a point the sum of whose undirected distances from two fixed points equals a constant, wherein the two fixed points are the foci or focal points of the ellipse;  
         [0024]    [0024]FIG. 10 is a diagram of a truncated ellipse showing both foci, and including two lines extending outwardly from the first foci to the truncated ellipse and reflecting from a contacting point on the ellipse to the second foci, such view being a geometric diagram of the shock-wave lithotripter shown by FIG. 1, minus the direct and focused waves;  
         [0025]    [0025]FIG. 11 is a diagram like FIG. 10 but including the direct wave cavitation suppressor of the present invention minus structural detail;  
         [0026]    [0026]FIG. 12 is a view taken substantially along line  12 - 12  of FIG. 15, but with the suppressor disk tilted somewhat to show the thickness dimension of the suppressor disk;  
         [0027]    [0027]FIG. 13 is a view similar to FIG. 12, but with a support arm added to the suppressor disk and with the suppressor disk and the support arm rotated forwardly from the lower end of the support arm from a true elevational view;  
         [0028]    [0028]FIG. 14 is a side view of the suppressor disk and support arm shown by FIG. 13, showing the lower end of the support arm connected to a support member which includes a screw hole for receiving a screw that is used to adjustably mount it onto a housing portion of the shock-wave lithotripter;  
         [0029]    [0029]FIG. 15 is a diagram showing a broken line showing of how the direct wave intercepted by the suppressor disk would be focused if the suppressor disk had a smooth edge;  
         [0030]    [0030]FIG. 16 is a view like FIG. 15 but showing the disk mounting structure that is illustrated by itself in FIG. 14 added to the reflector housing;  
         [0031]    [0031]FIG. 17 is a view like FIG. 1, but with a suppressor disk added, such view showing the suppressor disk mounted on a portion of the shock-wave generator;  
         [0032]    [0032]FIG. 18 is a view like FIG. 17 but showing a suppressor member mounted onto the frame portion of the shock-wave generator in a position to block the direct waves;  
         [0033]    [0033]FIG. 19 is a fragmentary view taken from the aspect of line  19 - 19  of FIG. 18, such view showing the suppressor member positioned between two laterally spaced apart frame members; and  
         [0034]    [0034]FIG. 20 is a sectional view taken substantially along line  20 - 20  of FIG. 19, showing one manner of securing the suppressor member to the frame members. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0035]    [0035]FIG. 1 is a schematic diagram of a prior art lithotripter  10 . It comprises a body  12  formed to provide a focusing reflector  14  and mounts a spark discharge device  16 . The focusing surface  14  is an end portion of an ellipsoid or has a curvature that will perform substantially like an elliptical reflector. For background purposes, FIG. 9 is a diagram of a true ellipse. By definition, an ellipse is the locus of a point the sum of whose undirected distances from two fixed points equals a constant. The two fixed points are the foci F (−c, 0) and F (c, 0). The midpoint of the segment joining the foci is the center and the line through them is the principal axis of the ellipse. The distance F (−c, 0) P (x, y) added to the distance P (x, y) F (c, 0) is a constant for all points P (x, y) on the ellipse. The important feature of the ellipse to the present invention is that if the ellipse is three-dimensional, viz. ellipsoidal, energy extending from F (−c, 0) to P (x, y) would be reflected by the ellipsoid to F (c, 0). The same is true in the opposite direction. Energy traveling from F (c, 0) to P (x, y) would be reflected by the ellipsoid to F (−c, 0).  
         [0036]    Referring to FIG. 1, the surface  14  is the frustum of an ellipsoid, or a surface that is similar enough to have two foci F 1 , F 2 . Herein the terms “ellipse” and “ellipsoid” are used to mean both a true ellipse and a true ellipsoid and other curves that are substantially similar enough to the true curves that they will have two foci and will behave the same when used in a focused-wave device.  
         [0037]    The device shown by FIG. 1 is submerged in a fluid. The shock-wave generator is positioned to provide a spark discharge at F 1 . It functions as a shock-wave generator at the first foci F 1 . The generated shock-wave energy will radiate from foci F 1 . The portion of this energy that moves out to and contacts the surface  14  will be reflected by the surface  14  and sent on a focused path onto loci F 2 . This reflected energy forms what is referred to as the “focused wave.” The envelope of this wave is shown by solid lines in FIG. 1. Some of the shock-wave energy never strikes the surface  14 . This energy moves away from foci F 1  towards foci F 2 . This energy is referred to herein as the “direct wave.” In FIG. 1 the direct wave is shown by a succession of dashed wave front lines. As shown by FIG. 1, the center region of the direct wave, if left alone, as is the case in the prior art devices, will travel directly to foci F 2 . In a shock-wave lithotripter, a target object is located substantially at foci F 2 . By way of typical and therefore non-limitive example, the target may be kidney stones in a person.  
