Instrument for crushing stones in urinary bladder

Claim 2

An instrument for crushing concretions in a urinary tract comprising: an electric pulser means having a pair of output terminals and a power transformer having a high voltage secondary winding, electrical circuitry connected between said high voltage secondary winding and said terminals including capacitor means, spark discharge members forming at least one electrical discharge gap of a predetermined size for breaking down when said capacitor discharges and being connected in series circuit relationship with said terminals and across said capacitor means, and a lithotrite having two electrodes electrically connected to said output terminals and insulated from each other and adapted for being positioned into the urinary tract adjacent a concretion to be crushed, one of said electrodes being a central conductor and the other electrode being an outer substantially cylindrical conductor coaxially surrounding said central conductor; and a manually operable device for remote control of said pulser means to thereby produce an electrical discharge between said lithotrite electrodes when discharging said capacitor means across said gap.

Claim 3

The instrument recited in claim 1 together with lithotrite positioning means comprising a cystoscope having a hollow operational channel through which said lithotrite electrodes are adapted to pass, and means for illuminating the portion of the lithotrite adjacent the concretion to be crushed.

Claim 4

The instrument recited in claim 1 further comprising electrical protective means operatively connected between said manually operable device and said pulser means, and protective means comprising a circuit member adapted for connection between an external electric ground conductor and a portion of the circuit in the electRic pulser means whereby failure to have such connection prevents operation of said instrument.

Claim 5

The instrument recited in claim 1 wherein said coaxial electrodes have butt end portions located in substantially a single plane with an insulative covering on said inner electrode extending up to said butt end portions.

Claim 6

The instrument recited in claim 1 wherein said coaxial electrodes have butt end portions located in different planes with said inner electrode and an insulative covering thereon both extending beyond the butt end portion of said outer electrode.

Claim 7

The instrument recited in claim 1 wherein said spark discharge members comprise a pair of metallic cylinders having plane-parallel opposed discharge butt end surfaces to form said discharge gap.

Claim 8

The instrument recited in claim 6 wherein said cylinders are formed of tungsten.

Claim 9

The instrument recited in claim 1 wherein said electrical circuitry includes two pairs of spark discharge members, the members of each pair being separated so as to form an electrical discharge gap and being connected in series circuit relationship between said coaxial electrodes and said capacitor means.

Claim 10

The instrument recited in claim 8 wherein said spark discharge members have spacings between about 0.3 and 0.7 millimeters, and the spacing between the coaxial electrodes is approximately 0.5 millimeters.

Claim 11

The instrument recited in claim 1 wherein said electrical circuitry includes three pairs of spark discharge members, the members of two of said pairs being separated with substantially equal spacings, and the members of the third pair being separated with a different spacing; and means for controlling the intensity of the discharge between said coaxial electrodes including means for optionally connecting either said two pairs in operative relation with said coaxial electrodes or said third pair and only one of said pairs in operative relation with said coaxial electrodes.

Claim 12

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior and an illuminating lamp; an elongated lithotrite adapted for introduction through the interior of said cystoscope and having an inner and an outer electrode insulated from each other and adapted to extend beyond one end of the cystoscope, and conductor members adapted to extend through the cystoscope interior and beyond the other cystoscope end; electric pulser means connected to said lithotrite conductor members and comprising a power transformer having windings located on separate legs and air gaps between the windings and the legs; an electrical grounding system connected with said cystoscope lamp; a device for remote control of said transformer connected to it through said grounding system; an accumulating device with capacitors fed from said power transformer and at least one pair of tungsten cylinders connected between said electrodes, the tungsten cylinders having plane-parallel opposed discharge butt end surfaces, and means for changing the discharge gap spacing between said end surfaces.

