Patent Publication Number: US-2019175201-A1

Title: Acoustic gel container

Description:
TECHNICAL FIELD 
     This disclosure relates to acoustic lithotripsy devices and in particular, to acoustic gel containers to be used with acoustic lithotripsy devices. 
     BACKGROUND 
     The statements in this section merely provide background information related to the present disclosure and may not constitute prior art. 
     Acoustic lithotripsy is used to break up or move stones within the body of a patient. Examples of acoustic lithotripsy devices may include ultrasound or shockwave. The lithotripsy devices transmit concentrated sound waves through the body to break up the stone. The effectiveness of acoustic lithotripsy is dependent on the sound waves being able to travel through a consistent medium to reach the stones such that the speed of sound through the medium is consistent. Acoustic gel and other liquids are sometimes used as a coupling agent between the lithotripsy device to the body of the patient, providing a consistent medium between lithotripsy device and the body of the patient. However, air bubbles and impurities in the coupling agent can diminish and/or interfere with the uniform propagation of the sound waves through the medium, decreasing the effectiveness of the lithotripsy procedure. Therefore, a container which can be used to provide a consistent and effective coupling agent for acoustic lithotripsy is desirable. 
     SUMMARY 
     Further areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. 
     In one embodiment, an acoustic gel pack is provided including a container, a first pad, and a second pad. The container includes a wall, a first end having a first opening, and a second end having a second opening. A chamber is defined within the wall between the first end and the second end. The first pad is removeably coupled to the container to seal the first opening. The second pad is removeably coupled to the container to seal the second opening. The seals formed by the first pad over the first opening and the second pad over the second opening are adapted to prevent fluid infiltration into the chamber. 
     In another embodiment, a lithotripsy system is provided including an acoustic wave generating apparatus, a container, a first pad, and a second pad. The acoustic wave generating apparatus includes an acoustic wave head. The container includes a wall having a first opening and a second opening. A chamber is defined within the wall between the first opening and the second opening. The chamber contains acoustic gel. The first pad is removeably coupled to the container to seal the first opening. The second pad is removeably coupled to the container to seal the second opening. 
     In yet another embodiment, a method of performing lithotripsy using an acoustic gel pack is provided including removing a first pad from a first opening of the acoustic gel pack, applying the first opening of the acoustic gel pack to one of an acoustic wave head or a body of a patient, removing a second pad from a second opening of the acoustic gel pack, and applying the second opening of the acoustic gel pack to the other of the acoustic wave head or the body of the patient. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The embodiments may be better understood with reference to the following drawings and description. The components in the figures are not necessarily to scale. 
         FIG. 1  illustrates a cross-sectional side view of a first example of an acoustic gel pack; 
         FIG. 2  illustrates a cross-sectional top-down view of a second example of the acoustic gel pack of  FIG. 1 ; 
         FIG. 3  illustrates a perspective view of a third example of an acoustic gel pack; 
         FIG. 4  illustrates a cross-sectional side view of a fourth example of an acoustic gel pack; 
         FIG. 5  illustrates a cross-sectional side view of a fifth example of an acoustic gel pack; 
         FIG. 6  illustrates a cross-sectional side view of a sixth example of an acoustic gel pack; 
         FIG. 7  illustrates a cross-sectional side view of a seventh example of an acoustic gel pack; 
         FIG. 8  illustrates a cross-sectional side view of two eighth examples of acoustic gel packs; 
         FIG. 9  illustrates a cross-sectional front view of a ninth example of an acoustic gel pack; 
         FIG. 10  illustrates a cross-sectional side view of the ninth example of the acoustic gel pack of  FIG. 9 ; 
         FIG. 11  illustrates a side view of a first step in an example method of performing lithotripsy including an acoustic gel pack, a lithotripsy device, and a body; 
         FIG. 12  illustrates a side view of a second step in an example method of performing lithotripsy including an acoustic gel pack, a lithotripsy device, and a body; 
         FIG. 13  illustrates a side view of a third step in an example method of performing lithotripsy including an acoustic gel pack, a lithotripsy device, and a body; and 
         FIG. 14  illustrates a flow diagram of example operations to perform as part of a lithotripsy procedure. 