         [0038]    In lithotripsy, the intense shock waves, over the course of a few thousand shocks, fragment the kidney stone into small pieces that can be safely removed via the urinary tract. Because several thousand shocks are necessary, the clinician usually operates the instrument at the highest safe rate of operation, the pulse repetition frequency (PRF). Current modes of operation are typically 0.5-2.0 Hz PRF.  
         [0039]    In addition to fragmenting the kidney stone, there is evidence that normal tissue is also damaged by the shock-waves. For this reason, electrohydraulic lithotripters are limited in use. There is a current need to decrease the total number of shocks for kidney stone comminution, to reduce the unhealthy bioeffects on healthy tissue.  
         [0040]    The leading direct wave is usually considered to be much smaller in amplitude than the focused wave. However, we have observed its influence on the target substantially at F 2  by using light-scattering techniques. We have found that the direct wave causes the premature growth of preexisting bubbles on and near the region of interest, viz. the kidney stone or stones, substantially at F 2 . These bubbles can act as a protective membrane around the region of interest, viz. the kidney stone, decreasing the efficiency of the focused wave. FIG. 2 shows the influence of the direct wave on preexisting bubbles. The preexisting bubbles respond to the direct wave before the focused wave arrives. Because of this interaction, the bubbles grow and can shield the region of interest from the focused wave. By removing or decreasing the effect of the direct wave, the focused wave will be more efficient, leading to shorter clinical procedures.  
         [0041]    Electrohydraulic lithotripters generate a shock wave at the focus that can be modeled with the following equation:  
           P ( t )=2 P   a   e   −(a  cos(ω t+/ 3).   (1)  
         [0042]    In our models we use =3.5×10 5  for the decay constant of the positive pressure spike, and f=50 kHz for defining the negative tail. Because bubble dynamics, especially the explosive growth, is not governed by the positive pressure spike, we neglect the finite rise-time of the spike, and assume is occurs instantaneously.  
         [0043]    The shock wave described by Eq. 1 results from an underwater spark discharge from one foci F 1  of an ellipsoid that is then focused by a truncated ellipsoidal reflector to the other foci F 2 . At F 2 , this shock wave pressure amplitude is about 30 Mpa. See Cleveland, R. O., et al.,  Design and characterization of a research electrohydraulic lithotripter patterned after the Dornier HM 3. Review of Scientific Instruments, 2000. 71 (6): p. 2514-2525. There is also the direct spherically expanding wave that passes directly from F 1  to F 2 . Although smaller in amplitude, the peak amplitude can be greater than 1 Mpa. See Coleman, A. J., et al.,  Pressure waveforms generated by a Dornier extra-corporeal shock-wave lithotripter.  Ultrasound Med Biol, 1987. 13: p. 651-657.  
         [0044]    The direct wave, with a negative tail of sufficient amplitude, can affect preexisting bubbles at F 2 . Because of the geometric location of the sparker, the direct wave precedes the focused wave by approximately 30 us. In our model we assume for simplicity that the direct wave has the same shape as that given by Eq. 1, with reduced amplitude, and that it precedes the focused wave by 30 us. This is shown by FIG. 3 in which the focused shock wave from the spark discharge is modeled as shown in Eq. 1. For simplicity, we also assume that the direct wave has a similar form, but at a reduced amplitude factor. Evidence that supports our assumption is shown in FIG. 7. For this figure, the reduction factor is  10 .  
         [0045]    Corresponding bubble dynamics from such a wave were calculated using the Gilmore equation. The equation was solved for an initial bubble radius of 5 um. Other parameters were taken from the literature. See in particular Church, C. C.,  A theoretical study of cavitation generated by an extracorporeal shock wave lithotripter.  J. Acoust. Soc. Am., 1989. 86: p. 215-227. For this work, we did not include gas diffusion.  
         [0046]    We show in FIGS. 4 and 5 examples of bubble dynamics resulting from the direct wave preceding the focused wave. FIG. 4 shows calculated bubble dynamics for the lithotripter pulse from FIG. 3. The calculations were for peak pressures (P a ) of 20, and 40 Mpa, from the focused wave. As the pressure amplitude increases, bubble growth from the direct wave also increases. The effect of the pre-factor used to determine the amplitude of the direct wave is shown in FIG. 5. For a given peak positive pressure, the bubble growth from the direct wave depends on the prefactor used. The negative tail associated with the direct wave causes preexisting bubbles to grow. The duration of this growth stage depends on the pressure amplitude and the relative amplitude of the direct wave. In FIG. 4, where we have assumed that the direct wave amplitude is a factor of 20× smaller than the focused wave, bubble expansion increases with pressure amplitude. For higher pressures, an asymmetry occurs (near t=30 us) when the incident focused wave forces the growing bubble to collapse. In FIG. 5, we show the effect of changing the direct wave prefactor (amplitude reduction factor). Shown are a 10× prefactor and a 30× prefactor. Bubble expansion from the direct wave is dependent on the prefactor, as expected.  
