Ultrasound probe

Abstract

A method for treating a stone mass may include using an ultrasonic probe to generate acoustic energy and disrupt the mass. The method may include varying the frequency at which disruption occurs to treat the mass using a resonant frequency. The ultrasonic probe may have a distal tip for contact with the mass, the tip having a configuration for concentrating stress on the mass. The ultrasonic probe may have two or more ultrasonic horns to allow for higher voltage and power levels.

Description

[Technical Field]

[0001] This specification relates to techniques and exemplary ultrasound probes for destroying obstructions such as physiological "stones" using lithotripsy. [Background technology]

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 908,020, filed September 30, 2019, the entire contents of which are incorporated herein by reference.

[0003] Medical endoscopes, first developed in the early 1800s, have been used to examine the interior of the body. A typical endoscope has a distal end equipped with an optical or electronic imaging system and a proximal end with controls for operating the device or viewing images. An elongated shaft connects the proximal and distal ends. Some endoscopes allow a physician to pass instruments through one or more working channels, for example, to remove tissue or retrieve objects.

[0004] Over the past several decades, several advances have been made in the field of endoscopy, and particularly with regard to the destruction of physiological stones in the bile duct, urinary tract, kidney, and gallbladder. Physiological stones in these areas are destroyed and / or removed because they can obstruct the duct and cause considerable pain to the patient. Different techniques have been developed to destroy stones, including ultrasound or other acoustic lithotripsy, pneumatic lithotripsy, electrohydraulic lithotripsy (EHL), and laser lithotripsy, which may involve the destruction of stones using, for example, green light, YAG, or holmium lasers. Summary of the Invention [Means for solving the problem]

[0005] The present disclosure provides, among other things, devices and methods for stone fragmentation and removal using an ultrasonic probe. During treatment, drive signals can be mixed to treat the stone mass. The ultrasonic probe can include a probe tip with a morphology that correlates to the targeted stone mass type or size. The ultrasonic probe can include two or more ultrasonic horns to aid in probe performance.

[0006] During stone treatment, one or more drive signals may be transmitted to an ultrasonic transducer within the probe. The transducer may vibrate the probe shaft (e.g., a waveguide) based on the drive signals transmitted to the transducer. In some cases, the drive signals may be provided at two or more variable frequencies. The use of several variable frequencies may allow for sweeping around several frequencies to find the resonant frequency of the targeted stone and may allow for more efficient destruction of the stone mass.

[0007] The ultrasound probe may have a probe tip with a configuration designed to treat the targeted stone mass. For example, the probe tip may have a tip with a reduced area and more concentrated corners for treating harder stone masses. In contrast, the probe tip may be flatter for treating softer stone masses.

[0008] Two or more ultrasonic horns may be used in an ultrasonic probe, such as in the transducer and in the waveguide, and the ultrasonic horns may be placed against one or more stress nodes in the waveform to allow the probe to withstand higher voltage or power levels.

[0009] In the drawings, which are not necessarily drawn to scale, the same numbers may describe similar components in different views. The same numbers with different letter suffixes may represent different instances of similar components. The drawings generally illustrate, by way of example, but not by way of limitation, various examples discussed in the present specification. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a schematic diagram of an exemplary device incorporating features of an ultrasound probe. [Figure 2] FIG. 1 is a perspective view of an exemplary ultrasound probe. [Figure 3] 3 is a close-up view of an exemplary distal tip of the ultrasound probe of FIG. 2. [Figure 4] FIG. 3 is a side view of the exemplary ultrasound probe of FIG. 2. [Figure 5] FIG. 5 is an expanded view of an exemplary waveguide of the ultrasound probe of FIG. 4. [Figure 6] 5 is a close-up view of an exemplary distal tip of the ultrasound probe of FIG. 4. [Figure 7A] 1 is a schematic diagram of an exemplary distal tip of an ultrasound probe. [Figure 7B] 1 is a schematic diagram of an exemplary distal tip of an ultrasound probe. [Figure 8] FIG. 1 illustrates a side view of an exemplary distal tip and associated waveforms of an ultrasound probe. [Figure 9] FIG. 1 illustrates a side view of an exemplary distal tip and associated waveforms of an ultrasound probe. [Figure 10] 1 is a graph depicting an example of node and anti-node placement in an ultrasound probe. [Figure 11] 1 is a graph depicting an example of node and anti-node placement in an ultrasound probe. [Figure 12] 1 is a graph depicting an example of a waveform in an ultrasound probe. [Figure 13A] 1 is a graph illustrating an example of a waveform in an ultrasound probe. [Figure 13B] 1 is a graph illustrating an example of a waveform in an ultrasound probe. [Figure 13C] 1 is a graph illustrating an example of a waveform in an ultrasound probe. [Figure 13D] 1 is a graph illustrating an example of a waveform in an ultrasound probe. [Figure 13E] 1 is a graph illustrating an example of a waveform in an ultrasound probe. [Figure 14] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 15] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 16] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 17] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 18] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19A] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19B] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19C] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19D] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19E] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19F] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19G] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19H] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19I] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. [Figure 19J] 1 is a schematic diagram of an exemplary probe tip of an ultrasound probe. DETAILED DESCRIPTION OF THE INVENTION