     
    
    
     The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way. The various descriptors provided for the elements are examples and should not be construed as describing the extent of the features/functionality and therefore should not be construed as limiting in this regard. 
     DETAILED DESCRIPTION 
     The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. 
     In one example, an acoustic gel pack is provided including a container, a first pad, and a second pad. The container includes a wall, a first end having a first opening, and a second end having a second opening. A chamber is defined within the wall between the first end and the second end. The first pad is removeably coupled to the container to seal the first opening. The second pad is removeably coupled to the container to seal the second opening. The seals formed by the first pad over the first opening and the second pad over the second opening are adapted to prevent fluid infiltration into the chamber. 
     One interesting feature of the systems and methods described below may be that the acoustic gel pack may provide a sealed environment preventing infiltration of gas and other contaminants into the acoustic gel prior to use. Another feature may be that the acoustic gel pack may be easy to fill from a vacuum state with gas-evacuated acoustic gel. Yet another feature may be that the acoustic gel pack may be easy to unseal and apply to the lithotripsy device and to the body of a patient. Yet another feature may be that the acoustic gel pack may promoted purging of gas bubbles during the process of coupling the lithotripsy device to the body of the patient. Yet another feature may be that the container may maintain coupling while allowing for adjustment of standoff distance between an acoustic wave head and the body of the patient, ensuring that the acoustic wave is focused at an appropriate depth. 
     In addition to the features that have been explicitly described, there are other features and advantages that are depicted and represent part of the system. While various embodiments have been described, it will be apparent to those of ordinary skill in the art that many more embodiments and implementations are possible. Accordingly, the embodiments described herein are examples, not the only possible embodiments and implementations. 
       FIG. 1  illustrates an acoustic gel pack  10  including a wall  12  extending from a first surface  28  to a second surface  30 , a first pad  18  coupled to the first surface  28  of the wall  12 , and a second pad  20  coupled to the second surface  30  of the wall  12 . The acoustic gel pack  10  may be any device which can be used to contain and apply acoustic gel ( 50  in  FIG. 11 ) to an operating surface ( 64  in  FIG. 11 ) of a patient ( 58  in  FIG. 11 ). Examples of the acoustic gel pack  10  may include a container, a bag, or a canister. The acoustic gel pack  10  may be used in a variety of procedures, including extra-corporeal shockwave lithotripsy, burst wave lithotripsy, high intensity focused ultrasound probes, tissue ablations, and other non-stone breaking therapies. Some examples of non-stone breaking therapies in which the acoustic gel pack  10  may be used may include extra-corporeal shock wave for myocardial revascularization, radial shockwave therapy for tendinosis, bursitis, epicondylitis, tendonitis, fasciitis, trigger finger, back pain, muscle-knots, non-union fractures, avascular necrosis, stress fracture, cellulite and body firming, prostate tissue ablation, equine orthopedic therapy, prostate, kidney, liver, pancreatic, bladder, and other cancers, uterine fibroids, neurological disorders, cosmetic therapies, thyroid nodule treatment, and breast fibromyalgia treatment. 
     The wall  12  may be any structure configured to contain an acoustic gel  50  and which is configured to prevent infiltration of gases such as air. Examples of the wall  12  may include a shell, a cylindrical barrier, or a bag. The wall  12  may define a first opening  14  at the first end of the wall  12  and may define a second opening  16  at the second end of the wall  12 . A chamber  26  may be enclosed within the wall  12 , the chamber  26  extending from the first opening  14  to the second opening  16 . The wall  12  may be sufficiently rigid to contain the acoustic gel  50  within the chamber  26  but may also be flexible enough to be removed from the acoustic gel  50  once the acoustic gel  50  has been applied to an operating surface  64 . In some embodiments, the wall  12  may include a break, allowing the wall  12  to be removed by unwrapping the wall  12  about the chamber  26 . The wall  12  may be made of materials such as polymers, rubber, or aluminum. 
