JP3129795B2 - Stone crushing equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a calculus crushing apparatus for crushing and treating calculus by irradiating a calculus in a subject with a shock wave from outside the body.

[0002]

2. Description of the Related Art In recent years, calculus crushing treatment, which crushes and treats a calculus of the kidney by focusing and irradiating a shock wave from outside the body on the calculus of the kidney, has become the first treatment in the treatment of urinary tract calculus instead of surgery. It has been positioned as a means. In addition, calculus breaking treatment for gallstones has been performed.

[0003] When a kidney stone is to be treated, in order to improve the operability of the ultrasonic probe, an operating unit mounted on the applicator is operated to apply the applicator to the subject. Use the upper approach to make contact.

On the other hand, when gallstones are to be treated,
Due to the deep position of the calculus, the image quality of the ultrasound image deteriorates,
Since it is necessary to make a large angle to avoid the ribs, the operability or the like is not always good in the upper approach. Therefore, an applicator is provided above and below the subject so that the approach can be performed from below the subject, or an applicator configured so that the approach above or below the subject can be selected. It is considered.

[0005]

However, when the applicator is configured so that the orientation of the applicator can be selected by an upper applicator or a lower approach, when the applicator is turned over, the operation unit mounted on the applicator is used. The direction in which the data is moved up, down, left and right is also reversed. For this reason, the operation unit for moving the applicator must be attached not on the applicator but on a bed or console, and there is a problem that the operability of the applicator deteriorates.

When the applicator is brought into contact with the subject by an upward approach, the depth of the kidney stone is about 5 cm to 12 cm.
cm, when the applicator is brought into contact with the subject by a downward approach, the depth of the gallstone is about 2 cm to 10 cm. Therefore, the performance of the ultrasonic diagnostic apparatus used for positioning the focal point of the shock wave cannot be set to a range that covers both ranges. Therefore, if the setting of the ultrasonic diagnostic apparatus is made in accordance with one of the ranges, there is a problem that the image quality of the other is deteriorated.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problem, and an object thereof is to impair operability even when an applicator selects either an upper approach or a lower approach of a subject. Another object of the present invention is to provide a calculus crushing apparatus that does not cause deterioration of the image quality of a tomographic image due to ultrasonic waves.

[0008]

According to the present invention, in order to solve the above-mentioned problem, the orientation of the applicator having the operation unit can be reversed in accordance with the upper approach or the lower approach. And a drive means for moving the applicator up, down, left, and right with respect to the applicator holding means in accordance with the operation status of the operation unit. Reversal detecting means for detecting the direction of the applicator in the applicator holding means, and up, down, left, right, and Moving direction switching means for reversing the moving direction, and two rotations in which the detection frequency is switched when switching to the upper approach or the lower approach A probe and, when either the upper or lower approach is selected in the operation unit, performing the upward movement operation moves the applicator upward, and performing the downward movement operation moves the applicator downward. The detection frequency is switched when the upper approach or the lower approach is switched, and the calculus crushing device is characterized in that the calculus crushing device is characterized in that if the left and right movement operations are performed, the calculus crushing device is moved right and left accordingly.

[0009]

In the calculus crushing apparatus of the present invention having the above-described structure, the upward movement operation is performed by the operation unit mounted on the applicator, regardless of whether the applicator is directed to the upper approach or the lower approach. For example, the applicator can be moved upward by performing the downward movement operation by moving the applicator upward. Also,
If the operation of moving to the left and right is performed, it can be moved to the left and right correspondingly. Therefore, even if the direction of the applicator is reversed, the direction in which the applicator moves when operated is not reversed, so that operability is not impaired.

Further, no matter which of the upper approach and the lower approach is selected, the optimum frequency and processing method can be set, so that the image quality of the tomographic image by the ultrasonic wave does not deteriorate.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS One embodiment of the present invention will be described below with reference to the drawings.

FIG. 1 is an overall view showing a schematic configuration of a calculus breaking device according to an embodiment to which the present invention is applied. In FIG. 1, an applicator 1 that generates a shock wave is held by an applicator holding device 3 so that the applicator 1 can be inverted with respect to a bed 2 in accordance with an upper approach and a lower approach. As shown in FIG. 2, the applicator 1 includes an ultrasonic probe 5 of an ultrasonic diagnostic apparatus 4 for aiming and positioning a crushing point, and a shock wave source 6 using a piezo element.
, Respectively, and the applicator 1 is filled with water. A system for controlling the entire system including a water circulation controller 7 for controlling and circulating water in the applicator 1 and a pulse controller 8 for applying a high voltage pulse to the piezo element to generate a shock wave. A console 9 is provided.