Claim 13

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior and an illuminating lamp; an elongated lithotrite adapted for introduction through the interior of said cystoscope and having an inner and an outer electrode insulated from each other and adapted to extend beyond one end of the cystoscope, and conductor members adapted to extend through the cystoscope interior and beyond the other cystoscope end; electric pulser means connected to said lithotrite conductor members and comprising a power transformer having windings located on separate legs and air gaps between the windings and the legs; an electrical grounding system connected with said cystoscope lamp; a device for remote control of said transformer connected to it through said grounding system; an accumulating device with capacitors fed from said power transformer and at least one pair of tungsten cylinders connected between said electrodes, the tungsten cylinders having plane-parallel opposed discharge butt end surfaces, and means for changing the discharge gap spacing between said end surfaces.

Claim 14

An instrument for crushing stones in the urinary bladder as claimed in claim 11, wherein the lithotrite electrodes have end portions which are positioned in different planes while the insulation between the electrodes covers the inner electrode up to its end and extends beyond the end of the outer electrode.

Claim 15

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior; an elongated lithotrite adapted for introduction into a urinary bladder through the interior of said cystoscope and having two coaxial electrodes insulated from each other with each of said electrodes having butt end portions separated by a gap adapted to extend beyond one end of the cystoscope; and electric pulser means connected to said lithotrite for causing an electric breakdown of the gap formed between the butt end portions of said electRodes when the electrodes are immersed in a liquid medium as a result of which a hydraulic shock wave is formed in the liquid medium, said electric pulser means including a pair of spaced discharge members connected in series circuit relationship with said electrode gap.

Claim 16

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior; an elongated lithotrite adapted for introduction into a urinary bladder through the interior of said cystoscope and having two coaxial electrodes insulated from each other with each of said electrodes having butt end portions separated by a gap adapted to extend beyond one end of the cystoscope; and electric pulser means connected to said lithotrite for causing an electric breakdown of the gap formed between the butt end portions of said electRodes when the electrodes are immersed in a liquid medium as a result of which a hydraulic shock wave is formed in the liquid medium, said electric pulser means including a pair of spaced discharge members connected in series circuit relationship with said electrode gap.

Claim 17

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior and an illuminating lamp; an elongated lithotrite adapted for introduction into a urinary bladder through the hollow interior of said cystoscope and having two coaxial electrodes insulated from each other; grounding means for said lithotrite connected with said cystoscope lamp; and electric pulser means connected to said electrodes comprising a power transformer, a device for remote control of said transformer connected with the transformer, an accumulating device including capacitors fed from said power transformer, and pulse-forming dischargers including a pair of spaced discharge members connected with the electrodes of said lithotrite and with said accumulating device.

Claim 18

An instrument for crushing stones in the urinary bladder comprising in combination: an operative cystoscope having a hollow interior and an illuminating lamp; an elongated lithotrite adapted for introduction into a urinary bladder through the hollow interior of said cystoscope and having two coaxial electrodes insulated from each other; grounding means for said lithotrite connected with said cystoscope lamp; and electric pulser means connected to said electrodes comprising a power transformer, a device for remote control of said transformer connected with the transformer, an accumulating device including capacitors fed from said power transformer, and pulse-forming dischargers including a pair of spaced discharge members connected with the electrodes of said lithotrite and with said accumulating device.

Claim 19

An instrument for crushing concretions in a urinary tract comprising: two coaxial electrodes insulated from each other, one of said electrodes being a central conductor and the other being an outer conductor surrounding said central conductor, said electrodes having butt end portions located in substantially a single plane with insulation covering the central electrode up to the butt end portion; means for positioning said electrodes in a urinary bladder adjacent a stone to be crushed; and electric pulser means connected to said coaxial electrodes and including a power transformer having a high voltage winding, a manually operated device for remote control of said electric pulser means, and an accumulating device including capacitors connected to be energized from said power transformer and two pairs of spark discharge members forming two discharge gaps connected in series with the gap between said electrodes and across the accumulating device, said two discharge gaps being between a pair of plane-parallel, opposed butt end surfaces of said discharge members.