     The first pad  18  may be any structure which may be applied to the first opening  14  of the wall  12 . Examples of the first pad  18  may include a covering, a film, or a sheet. The first pad  18  may completely extend over the first opening  14  to prevent the acoustic gel  50  from escaping from the chamber  26  through the first opening  14 . The first pad  18  may also seal the first opening  14  to prevent gas from infiltrating the acoustic gel  50  within the chamber  26 . The first pad  18  may be coupled to a first surface  28  at the first end of the wall  12  by an adhesive. The first pad  18  may be removeable from the first opening  14  by peeling the first pad  18  from the first surface  28  of the wall  12  or by puncturing the first pad  18 . The first pad  18  may be made of any material which may maintain a seal over the first opening  14  such as a polymer film. The first pad  18  may be transparent to allow inspection of the acoustic gel  50  within the chamber  26  to ensure that any gas contained within the acoustic gel  50  in the chamber  26  is at an acceptably low level. 
     The second pad  20  may be any structure which may be applied to the second opening  16  of the wall  12 . Examples of the second pad  20  may include a covering, a film, or a sheet. The second pad  20  may completely extend over the second opening  16  to prevent the acoustic gel  50  from escaping from the chamber  26  through the second opening  16 . The second pad  20  may also seal the second opening  16  to prevent gas from infiltrating the acoustic gel  50  within the chamber  26 . The second pad  20  may be coupled to a second surface  30  at the second end of the wall  12  by an adhesive. The second pad  20  may be removeable from the second opening  16  by peeling the second pad  20  from the second surface  30  of the wall  12  or by puncturing the second pad  20 . The second pad  20  may be made of any material which may maintain a seal over the second opening  16  such as a polymer film. The second pad  20  may be transparent to allow inspection of the acoustic gel  50  within the chamber  26  to ensure that any gas contained within the acoustic gel  50  in the chamber  26  is at an acceptably low level. The first pad  18  and the second pad  20  may be a circular, may be oval-shaped, or may be any other shape which may seal the first opening  14  or second opening  16 . 
     The first pad  18  and second pad  20  may each also include a tab  22 . The tab  22  may extend over the wall  12  of the acoustic gel pack  10  such that the tab  22  may be gripped by fingers of a user. Examples of the tab  22  may include a lip, a flap, or an overhanging projection. The tab  22  may be textured to allow gripability by the user. 
     The acoustic gel  50  may be any solution through which acoustic energy may be transmitted with minimal loss. Properties relating to wave transmission may include sound velocity, acoustic impedance, and sound attenuation. Examples of acoustic gel  50  may include low viscosity ultrasound gel or high viscosity ultrasound gel. A suitable acoustic gel  50  may have a higher viscosity and higher surface tension than other unsuitable solutions such as water. The acoustic gel  50  may be evacuated of air or other gases to provide a clear conduit for acoustic transmission. Air or other gases may make up as little of the composition of the acoustic gel  50  as possible. 
     For example, in some embodiments, the acoustic gel  50  may be a semi-solid material which retains its shape when unconstrained by the wall  12 . The acoustic gel  50  may absorb water or another low-viscosity fluid to form an acoustic pathway through the acoustic gel  50  which will not alter or distort shockwaves travelling through the acoustic gel. In such embodiments, fluid may be included within the chamber  26  to prevent infiltration of gas into the acoustic gel  50 . Water or another fluid may be applied to the acoustic gel  50  during use to maintain the acoustic pathway and to prevent infiltration of gas into the acoustic gel  50 . 