The applicator 1 is an applicator holding device 3
, And is supported by a rotating support 11.
It is held by the applicator holding device 3 so as to be rotatable by 80 °. FIG. 3A is a configuration diagram illustrating a case where the applicator 1 is adapted to the upper approach, and FIG. 3B is a configuration diagram illustrating a case where the applicator 1 is adapted to the lower approach. By inverting the applicator 1 by 180 °, the direction of irradiating the subject with the shock wave can be switched upward or downward.
The configuration is such that the subject can be approached from any direction by a combination of movement in the Y and Z directions and angulation in the body side direction and the body axis direction. The applicator 1 is moved in the X and Y directions (planar direction) by the moving stage of the pedestal 12 to support the support 1.
The movement in the Z direction (height direction) is performed by a movement motor (not shown) in the column 10. An operation unit 13 (FIG. 4) for performing an operation of moving the applicator 1 is provided on the applicator 1.
The operation unit 13 moves the applicator 1 by tilting the joystick 14 and the lever 15 in the moving direction of the applicator 1. As shown in FIGS. 5 and 6, a potentiometer 16 is provided in the rotation support unit 11, and the vertical position of the applicator 1 is detected by detecting the output of the potentiometer 16. The output of the movement direction switching circuit 18 is switched based on the up / down detection signal and the signal of the joystick movement amount detection circuit 17. The output of the pulse motor driver 19 is reversed by this signal,
In this configuration, the applicator 1 is moved by operating the pulse motor 20 in the inside.

The ultrasonic probe 5 is, as shown in FIG.
It is arranged at the center of the shock wave source 6 in the applicator 1. As shown in FIG. 7, two vibrators 22 and 23 are superimposed and adhered to the backing material 21 on the front surface of the backing material 21 attached to the tip of the ultrasonic probe 5. Electrodes 24 are extracted from the outside and inside of the vibrators 22 and 23. Utilizing the fact that the resonance frequency of the oscillators 22 and 23 by the pulsar 25 is determined by the thickness thereof, the oscillators 22 and 23 were driven on both outer sides and between the inner side and either outer side. In some cases, a low frequency and a high frequency can be selected by the selector 26.

As shown in FIGS. 8A and 8B,
The couch 2 on which the subject is placed has an opening 27 at the center of the couch 2 so as to be able to cope with a downward approach of the applicator 1. The couch 2 is separated into a head side and a leg side, and the opening 27 has a slide table 28 slidable in the longitudinal direction of the couch 2, and the couch 2 has a head side and a leg side. Storage section 2 for storing the slide table 28
9 Further, a cushion 30 is provided on the bed 2, and a plurality of divided cushions 30 are attached on the slide table 28. As the slide table 28 is put in and taken out, the cushion 30 is stored in the storage portion 29 while rotating under the slide table 28, and the slide table 28 can be fixed at an arbitrary position.

As described above, the calculus breaking device in the present embodiment can be selected as an upper approach when targeting a kidney stone, or a lower approach when targeting a gallstone. Even if the direction of the applicator 1 selects the upper approach or the lower approach,
In the operation unit 13 mounted on the applicator 1, if an upward moving operation is performed, the applicator 1 is moved upward,
By performing the downward movement operation, the applicator 1 can be moved downward. In addition, if an operation of moving to the left and right is performed, the operation can be moved to the left and right so as to correspond. Therefore, even if the direction of the applicator 1 is reversed, the direction in which the applicator 1 moves when the joystick 14 or the lever 15 is operated is not reversed, so that the applicator 1 can be inspected from any direction without impairing operability. Can be approached.

When a kidney stone is targeted by the upper approach, its depth reaches about 5 cm to 12 cm. Therefore, the frequency of the ultrasonic probe 5 is as low as about 3.5 MHz which can detect a deep position. Is used. When gallstones are targeted by the downward approach, the depth is 2
Since the depth is as small as 7 cm to 7 cm, the frequency of the ultrasonic probe 5 is about 5 MHz in order to obtain a clear image. Since the resolution is improved by using the optimal frequency, smaller calculi can be detected. By presetting the frequency output from the moving direction switching circuit 18 in advance so that the frequency can be switched, an optimal ultrasonic image can be obtained at any time. In addition to presetting the frequency, it is also possible to set various information related to ultrasonic diagnosis, such as the degree of amplification depending on the focus position and depth, and it is possible to switch these settings simultaneously with switching the frequency.