[0011] The devices and techniques described herein can be used in conjunction with an ultrasound probe, such as for use with a nephroscope or trocar. Features can be used with ultrasonic lithotriptor devices to provide techniques that allow for faster targeted removal, such as stone removal. A faster mass removal rate for stones may indicate that greater force is required. For example, a higher drive voltage / power level, resulting in greater probe tip displacement, is more effective in accelerating mass removal time. However, the use of higher drive voltage / power levels means that the stress of pushing the probe with such force can destroy the probe within minutes or even seconds. Features described herein can address this problem of probe breakage when using higher drive voltage / power levels by providing the probe with a probe tip horn at its distal end. Providing a probe tip horn allows the probe to move at higher displacements (with the use of higher drive voltage / power levels) without probe breakage. This can be used with sinusoidal or approximately square waveforms.

[0012] 1 and 2, there is shown a schematic diagram of a system 10 for use with an exemplary probe 14. Features are described with reference to the examples shown in the drawings, but it should be understood that the features may be embodied in many alternative forms of the examples. Additionally, any suitable size, shape, or type of elements or materials may be used.

[0013] The system 10 may include a controller 12 and an ultrasonic probe 14. In an example, the system 10 is a medical system, such as for lithotripsy. The controller 12 may include at least one processor 16 and at least one memory 18 with software 20. For example, the ultrasonic probe 14 shown in FIG. 2 may include a transducer 22 and a shaft as a waveguide 24. The controller 12 may include or control a driver to send a drive signal to the transducer 22. The transducer 22 may include one or more piezoelectric members 23, such as a stack, as illustrated in FIG. 1. Here, the piezoelectric members 23 may be configured to receive a drive signal via the controller 12 to actuate the transducer. The waveguide 24 may be configured to be moved or vibrated by the transducer 22.

[0014] FIG. 3 illustrates the distal tip 26 of the probe 14. As illustrated in FIG. 3, the distal tip 26 of the waveguide 24 can be inserted into a patient 28 and brought into contact with a target 30, such as a stone, to enable the probe 14 to fragment the target 30 using ultrasound. In this example, the probe 14 can include a handle section 32 for a user. The handle section 32 can include user controls 34. The transducer 22 can be located within the handle section 32. The waveguide 24 can extend forward from the distal end of the handle section 32 in a generally cantilevered manner.

[0015] 4-6 show additional views of the probe 14. Referring to FIGS. 4-6, a mounting section or connector 36 is provided at the proximal end of the waveguide 24 for connecting the waveguide to a transducer section having the transducer 22. The transducer section may include a first horn 38. The first horn 38 may be part of the transducer 22 and the proximal end of the waveguide 24. The waveguide 24 may include a probe tip section 40 and a distal horn section 42. Thus, two horns are provided: the first horn 38 located as part of the transducer 22, and the second horn 42 located proximate the distal end or tip 26 of the probe. In some cases, three or more horns may be provided. Additionally, in another alternative, only a single horn, horn 42, may be provided. The probe tip section 40 may be configured to have a section with a first level of displacement, and the distal horn section 42 may be configured to have a different second level of displacement. In the example shown, the second level of displacement is relatively higher than the first level of displacement. The distal end 26 of the probe forms a cutting surface for direct contact with the target 30. The waveguide 24 may also include a passage or conduit 37 for suction from the distal end 26 into the handle section 32. By providing a horn at the distal end of the probe, such as above the ultimate stress node, the probe may provide a higher displacement at the distal cutting edge 26 than conventional probes, with a reduced risk of the probe breaking at the higher displacements.

[0016] 6, the probe tip horn may include a transition section 44 between the probe tip section 40 and the distal horn section 42. The transition section 44 may be located after the distal final stress node 46, as discussed further below. The transition section 44 may provide a tapered region from the final stress node 46 to a location of a second, relatively higher displacement of the waveguide 24 in the distal horn section 42.