       FIG. 2  illustrates another possible embodiment of the acoustic gel pack  10 . In some embodiments, the first pad  18  may be peeled off the first opening  14  in a single motion from a first side of the acoustic gel pack  10  to a second side. However, in some embodiments, the first pad  18  may include a perforation  24  to control the direction of the removal of the first pad  18 . The perforation  24  may be any feature of the first pad  18  which allows separation and removal of the first pad  18  along a guided path. Examples of the perforation  24  may include indentations, micro-channels within the first pad  18 , or a series punctures in the first pad  18 . The perforation  24  may be arranged in a variety of shapes, such as a spiral, as shown in  FIG. 2 , or in a series of strips crossing consecutively across the wall  12  from the first side of the wall  12  to the second side of the wall  12 . In some embodiments, the perforation  24 , may extend only partially through the first pad  18  to prevent gas from infiltrating the acoustic gel  50  in the chamber  26 . Similar arrangements may be made with the second pad  20 . 
       FIG. 3  illustrates another possible example of the acoustic gel pack  10 . As shown in  FIG. 1 , in some embodiments, the tab  22  of the first pad  18  and the tab  22  of the second pad  20  may be on opposing sides of the acoustic gel pack  10  such that the first pad  18  may be removed, the acoustic gel pack  10  may be flipped and applied to the operating surface  64  and then the second pad  20  may be removed from the same orientation. Alternatively,  FIG. 3  illustrates an example where the tab  22  of the first pad  18  is circumferentially aligned with the tab  22  of the second pad  20  such that flipping of the acoustic gel pack  10  need not occur. 
     Additionally, in some embodiments, the first pad  18  may be integrally coupled to the wall  12  such that when the first pad  18  is removed, the entire wall  12  is removed from the acoustic gel  50  as well. Such an arrangement may minimize the steps needed to quickly apply the acoustic gel  50 . A similar configuration may be made with the second pad  20  and the wall  12 . 
       FIG. 4  illustrates another possible embodiment of the acoustic gel pack  10 . In some embodiments, the first side of the chamber  26  may have a first width  32  defined by the wall  12  which is greater than a second width  34  of the second side of the chamber  26  defined by the wall  12 . As a consequence of this difference in width, the acoustic gel  50  may have a great width near the first opening  14  than near the second opening  16 . With such an arrangement, the first pad  18  may be removed first and the first opening  14  may be applied to the operating surface  64 . The acoustic gel  50  having greater width at or near the first opening  14  to allow the acoustic gel  50  to better maintain its shape on the operating surface  64 . Such an arrangement may also allow the second pad  20  and the wall  12  to be removed more easily once the first opening  14  has been applied to the operating surface  64 . Alternatively, the second width  34  of the second opening  16  may be greater than the first width  32  such that the acoustic gel  50  has a greater width at or near the wave head  62 . 
     As illustrated in  FIG. 5 , in some embodiments, the first width  32  of the chamber  26  may be equal to the second width  34  of the chamber  26 . Between the first opening  14  and the second opening  16 , an intermediate width  36  of the chamber  26  may be less than either the first width  32  or the second width  34 . In some embodiments, the intermediate width  36  may be located at a centerline  40  of the acoustic gel pack  10 , midway between the first opening  14  and the second opening  16 . The decreasing width of the chamber  26  defined by the wall may allow the wall  12  be more rigid and to better contain the acoustic gel  50  within the wall  12  when the acoustic gel pack  10  is applied to the operating surface  64 . For example, in some embodiments, particularly where the acoustic gel pack  10  is significantly wider than the wave head ( 62  in  FIG. 11 ), the wave head  62  may be inserted into and moved within the chamber  26  of the acoustic gel pack  10 . To prevent the acoustic gel  50  from excessively spreading and thinning on the operating surface  64 , the wall  12  may remain in place to contain the acoustic gel  50  within the chamber  26 . The wall  12  may be configured to maintain a thickness  38  of the acoustic gel  50  within the chamber  26  at a sufficient level. 