Further, the opening 27 of the bed 2 allows the slide table 28 to be fixed at an arbitrary position according to the physique and the like of the subject.

Although one embodiment of the present invention has been described above, the present invention is not limited to the above embodiment, and various modifications can be made. For example, when switching the applicator 1 between the upper approach and the lower approach, an applicator holding device 3 having a C-arm 31 as shown in FIG. 9 may be used. Applicator 1 is C arm 31
Can be slid, and the C-arm can slide with respect to the rotation support portion 11. When switching to the lower approach, the applicator 1
Is slid with respect to the C arm 31, and the C arm 3
1 is slid with respect to the rotation support portion 11. Then, the applicator 1 is moved one by one so that the operation unit 13 comes to the front.
Rotate 80 °. Such an applicator holding device 3
When the applicator 1 is switched up and down, the applicator 1 passes beside the bed 2. For this reason, the opening 27 of the bed 2 can fix the applicator 1 at the minimum position for contacting the subject.

In order to switch the frequency of the ultrasonic probe 5, the ultrasonic probe 5 in which the two transducers 22 and 23 are superposed in the above embodiment is taken as an example. An ultrasonic probe may be mounted in the applicator 1.

According to the present embodiment, the operability is not impaired and the image quality of the ultrasonic tomographic image is degraded regardless of whether the applicator 1 is selected from the upper approach and the lower approach of the subject. There is no.

[0022]

The calculus crushing apparatus of the present invention has the above-described configuration and operation. Even when the applicator is selected from the upper approach and the lower approach of the subject,
The operability is not impaired, and the image quality of the tomographic image by the ultrasonic wave is not deteriorated.

[Brief description of the drawings]

FIG. 1 is an overall view showing a schematic configuration of a calculus breaking device according to an embodiment to which the present invention is applied.

FIG. 2 is a configuration diagram showing an arrangement of a shock wave generation source and an ultrasonic probe in an applicator in the embodiment.

FIG. 3 (a) shows an applicator 1 in the embodiment.
Is a configuration diagram showing a case in which
(B) is a block diagram showing a case where the applicator 1 is adapted to the downward approach.

FIG. 4 is a diagram showing an operation unit mounted on an applicator in the embodiment.

FIG. 5 is a configuration diagram showing a configuration inside a rotation support unit in the embodiment.

FIG. 6 is a view showing a moving direction switching means of the applicator in the embodiment.

FIG. 7 is a configuration diagram showing an ultrasonic probe in the embodiment.

FIG. 8 is a configuration diagram showing a bed in the embodiment.

FIG. 9 is a configuration diagram showing an applicator and an applicator holding device in another embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Applicator 2 Bed 3 Applicator holding device 4 Ultrasonic diagnostic device 5 Ultrasonic probe 6 Shock wave source 11 Rotation support part 13 Operation part 14 Joystick 15 Lever 17 Joystick movement amount detection circuit 18 Moving direction switching circuit 22 Vibrator 23 Vibration Child 31 C arm

──────────────────────────────────────────────────続 き Continuation of the front page (56) References JP-A-3-39150 (JP, A) JP-A-2-111347 (JP, A) JP-A-3-155840 (JP, A) JP-A-4- 329941 (JP, A) JP-A-3-141938 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 17/22 330 A61B 17/36 330 A61B 18/00

Claims (1)

(57) [Claims] An applicator holding means having a mechanism capable of reversibly holding the direction of an applicator equipped with an operation unit corresponding to an upper approach or a lower approach, and capable of moving the applicator up, down, left, and right; Drive means for moving the applicator up, down, left and right with respect to the applicator holding means in accordance with the operation state of the operation unit; inversion detecting means for detecting the orientation of the applicator in the applicator holding means; Movement direction switching means for reversing the up, down, left and right movement directions indicated by the movement amount instruction signal from the operation unit to the drive means when a detection output is generated in the means, and a detection frequency when switching to the upper approach or the lower approach And a two-frequency probe that switches between the upper and lower approaches in the operation unit. Even in the case of selection, the applicator is moved upward by performing the upward movement operation, and the applicator is moved downward by performing the downward movement operation, and the detection frequency is switched when the upper approach or the lower approach is switched. Alternatively, the calculus crushing device is characterized in that it is moved left and right so as to correspond to a left and right movement operation.