         [0047]    [0047]FIG. 6 shows an example of bubble dynamics associated with lithotripsy. The precursor signal corresponds to bubble growth due to the direct wave. The experimental system is described in detail in Matula, T. J.,  Radial response of individual bubbles subjected to shock wave lithotripsy pulses in vitro.  Physics of fluids, 2002. 104: 913-921. Essentially, a laser beam passing through a water-filled chamber placed at the lithotripter focus scatters off bubbles, and the scattered light is focused onto a photomultiplier tube (PMT). The resulting signal depends on the bubble size—larger bubbles scatter more light (in this context). An example of such a signal is shown in FIG. 6. Here, the focused wave is incident near t=−120 us. The bubble collapses near t=180 us. There is also a relatively large precursor signal. This signal is due to one or more bubbles growing after the direct wave passes through Referring to FIG. 7, the main bubble growth from the lithotripter pulse is preceded by a precursor. The precursor signal, due to bubble growth from the direct wave, depends on sparker voltage. Higher spark voltages result in an increased growth of preexisting bubbles. FIG. 8 presents a qualitative comparison of the asymmetries observed with the direct wave bubble and the calculation. Bubble growth from the direct wave can be halted when the focused wave arrives.  
         [0048]    The amplitude of the precursor signal depends on the applied voltage. Larger signals are observed with higher spark discharge voltages. FIG. 7 shows this effect. There is an initial large transient signal corresponding to electrical coupling when the sparker discharges. The distance between the sparker and F 2  is about 228 millimeters, corresponding to a delay time of about 150 us. The focused wave delay time is about 180 us. The main bubble growth resulting from the focused wave is truncated so that we can focus on the direct wave influence. As the voltage is increased from 16 kV to 22 kV, the amplitude of the precursor—the direct wave bubble—increases.  
         [0049]    A qualitative comparison between the model and the experiment is shown in FIG. 8. Here we show the similarity in the asymmetry of bubble growth and collapse due to the direct wave. The collapse is due to the arrival of the focused shock wave, causing the bubble to be compressed. No attempt was made to fit the calculation with the data. Not all experiments (or calculations) show such an asymmetry. Bubble growth must be sufficiently long so that the focused wave can initiate the collapse. For smaller spark voltages, inertial bubble collapse may occur before the focused wave arrives.  
         [0050]    We have shown evidence of bubble dynamics associated with the direct wave. Although the direct wave is much smaller in amplitude than the focused wave, it is still sufficiently large to affect preexisting bubbles. Bubble growth due to the direct wave must be due to a negative pressure, even though most explosion models only account for the positive spike. In our model, we assume the direct wave is a miniature version of the focused wave; FIG. 7 confirms this. Bubble growth due to the direct wave depends on the sparker voltage. At high voltages, we observe an asymmetry that corresponds to the arrival of the focused wave when the bubble is still relatively large.  
         [0051]    As a final observation, we inserted an aperture stop, essentially a disk, near the sparker, so that it can block the direct wave. When inserted, hydrophone measurements of the direct wave disappear, as do bubble dynamics associated with the direct wave.  
         [0052]    [0052]FIG. 10 shows examples of the energy that contacts the ellipsoidal reflector and is focused by it and directed onto the foci F 2 . FIG. 11 is like FIG. 10 but it shows an aperture stop  18  positioned between the foci F 1 , F 2 . The aperture stop  18  is also herein referred to as a suppressor disk.  
         [0053]    The preferred implementation of the invention is described as follows:  
         [0054]    An irregularly-shaped aperture stop  18  (suppressor disk) of approximately 1.5-inch diameter is machined out of metal, plastic, rubber, or other material (see FIG. 12). The device should be somewhat “disk-shaped”, but with sufficient surface contours to prevent diffraction enhancements to the outgoing wave. It is important that diffraction not focus the outgoing wave.  
         [0055]    In one embodiment, the disk edge is mounted to a metal or plastic rod  20 , as shown in FIG. 13. The rod, in turn, is mounted to a moveable plate  22 , shown in FIG. 14. The plate is secured to the bottom of the reflector such that the direct wave is blocked (FIG. 16).  