     The wave head  62  may be any device which, when coupled with a lithotripsy machine ( 60  in  FIG. 11 ), may transmit shockwaves from the lithotripsy machine through the wave head  62 . Examples of the wave head may include a membrane or a drum. Shockwaves may any wave of acoustic energy which may be transmitted through an acoustic medium, such as the body of the patient, or the acoustic gel  50 . Examples of shockwaves may include any acoustic waves, such as ultrasound burst waves, ultrasound waves, and ultrasound imaging waves. 
       FIG. 6  illustrates an alternative embodiment of the acoustic gel pack  10  including a wall  12  which is divided into a first portion  42  and a second portion  44 . In such an embodiment, the first pad  18  and the second pad  20  may be sealed against each other, which the first portion  42  and second portion  44  of the wall holding the first pad  18  and second pad  20  together. To unseal the chamber  26 , at least one of the first portion  42  or second portion  44  of the wall  12  much be removed from the respective first pad  18  or second pad  20 . In some embodiments, the first pad  18  may be sealed to the second pad  20  with an adhesive. 
     In such an embodiment, the chamber  26  may be entirely defined by the shape of the first pad  18  and the second pad  20  which may be joined at the centerline  40  of the acoustic gel pack  10 . The chamber  26  may be subdivided between a first portion defined by the first pad  18  and a second portion defined by the second pad  20 . In some embodiments, a thickness  46  of the first portion of the chamber  26  may be equal or similar to a thickness  48  of the second portion of the chamber  26 . As illustrated in  FIG. 6 , in some embodiments, the thickness  46  of the first portion may be greater than the thickness  48  of the second portion of the chamber  26 . In such configurations, the first pad  18  may be large in size than the second pad  20  and may be shaped to contain more acoustic gel  50  within the chamber  26 . For example, the first pad  18  may have a mound-like or pyramidal shape. The second pad  20  may have less thickness  48  but may have a greater width, operating as the base of the acoustic gel  50  when applied to the operating surface  64 . The first pad  18  may have an outwardly convex curved surface. The second pad  20  may also have an outwardly convex curved surface which may be less convexly curved than the first pad  18 . 
     In such an arrangement, the second portion  44  of the wall  12  may be removed, followed by the second pad  20 , exposing the second opening  16  of the acoustic gel pack  10 . The second opening  16  may then be applied to the operating surface  64 . The first portion  42  of the wall  12  and the first pad  18  may then be removed. The pyramidal shape of the remaining acoustic gel  50  may then spread evenly as the wave head  62  is then applied. Where the thickness of the acoustic gel  50  is sufficient, the position of the wave head  62  with respect to the operating surface  64  may be adjusted without excessively thinning the acoustic gel  50  or introducing gas into the acoustic gel  50 . 
       FIG. 7  illustrates another possible embodiment of the acoustic gel pack  10  having an intermediate width  36  which is greater than the width  32  of the chamber  26  at the first opening  14  or the thickness  34  of the chamber  26  at the second opening  16 . In such an embodiment, the first opening  14  may be sized to closely encircle the wave head  62 . The diameter  32  of the first opening  14  may be substantially similar to a diameter of the wave head  62 . For example, the diameter  32  of the first opening  14  may less than  10 % greater than the diameter of the wave head  62 , but may be larger or smaller depending on the specific embodiment of the wave head  62 . In some embodiments, the wall  12  encircling the first opening  14  may be friction fit against the wave head  62 . The first pad  18  may be removed to expose the first opening  14 . The acoustic gel pack  10  may then be applied to the wave head  62  through the first opening  14 . The second pad  20  may then be removed to expose the second opening  16 . The wave head  62  and acoustic gel pack  10  may then be applied to the operating surface  64 . The additional acoustic fluid contained in the intermediate width  36  of the wall  12  may act as a reserve which may allow the wave head  62  and acoustic gel pack  10  to be moved on the operating surface  64 . 