[0017] 7A and 7B illustrate close-up views of the probe tip and horn. In FIGS. 7A and 7B, the waveguide 24 has a generally non-uniform wall thickness. FIG. 7A illustrates a cross-section of the waveguide at the probe tip section 40, and FIG. 7B is a cross-section of the waveguide at the distal horn section 42. As can be seen, in this example, the wall thickness is smaller in the distal horn section 42 relative to the probe tip section 40. Thus, the passage 37 may be larger in the distal horn section 42 than in the probe tip section 40. A transition section 44 provides a taper between these two sections to form the horn functionality.

[0018] Horns 38, 42 (ultrasonic horns) are a means of creating increased amplitude of displacement from an ultrasonic transducer. This is done by varying the cross-sectional area of ​​the base of the horn relative to the tip of the horn. The gain of a horn is the ratio of the surface area at the base to the surface area at the tip, in the lossless case. Horn gain applies to mechanical wave displacement. The shape of the horn can determine the gain of the horn. This is because of the displacement node effect. Horns can be designed as long resonating bars with half a wavelength. By varying the shape of the horn, it is possible to impart a gain factor to the horn, increasing the amplitude of vibration. Exemplary horns are illustrated in Figures 8 and 9. Three common horn designs are step, exponential, and catenoidal, as shown in Figure 8 (Ultrasonic Welding. Handbook of Plastics Joining (2nd Edition). A Practical Guide. 2009, Pages 15-35; https: / / www.sciencedirect.com / science / article / pii / 897808l5515814500044). The catenoidal horn has the highest amplitude gain and limited stress. Further amplitude and stress curves are shown in Figure 9 for other examples (Power Ultrasonic Equipment - Practice and Application http: / / www.sonicsvstems.co.uk / page / power-ultrasonics-a-guide / 39 / ).

[0019] In FIG. 10, a diagram illustrating displacement along the length of waveguide 24 for a simulated 20 kHz standing wave is shown. As can be seen, there are nodes (also called compression nodes or steady nodes or stress nodes) that (ideally) have compression or tension with no displacement. As shown in FIG. 10, there are antinodes (also called displacement nodes or extension nodes). The antinodes are configured to have displacement or extension. The locations of the steady nodes are locations of stress where failure can occur. A transition section 44 is located after the last steady node 46.

[0020] In this example, the exemplary probe tip horn is composed of three main sections, two of which are shown in FIG. 6 . The first section is the probe tip section 40, which provides a cross-sectional area across all stress nodes shown in FIG. 10 that is relatively larger than the cross-sectional areas of the other two main sections. The relatively larger cross-sectional area along the probe tip section 40 can help protect this area from failure. The distal horn 42 has a cross-sectional area that is thinner, averaged over its length, than the cross-sectional area of ​​the probe tip section 40. This relatively thinner cross-sectional area can be configured to exhibit a larger displacement in response to the same force passing through the probe tip body. The transition 44 between the distal horn 42 and the probe tip section 40 can have a taper between the two cross-sectional areas, which can be derived with any decreasing mathematical function, or a single step from one inner diameter to another. The taper or overlap of the two sections reduces stress at the beginning or bottom of the horn 42. In this example, because stress still exists in areas adjacent to the stress node 46 and is not solely located at the center of the stress node 46, the transition 44 provides a gradual change or step-like transition in this area. The location of the horn section and the beginning of the taper is at or near the final stress node 46 in the probe tip section 40. This allows the areas with peak stress to have a large cross-sectional wall area across them. The length of the probe tip horn is approximately one-quarter to one-half wavelength of the fundamental frequency. A longer horn relative to the final displacement node allows for a more global displacement to occur (terminating at the tip 26). A passage 37 in the center of the horn 42 provides suction to remove the stone or particulate fragments being removed. The tip 26 of the horn is the cutting surface. The feature, as described herein, is hollow, providing a cutting surface and having an entrance into the suction passage at the distal end of the probe. The target material 30 can be, for example, a stone, which may have a variety of hardnesses.

[0021] The waveguide 24 may have an attachment point 36 for connection to the transducer 22. The waveguide 24 may have attachment points (not shown) for a spring and free mass. However, the waveguide 24 may function without a spring. The probe tip section 40 has a length many times longer than the horn 42, allowing for passage / positioning of a low-stress area of ​​the probe tip section through the device and into the patient's body. This may cover two or more stress nodes over this length.

