(57) Abstract:Usage: in medicine, in devices for the destruction of the stones inside the organs of the human body. The inventive laser lithotripter includes a pulsed laser with a wavelength of from 2.6 to 3.0 μm. The laser light through the system input radiation is introduced into the optical fiber, transparent at the wavelength of laser radiation. On the output end of the optical fiber is beam expander laser radiation, improves the performance in the destruction of the stones. 5 C. p. F.-ly, 4 Il. The invention relates to medicine and is industrially applicable in devices for the destruction of the stones inside the organs of the human body.Known laser lithotripters, containing the laser and successively installed along its beam input radiation into an optical fibre, the optical fibre.The disadvantage of these lithotripters is that collapse is not all stones in the organs of the human body.The aim of the invention is the expansion of the range of destructible rocks.The aim is achieved in that in the known laser lithotripter, containing the laser and successively installed along the beam from 2.6 to 3.0 μm, and the optical fiber is made transparent at the wavelength of the laser radiation.In particular, to improve the performance of the device may further comprise a beam expander radiation, mounted on the output end of the optical fiber. This extender can be made in the form of a hollow cylinder, one end of which is hermetically fitted with a window, transparent to the wavelength of the laser, and on the other end made a hole through which the expander is hermetically mounted on the output end of the optical fiber. The diameter of the output window extender D is in the range of d < D (4Q/ Eus)1/2where d is the diameter of the optical fiber; Q rated power or energy of the laser; Fussurface power density or energy of the laser radiation, in which the destruction of the stones reaches saturation. However, in order to regulate the surface energy density of the laser radiation extender is installed on the output end of the optical fiber can be moved.Alternatively, the optical fiber can be performed with the extended part at the end. With a view to further improve the performance of cluster lithotripter; in Fig.2 and 3 beam expander laser radiation, embodiments of the Fig.4 experimental data explaining the choice of the surface energy density of the laser radiation, in which the destruction of the stones reaches saturation.Laser lithotripter (Fig.1) includes a laser 1, the system 2 input radiation into the optical fiber, the optical fiber 3, the expander 4 beam laser, optically and acoustically associated with stone 5. Optical fiber (Fig.2) can be performed with the extended part at the end of 6, the end of which can be performed with a concave surface. In the second embodiment, the dilator may include a hollow cylinder 7, at the output end of which is equipped with a transparent window 8 and at the opposite end of the hole 9.Laser lithotripter works as follows.The laser light with a wavelength of from 2.6 to 3.0 μm is well absorbed by the material of all stones, which may be formed inside the organs of the human body. In this range emit lasers, in which the activator ions are erbium, and the wavelength of the radiation depends on the type of the crystalline matrix of the laser material. The laser pulses through the system is / establishment, which the laser light with almost no loss leads to broken stone 5. To increase the cross section of the laser beam using the extender. As a result of successive actions of pulses of laser radiation is the destruction of the stone. Fiber 3 to the expander 4 with the help of an endoscope is brought to the location of the stone inside the human body.In the prototype near the stone surface is formed radial breakdown with formation of bystrorasshiryayuscheysya volume of hot plasma. When this stone feels the push and destroyed. In the prototype, the wavelength is not optimal, as it is not absorbed in some stones, so they are not destroyed. The increase of laser energy in the prototype does not allow to achieve the destruction of the most durable stones, if this is the destruction of the output end of the fiber.In the proposed laser lithotripter specified selection of the emission wavelength of the laser delivers its strong absorption in all the stones that can form in the organs of the human body. In addition, this radiation is highly absorbed in all liquids and solutions surrounding the stones in the organs of the human body. This ensures the formation of a shock wave, unusual prototype, which leads to additional destruction of the stone.shock acoustic waves, that accelerates the destruction of the stone. It is found experimentally that there is a certain surface density of laser energy Eusexcess of which leads to improved performance in the destruction of the stones. This means that when a powerful laser is expedient to use the expander 4 beam laser radiation. The optimum diameter of the expanded beam D can be determined from the ratio