       FIG. 8  illustrates another possible embodiment of the acoustic gel pack  10  which is stackable. In some procedures, the distance ( 68  in  FIG. 13 ) through the acoustic gel  50  between the operating surface  64  and the wave head  62  may be important to direct the energy of the wave head at  62  a specific focal point below the operating surface  64 . Depending on the patient ( 58  in  FIG. 11 ), this distance may be unpredictable and vary considerably. Therefore, in some embodiments, the acoustic gel pack  10  may be stacked upon other acoustic gel packs  10  to provide a continuous pathway of acoustic gel  50  between the wave head  62  and the operating surface  64 . The first surface  28  may include a upper shoulder  70  which is vertically offset below the first opening  14 . The upper shoulder  70  may be any surface which is configured to receive the second surface  30  of another acoustic gel pack  10 . The upper shoulder  70  may be spaced radially outward from the portion of the first surface  28  which is aligned with the first opening  14 . 
     The second surface  30  may also include a lower shoulder  72  which is vertically offset below the second opening  16 . The lower shoulder  72  may be any surface which is configured to receive the first surface  28  of another acoustic gel pack  10 . The lower shoulder  72  may be spaced radially inward from the portion of the second surface  30  which is aligned with the second opening  16 . 
     The presence of the upper shoulder  70  and lower shoulder  72  may divide the chamber  26  into an upper portion  74  and a lower portion  76 . The upper portion  74  of the chamber  26  may have the width  32  of the first opening  14 . The lower portion  76  of the chamber  26  may have the width  34  of the second opening  16  and may be greater than the width  32  of the first opening  14 . The width  34  of the second opening  16  may be greater than a width  80  of the portion of the first surface  28  which is vertically aligned with the first opening  14 . When the acoustic gel packs  10  are stacked upon one another, the total thickness of the acoustic gel may be greater than the combined thickness of the acoustic gel packs  10 , creating a reserve of acoustic gel  50  which may be utilized during the procedure. 
       FIGS. 9 and 10  illustrate another possible configuration of the acoustic gel pack  10  in the form of a sealable bag. The first surface  28  and second surface  30  may meet to form a perimeter  52  of the sealable bag. The perimeter  52  may include one or more ports  54  usable to fill the bag with acoustic gel  50 . The first pad  18  may be sealed to the first surface  28  in the form of a flap foldable at a joint  56 . Similarly, the second pad  20  may be sealed to the second surface  30  in the form of a flap foldable at a joint  56 . The first opening  14  and second opening  16  may be sized to receive the wave head  62 . 
       FIG. 14  illustrates a flow diagram of an example of a method ( 100 ) of performing lithotripsy using the acoustic gel pack  10 . The steps may include additional, different, or fewer operations than illustrated in  FIG. 14 . The steps may be executed in a different order than illustrated in  FIG. 14 . 
     The first pad  18  is removed from the first opening  14  of the acoustic gel pack  10  ( 102 ). As illustrated in  FIG. 11 , the first opening  14  may also be arranged to face the operating surface  64  of the patient  58  before or after the first pad  18  is removed. Once the first pad  18  has been removed from the first opening  14 , the first opening  14  of the acoustic gel pack  10  may then be applied to one of the wave head  62  or the operating surface  64  of the patient  58  ( 104 ). As described above, in some embodiments, particularly where the acoustic gel pack  10  is significantly wider than the wave head  62 , the acoustic gel pack  10  may be applied to the operating surface  64 . Where the acoustic gel pack  10  has a width which is close to the width of the wave head  62 , the acoustic gel pack  10  may be applied to the wave head  62 . Where the first surface  28  has an adhesive, the adhesive may be used to more securely couple the acoustic gel pack  10  to either of the operating surface  64  or the wave head  62 . 
     The second pad  20  may be removed from the second opening  16  of the acoustic gel pack  10  ( 104 ). As illustrated in  FIG. 12 , removal of the first pad  18  and the second pad  20  may create a clear acoustic passage through the acoustic gel pack  10  from the first opening  14  to the second opening  16 . 