Claim 20

An instrument for crushing concretions in a urinary tract comprising: two coaxial electrodes insulated from each other, one of said electrodes being a central conductor and the other being an outer conductor surrounding said central conductor, said electrodes having butt end portions located in substantially a single plane with insulation covering the central electrode up to the butt end portion; means for positioning said electrodes in a urinary bladder adjacent a stone to be crushed; and electric pulser means connected to said coaxial electrodes and including a power transformer having a high voltage winding, a manually operated device for remote control of said electric pulser means, and an accumulating device including capacitors connected to be energized from said power transformer and two pairs of spark discharge members forming two discharge gaps connected in series with the gap between said electrodes and across the accumulating device, said two discharge gaps being between a pair of plane-parallel, opposed butt end surfaces of said discharge members.

Claim 23

The method recited in claim 16 wherein step (g) comprises the steps of: a. setting the electric pulser so as to be conditioned to generate hydraulic shock waves of a first intensity and repetition frequency; b. manually operating said remote control device so as to activate said electric pulser and generate said hydraulic shock waves of said first intensity and repetition frequency; c. optically examining said concretion to determine whether the concretion has fractured; and d. in the event that the concretion has not fractured, adjusting the setting of the electric pulser so as to change the intensity and repetition frequency of said hydraulic shock waves, and repeating the above steps (e), (f), and (g).

Claim 24

For use with an instrument for crushing stones in the urinary bladder, a cable member having at one end a connector terminal member having a pair of insulated conductors for connection to a mating terminal member supplied witH power from said instrument and at the other end two electrodes, one of said electrodes being a central conductor and the other electrode being an outer, substantially cylindrical electrode coaxially disposed relative to said central conductor and separated from said central conductor by insulation material having a thickness of at least about 0.35 millimeters; a flexible cable having a length sufficient to extend through the urinary tract and into the urinary bladder comprising a central insulated wire, a second wire connecting said electrodes to said connector terminal member, and a tubing of insulation material extending as a unitary member of substantially uniform diameter between the connector terminal member and said electrode and covering the outer surface of said outer electrode, said tubing having a thickness sufficient to prevent arcing to other conducting materials and an outside diameter sufficiently small to allow insertion of said electrodes through the urinary tract into the urinary bladder.

Claim 25

For use with an instrument for crushing stones in the urinary bladder, a cable member having at one end a connector terminal member having a pair of insulated conductors for connection to a mating terminal member supplied witH power from said instrument and at the other end two electrodes, one of said electrodes being a central conductor and the other electrode being an outer, substantially cylindrical electrode coaxially disposed relative to said central conductor and separated from said central conductor by insulation material having a thickness of at least about 0.35 millimeters; a flexible cable having a length sufficient to extend through the urinary tract and into the urinary bladder comprising a central insulated wire, a second wire connecting said electrodes to said connector terminal member, and a tubing of insulation material extending as a unitary member of substantially uniform diameter between the connector terminal member and said electrode and covering the outer surface of said outer electrode, said tubing having a thickness sufficient to prevent arcing to other conducting materials and an outside diameter sufficiently small to allow insertion of said electrodes through the urinary tract into the urinary bladder.

Claim 26

Apparatus as defined in claim 18 wherein the second wire is an uninsulated single wire of sufficiently small diameter to extend along the outer surface of the insulation on the central wire and under the inner surface of said tubing of insulation material to thereby and not materially decrease the flexibility of said flexible cable.

Claim 27

Apparatus as defined in claim 19 wherein said flexible cable has a length of approximately one-half meter and an outside diameter of approximately six millimeters, the central insulated wire is not copper, and said second wire is copper.

Claim 28

Apparatus as defined in claim 18 together with a second cable having at one end a connector terminal member adapted to mate with the connector terminal member of said lithotrite and at the other end a pair of coaxial terminals, each having an insulated inner conductor and an outer coaxial shield, a junction member for merging said two insulated conductors inside a single outer coaxial shield which extends from said junction member to the vicinity of, but not beyond, said connector terminal member on said second cable.