EusQ/S (4Q/ D2).The expander 4 provides maximum performance in the destruction of the stone, while providing a gentle effect on the organs of the human body.In our experiments we used a pulsed solid-state lasers based on yttrium-aluminum, gadolinium-gallium, yttrium-scandium-aluminum, gadolinium-scandium-aluminum, yttrium-scandium-gallium, gadolinium-scandium-gallium, gadolinium-calcium-magnesium-zirconium-Gal - lievago, calcium-niobium-gallium garnets, in which the activator was the erbium ions. The lasers used in free-running mode with a duration of from 100 to 250 ICAC and the mode of generation of short pulses of 0.1 NS. The pulse frequency was varied from 0.2 to 10 Hz, the energy of 10 joules. In Kacha fiber 3 from materials with low svetoslava, in particular from fluorine and fluoride glasses. These optic fibers with small svetoslava in infrared transparent in the wavelength range from 2.6 to 3.0 μm, the choice of which depends on the crystalline matrix of the laser element. The hollow cylinder 7 were made from metal. The output window 8 were made from sapphire. The tightness of the cylinder 7 provided with a sealant. By changing the distance l (Fig.3) varied the diameter of the output beam D and, as a consequence, the surface energy density of the laser radiation that affect performance in the destruction of the stone. In Fig.4 shows a typical dependence of the reciprocal performance of the destruction of stone 1/P for different types of stones from the energy density of the radiation pulses erbium laser based on yttrium-aluminum garnet E. Performance was defined as 1/P m/E, where m is the mass of shattered pieces of stone, EQ/S; Q pulse energy of the laser radiation; and S the cross-sectional area of the output beam of laser radiation. The optical fiber of fluorite had an output diameter of 0.2 mmUsed 20 types of stones, almost completely overlapping range of practically interesting. All the stones were effectively destroyed with the help of ervatamia due to the weak absorption of the laser radiation. Curve 15 refers to the monohydrate, calcium phosphate is the most durable stone. It is evident from Fig.4 shows that when the density of laser energy Eusapproximately 100 j/cm2there comes a saturation performance of the destruction of P, i.e., with further increase E the P value is almost the same. If the value 4Q/ d2exceeds Eusit is advisable to use the expander 4 to improve the performance of R, which is confirmed experimentally by increasing the diameter of the output beam of laser radiation from 0.2 to 1.0 mm, which is optimal when Q 1 j.In the mode of generation of short laser pulses for the efficient formation of a shock wave concave end light fiber had a radius of 1 to 3 mm, while the shock wave is focused in the center of the spherical surface, however, the performance of the destruction of the stones was higher than in the free-running mode.An additional advantage of the proposed laser lithotripter is more gentle mode of operation by reducing its duration and the lack of impact of laser radiation on organs of the human body, which is virtually the floor is there is no, laser radiation can reach the surface of the organs of the human body and injure them. 1. LASER LITHOTRIPTER, pulse containing erbium laser, the optical fiber and the input radiation in it, characterized in that the device further comprises a beam expander radiation at the distal end of the optical fiber and erbium laser is made with a wavelength of 2.6
3.0 mm.2. Lithotripter according to p. 1, wherein the beam expander is made in the form of the extended distal end of the optical fiber.3. Lithotripter according to p. 2, characterized in that the end face of the enlarged distal end of the optical fiber is made concave.4. Lithotripter according to p. 1, wherein the extender is made in the form of a hollow cylinder with a window at one end, transparent at the wavelength of laser radiation, and a hole on the other end for sealing the cylinder on the optical fiber.5. Lithotripter according to p. 4, characterized in that the box extender is made with a diameter D satisfying the condition
where d is the diameter of the optical fiber;
Q nominal pulse energy emitter;
FIELD: medical engineering.
SUBSTANCE: device has casing having anode fixed inside with insulation member. The anode is manufactured as brass rod having end piece fixed on its end and rubber sealing members and metal cassette connected to the casing head having cathode with end piece mounted inside of the casing head. The end pieces fixed in the anode and cathode are removable and composite as steel casings having rigidly fixed wolfram-containing inserts and damping units having damping units at attachment places. The cassette is manufactured as two heavy rods connected to each other with head member on one side and with threaded bushing, having damping member, on the other side.
EFFECT: reduced materials output ratio; prolonged service life.
7 cl, 2 dwg
FIELD: medical engineering.
SUBSTANCE: device has electrode mounted in envelope having metal cylinder allowing electrode end to be introduced into its internal opening and to be engageable with basket end allowing pusher to pull it away.
EFFECT: enhanced effectiveness in crushing concrements to pieces; reduced risk of traumatic complications.
FIELD: medical equipment.
SUBSTANCE: shock-wave pulse oscillator has capacitor. Controlled discharger is disposed inside capacitor as well as case with focusing system, disc inductor, irradiating membrane and aid for providing cavities with water under "water pillow". The aid is used to provide vacuum pressing of membrane against inductor to change curvature of inductor and membrane's surfaces and for provision of asymmetrical shock-wave beam. Lithotripsy and therapy procedures are performed due to complex match of geometrical characteristics of focusing lens to geometric and kinetic properties of irradiating membrane, and to pulse characteristics of discharge circuit.
EFFECT: improved efficiency.
4 cl, 3 dwg
FIELD: medicine, urology.
SUBSTANCE: one should affect the calculus with energy impulse at frequency of impulse sequence being 1-5 Hz and duration of impulse front being 100 nsec, not more. Moreover, while carrying out lithotripsy it is necessary to affect urethral calculus with electric impulse at energy being 0.3-0.4 J and frequency of impulse sequence being 5 Hz. While performing lithotripsy one should affect bladder's calculus with electric impulse at energy being 0.6 J and frequency of impulse sequence being 5 Hz, and while conducting lithotripsy in urethra one should affect the calculus with electric impulse at 0.2-0/3 J energy and 1 Hz frequency of impulse sequence.