     After the second pad  20  has been removed ( 104 ), the second opening  16  may be applied to the other of the operating surface  64  or the wave head  62  ( 106 ). Where the first opening  14  was first applied to the wave head  62 , the wave head  62  and acoustic gel pack  10  combination may be advanced against the operating surface  64  of the patient  58 . Alternatively, as illustrated in  FIG. 13 , where the first opening  14  was first applied to the operating surface  64  of the patient  58 , the wave head  62  may be advanced into the acoustic gel  50  through the second opening  16 . 
     Once coupled, the operating surface  64 , the acoustic gel  50 , and the wave head  62  may form an acoustic pathway to transmit shockwaves into the body to perform a lithotripsy procedure. Shockwaves created by a lithotripsy machine  60  may travel through the wave head  62 , through the acoustic gel  50 , across the operating surface  64 , and through the body to break up objects at the focal point of the shockwaves. The distance  68  between the wave head  62  and the operating surface  64  may define the focal point of the shockwaves within the body of the patient  58 . The focal point may be adjusted by changing a depth  66  at which the wave head  62  is submerged into the acoustic gel  50 . The lateral position of the focal point may be adjusted by laterally moving the wave head  62  or by changing the angle of the wave head with respect to the operating surface  64 . The lateral movement of the wave head  62  may be through the acoustic gel pack  10 , across the acoustic gel  50 , or may move along with the acoustic gel pack  10 . 
     In some embodiments, the acoustic gel pack  10  may be filled with acoustic gel  50  before using the acoustic gel pack  10  with the wave head  62 , such as during the manufacturing process. The acoustic gel pack  10  may be filled through the port  54  or may be filled where one of the first pad  18  or second pad  20  is not sealed to the first opening  14  or second opening  16 . Once the chamber  26  has been filled, the first opening  14  or second opening  16  may be sealed, pushing out any extra gas. Some acoustic gels  50  require significant time to be infiltrated by gases, so the acoustic gel pack  10  may be slightly overfilled in an open air environment. Once the acoustic gel pack  10  is overfilled, the first pad  18  or second pad  20  may be applied, pushing out excess acoustic gel  50  to remove any air from the chamber  26 . 
     Each component may include additional, different, or fewer components. For example, in some embodiments a port  54  may not be present. Additionally, in some embodiments, tabs  22  may not be present on the first pad  18  or second pad  20 . Instead, the first pad  18  and second pad  20  may be punctured to unseal the first opening  14  and second opening  16 . 
     The method ( 100 ) may be implemented with additional, different, or fewer components. For example, in some embodiments of the method ( 100 ) the step removing the first pad  18 , removing the second pad  20 , and removing the wall  12  may occur simultaneously and in a single action. Specifically, where the acoustic gel  50   
     The logic illustrated in the flow diagrams may include additional, different, or fewer operations than illustrated. The operations illustrated may be performed in an order different than illustrated. 
     To clarify the use of and to hereby provide notice to the public, the phrases “at least one of &lt;A&gt;, &lt;B&gt;, . . . and &lt;N&gt;” or “at least one of &lt;A&gt;, &lt;B&gt;, . . . &lt;N&gt;, or combinations thereof” or “&lt;A&gt;, &lt;B&gt;, . . . and/or &lt;N&gt;” are defined by the Applicant in the broadest sense, superseding any other implied definitions hereinbefore or hereinafter unless expressly asserted by the Applicant to the contrary, to mean one or more elements selected from the group comprising A, B, . . . and N. In other words, the phrases mean any combination of one or more of the elements A, B, . . . or N including any one element alone or the one element in combination with one or more of the other elements which may also include, in combination, additional elements not listed. 
     While various embodiments have been described, it will be apparent to those of ordinary skill in the art that many more embodiments and implementations are possible. Accordingly, the embodiments described herein are examples, not the only possible embodiments and implementations. 