         [0056]    As an alternative, the disk suppressor  18  can be mounted directly to the shock wave source  16 , as shown by FIG. 17. For lithotripsy, the source is a sparker unit  16  inserted into a reflector housing  12 . A mounting ring  30  of suitable construction may surround a cylindrical housing  32  that is a part of the shock wave generator  16 . Mounting ring  30  is secured in any suitable fashion against movement relatively along the housing portion  32 . One or two rods  34  extend from the ring  30  to the disk  18 . It is attached to the disk  18 , either by weld, or by screws, or by some other method. Other mountings for shock wave devices can be designed and built relatively inexpensively. The only necessary criteria is that the mounting be such that the direct wave is blocked, and the focused wave is minimally affected.  
         [0057]    The suppressor disk operates by blocking the direct wave as the wave propagates outward. Its influence on the main shock wave is negligible because the main shock wave is focused by the surrounding reflector, and only a very small portion of the focused wave is interfered with. Because its location is nearby the shock wave source, it is probable that for safety reasons, the suppressor should be replaced often. The main criteria for replacement will be the physical state of the device (Is it sturdy? Are the connectors still securely holding the unit in place?). In addition, if there are many pits and marks on the suppressor, it should be replaced, because one does not wish to accidentally break off a piece of the device during its operation.  
         [0058]    The shock wave suppressor disk  18  can be utilized in any focused shock wave therapeutic device now being used, including lithotripters and other therapeutic devices. Our disk suppressor will reduce the time necessary for procedures, and thus will reduce the cost of a procedure. Furthermore, because the procedure time is shortened, there will be less harmful effects on healthy tissue.  
         [0059]    The treatment of kidney stones is not the only use of the shock-wave focusing device of the invention. It can also be used for shock-wave therapy to treat ailments from tendonitis to sprains, and general aches that commonly occur with athletes, both human and animal. Actually, any shock-wave device that uses focusing reflectors should benefit from this invention.  
         [0060]    [0060]FIG. 15 shows a disk  18  positioned between the two foci F 1 , F 2 . If disk  18  were to have a circular periphery, it would cause diffraction enhancement to the outgoing wave. This is shown by the broken line  26 . Note that the lines  26  represents a conical envelope that focuses towards F 2 , something that is not desirable. The irregularly-shaped disk  18  prevents this diffraction enhancement.  
         [0061]    FIGS.  18 - 20  illustrate another embodiment of the invention. In this embodiment, the disk  18  is replaced by a member  18 ′ that performs the function of disk  18 . Member  18 ′ blocks direct wave travel from the shock-wave generator  16 . The shock-wave generator  16  is typically provided with a cage-like frame structure  36  supports the shock-wave device. The corner located frame members  38 ,  40 ,  42 ,  44  may be metal rods that are circular in cross-section. The suppressor member  18 ′ is made from metal or plastic. Typically, member  18 ′ may measure approximately 0.5-0.75 inches long and about 0.38 inches wide. The thickness can be between 0.12 inches and 0.5 inches. The frame members  38 ,  40 ,  42 ,  44  are typically circular in cross-section and measure approximately 0.125 inches in diameter. In preferred form, a longitudinal groove is formed in the side edges  46 ,  48  of the suppressor member  18 ′. This allows the suppressor member  18 ′ to be press-fitted onto the frame structure  36 ′. As best illustrated by FIGS. 19 and 20, a pair of the frame members  42 ,  44  are received within the longitudinal grooves.  
         [0062]    As earlier described, the suppressor member  18 ′ operates by blocking the direct wave as the wave propagates outwardly from the location  52  whereat it is generated. A member  18 ′ has a negligible influence on the main shock-wave because the main shock-wave is focused by the surrounding reflector  14 . Because its location is nearby the shock-wave source  52 , the member  18 ′ should be replaced often. The main criteria for replacement will be the physical state of the suppressor member  18 ′. That is, is it still sturdy? Is it still securely held in place? In addition, the suppressor member  18 ′ should be replaced if there are many pits and marks on it. A suppressor member  18 ′ that is pitted or otherwise marked may accidentally break during use if it is not replaced.  
         [0063]    The grooved-edge method of mounting the suppressor member  18 ′ is preferred because it is very simple and makes economical manufacturing use of the member  18 ′ possible. However, in this embodiment, any suitable manner of connecting a suppressor member  18 ′ to the shock-wave generator  16  may be used.  
         [0064]    The illustrated embodiments are only examples of the present invention and, therefore, are non-limitive. It is to be understood that many changes in the particular structure, materials and features of the invention may be made without departing from the spirit and scope of the invention. By way of further example, the shock wave focusing device may be a STORTZ Lithotripter. This particular device first generates and then focuses electromagnetic energy. Direct waves can be blocked by positioning a suppressor disk endwise outwardly from the end of the cylinder. In this position it will block direct waves and increase the efficiency of the lithotripter. Therefore, it is my intention that my patent rights not be limited by the particular embodiments illustrated and described herein, but rather are to be determined by the following claims, interpreted according to accepted doctrines of patent claim interpretation, including use of the doctrine of equivalents and reversal of parts.