EFFECT: higher efficiency.
8 dwg, 3 ex
SUBSTANCE: method and device can be used for lithotripsy of concrements in human body by means of fragmentation. Device for electric-pulse fragmentation of concrement in living organism has pulse oscillator, robe to be introduced into organism which has envelope with first and second electrodes, disposed inside envelope. Proximal end of electrode is electrically connected with pulse oscillator. Distal end is limited by side peripheral surface and frond part. Device also has tools for manipulating probe to manipulate envelope inside organism. Side peripheral surface of distal end of any electrode has non-rigid isolating coating made of non-electro-conducting material. Coating covers total length of side peripheral surface excluding front part. Extension stresses are applied to concrements formed in human organism.
EFFECT: improved efficiency; higher reliability and safety of fragmentation.
23 cl, 10 dwg
SUBSTANCE: the present innovation deals with treating patients in case of nephrolithiasis with large-sized and stag-horn calculi due to applying the following technique: through either rigid or semi-rigid ureteroscope one should carry out transurethral contact nephrolithotripsy of a calculus or its part being available for instrumental impact to obtain small-sized fragments. The internal stent should be applied. If necessary, some days later it is important to carry out distance percussion-wave lithotripsy of the remained fragments or parts of calculi. Some time later, it is necessary to remove the stent after complete sanitation of calyx-pelvic renal system or in case of residual fragments of calculi at maximal size being 3 mm, not more. In peculiar case, one should carry out distance percussion-wave lithotripsy with low-energetic percussion-wave impulses, the duration ranged about 0.3-0.6 mcsec. The innovation enables to provide complete renal sanitation against calculi in case of the absence of surgical wound.
EFFECT: higher efficiency of therapy.
SUBSTANCE: the present innovation deals with destructing and extracting the calculi out of the ureters. The suggested lithoextractotriptor contains an element for clamping and keeping a calculus, a probe for destructing a calculus and a tubular guide with, at lest, two lateral foramens. In tubular guide one should observe the main carrier for fastening and manipulating the above-mentioned element for clamping and keeping the calculus which passes along the tubular guide. The probe for destructing the calculus is located in the tubular guide being eccentric and parallel to the main carrier. The element for clamping and keeping the calculus is located asymmetrically against the main carrier and designed as a petal and with possibility for its withdrawal onto lateral surface of the tubular guide through lateral foramen in case of longitudinal shift of the main carrier in proximal direction. The mentioned lateral foramen is located near distal end of the tubular guide. As a result, the innovation provides increased reliability in extracting the calculi in such patients.
EFFECT: higher efficiency.
8 cl, 5 dwg
SUBSTANCE: method involves introducing Polyoxidonium during 6 days before performing remote shock-wave lithotripsy at an intravenous dose of 6 mg in 200 ml of Rheopolyglukine every day during 5 days. Then, Polyoxidonium is introduced at a dose of 12 mg dissolved in 400 ml of Rheopolyglukine directly before carrying out remote shock-wave lithotripsy. Then, Polyoxidonium is introduced at a dose of 6 mg dissolved in 200 ml of Rheopolyglukine every day during 4 days.
EFFECT: enhanced effectiveness of prophylaxis.
FIELD: medical equipment.
SUBSTANCE: piezoelement for a focusing ultrasonic head is made from piezoceramics in the form of a part of a spherical cover with an angle of disclosing of 180°. In top part of a spherical cover of a piezoelement is made the flat site, its thickness coincides with thickness of part of the spherical cover, and the parity of diameter of the flat site and the diameter of part of the spherical cover makes 15-25% for provision of maximum acoustic pressure in focal maculae on resonant frequency.
EFFECT: effective focusing of acoustic emission in a zone of geometrical focus of piezoelement.
FIELD: medicine, surgery.
SUBSTANCE: transcutaneous surgical tool for breaking up stones or drilling bone contains converter for generation of vibrations on ultra-sound frequencies, horn, support, fixed and floating prods and fixed and floating prods having cutting tips of various configuration. Horn is connected with converter for enhancing converter vibration. Prods are capable of being disconnected from support. Each fixed prod is attached to said horn for linkage with stones and introduction of ultra-sound fluctuations in them. Floating prod is located concentrically and can slide over said fixed prod. Between horn and floating prod there is free mass for causing fluctuation between them and low-frequency co-hitting with stones, in response to converter vibrations. As a result, tool with double prod is created, which combines frequency of 20 kHz or higher and hits with high energy on low frequencies, for instance, lower than 1 kHz. When using concentrical prods, open space can be formed between them, which allows performing sucking-up to remove stones or stone fragments from patient's body.
EFFECT: increased efficiency of tool action.
24 cl, 4 dwg