     The subject-matter of the disclosure may also relate, among others, to the following aspects:
     1. An acoustic gel pack, comprising:   

     a container configured to contain acoustic gel, the container comprising a wall, a first end having a first opening, and a second end having a second opening, wherein a chamber is defined within the wall between the first end and the second end; 
     a first pad removeably coupled to the container to seal the first opening; and 
     a second pad removeably coupled to the container to seal the second opening, wherein the seals formed by the first pad over the first opening and the second pad over the second opening are adapted to prevent fluid infiltration into the chamber.
     2. The acoustic gel pack of aspect 1, wherein the wall comprises a collar encircling the chamber.   3. The acoustic gel pack of aspects 1 to 2, wherein the first opening has a width which is greater than a width of the second opening.   4. The acoustic gel pack of aspects 1 to 2, wherein the first opening has a first width, the second opening has a second width, and an intermediate width at a location within the chamber between the first opening and the second opening, wherein the intermediate width is less than both the first width and the second width.   5. The acoustic gel pack of aspects 1 to 4, wherein the collar further comprises a first surface at the first opening, wherein the first surface comprises an adhesive.   6. The acoustic gel pack of aspect 5, wherein the adhesive of the first surface of the collar is disposed to be exposed when the first pad is removed.   7. The acoustic gel pack of aspect 1, wherein the container comprises a bag, the bag comprising a top, a bottom, a first side, and a second side, wherein the first pad is removeably coupled to the first side of the bag and the second pad is removeably coupled to the second side of the bag.   8. The acoustic gel pack of aspects 1 to 7, wherein at least a portion of the first pad is coupled to the first side at a joint.   9. The acoustic gel pack of aspects 1 to 8, wherein the container comprises a first surface shaped to stackably receive a second surface of another container.   10. A lithotripsy system comprising:   

     an acoustic wave generating apparatus comprising an acoustic wave head; a container comprising a wall, the wall having a first opening and a second opening, wherein a chamber is defined within the wall between the first opening and the second opening, the chamber contains acoustic gel, and the second opening is sized to receive the acoustic wave head; 
     a first pad removeably coupled to the container to seal the first opening; and 
     a second pad removeably coupled to the container to seal the second opening.
     11. The lithotripsy system of aspect 10, wherein the second opening of the container has a diameter which is substantially similar to a diameter of the acoustic wave head.   12. The lithotripsy system of aspects 10 to 11, wherein the first opening has a cross-sectional area which is greater than a cross-sectional area of the acoustic wave head.   13. The lithotripsy system of aspects 10 to 12, wherein the wall contains a first portion which is separable from a second portion, wherein the first pad and second pad are constrained between the first portion of the wall and the second portion of the wall.   14. The lithotripsy system of aspects 10 to 13, wherein a portion of the first pad is transparent material.   15. The lithotripsy system of aspects 10 to 14, wherein the chamber has a pyramidal shape.   16. The lithotripsy system of aspect 15, wherein the first pad has an outward convex curved surface.   17. A method of performing lithotripsy, comprising:   

     removing a first pad from a first opening of an acoustic gel pack, the acoustic gel pack comprising a wall, a first end having the first opening, and second end having a second opening, wherein a chamber is defined within the wall between the first opening and the second opening, the chamber containing air-evacuated acoustic gel; 
     applying the first opening of the acoustic gel pack to one of an acoustic wave head or a body of a patient; 
     removing a second pad from the second opening of the acoustic gel pack; and 
     applying the second opening of the acoustic gel pack to the other of the acoustic wave head or the body of the patient.
     18. The method of aspect 17, further comprising moving the acoustic wave head within the wall of the acoustic gel pack.   19. The method of aspects 17 to 18, further comprising removing the wall from the body of the patient before applying the second opening of the acoustic gel pack to the other of the acoustic wave head or the body of the patient.   20. The method of aspects 17 to 19, further comprising adhesively coupling a surface of the wall of the acoustic gel pack to the body of the patient.