[0022] The ratio of the cross-sectional area of ​​the probe tip section 40 (see FIG. 7A) to the cross-sectional area of ​​the horn section 42 (see FIG. 7B) may be relatively larger. This allows for larger displacements to occur within the horn 42 relative to the remainder of the probe tip body. The cross-section of the horn 42 may be reduced in either the outer diameter, the inner diameter, or a combination of the outer and inner diameters relative to the remainder of the probe tip body. The horn 42 need not have the same inner or outer diameter as the probe tip section 40. The relative mechanical displacement gain of the probe tip 26 is given by the ratio of the cross-sectional area of ​​its probe tip (APT) to that of the horn (AH), as Gain:APT / AH. A larger cross-sectional area in the probe tip section 40 makes it stronger and protects it from damage at stress nodes, while a thinner cross-section in the horn section 42 allows it to have larger displacements at the distal tip 26. 4-7, by providing a horn at the distal end of the probe beyond the final stress node, the probe can provide increased displacement at the distal cutting edge 26 with a reduced risk of the probe breaking based on the increased displacement. Otherwise, the probe would likely break if the second horn were located before the final stress node.

[0023] As noted above, the features described herein can be used with, for example, sinusoidal or approximately square waveforms. Referring also to FIG. 11 , simulated displacement across a probe tip when driven by a wave approximating a square wave is shown, showing a fundamental frequency of 20 kHz, the third harmonic (60 kHz), and the fifth harmonic (100 kHz). The nodes (static nodes) and antinodes (displacement nodes) are indicated. Note that in FIG. 11 , the node for the fifth harmonic is not shown; only the fifth harmonic displacement waveform is shown. FIG. 12 shows a similar diagram for a fundamental frequency of 10 kHz, the third harmonic (30 kHz), and the fifth harmonic (50 kHz). This shows the opportunity for alternating harmonic drive to drive the transducer at different frequencies to increase the length of the displacement nodes while allowing the harmonics to have higher impulse repetition. The use of harmonic energy at multiples of the fundamental wavelength allows for the superposition of displacements at the tip of the transducer with harmonic energy as multiples of the fundamental wavelength (wave number).

[0024] Ultrasonic transducers convert electrical energy into mechanical waves through the piezoelectric effect. Thus, the transducer in this example comprises a piezoelectric member. The piezoelectric effect is a transduction mechanism that involves an increase in the mechanical length of the transducer in response to a voltage applied to the transducer. The change in length of the transducer is proportional to many variables, including, but not limited to, the voltage level and frequency at which the signal is applied to the transducer.

[0025] When the electrical frequency applied to the transducer is equal to the time it takes for the mechanical wave to traverse the crystal and return, optimal energy conversion can occur due to resonance, resulting in a mechanical displacement many times larger than that at any other frequency.

[0026] Referring to FIG. 13A, wave 100 represents a square wave, wave 102 is a first fundamental sine wave, wave 104 is a first harmonic, and wave 106 is a second harmonic. In this manner, the signal for creating the mechanical harmonics is included in the same wave signal used to excite the piezoelectric crystal. In one example, the input signal is the sum of multiple sinusoidal waveforms, each at a different frequency. The frequency of each sinusoidal waveform can be related to a particular sinusoidal frequency (e.g., its harmonics). In another example, the input signal can include waves at one or more frequencies related to the fundamental frequency of the piezoelectric stack. The input can include a signal whose frequency changes during processing. The input can include a signal that approximates a square wave. A square wave is simply an infinite sum of sine waves at the fundamental, first harmonic, second harmonic, third harmonic, and so on. Although it may not be possible to achieve an infinite sum or a perfect square shape (see the bumps 110 near the edges of the square shape in FIG. 13B in the digital signal), the signal may roughly approximate a square wave. Figures 13C-13E show the individual waves 102, 104, 108 of FIG. 13B separately for clarity.

[0027] In response to the input waveform of FIG. 13A, the mechanical state of the transducer may approach a ballistic-like impact s. The system may input multiple frequencies, including the resonant frequency, into the waveguide for use in destroying the target. The multiple frequencies may be provided in any waveform. The use of an approximate square wave is merely one example. Any suitable waveform with a variable frequency or multiple frequencies may be used, one of which induces resonance in the target. The use of multiple frequencies is likely to excite the resonant frequency of the target, allowing for self-resonance. The use of a square wave (or a wave approximating a square wave) may also result in increased acceleration of displacement in the waveguide relative to conventional acceleration of displacement, and increased velocity of displacement in the waveguide relative to conventional velocity of displacement, along with faster transitions in the transducer (piezoelectric driver).

[0028] The use of a drive system with multiple frequencies (fundamental and / or one or more harmonics) allows more overall energy and power to enter the transducer and, therefore, create more energy at the probe tip. The described system is capable of aspiration to remove target portions, such as stone portions, removed from the main target body. While the system is described as operating from a fundamental frequency, the electrical ultrasonic driver can be modified so that the fundamental frequency becomes what was originally a harmonic or sub-harmonic, allowing a new range of frequency combinations to be used. So, for example, if the primary system is designed to operate at 20 kHz, the fundamental frequency can be changed to 60 kHz or 10 kHz at a new location using a third harmonic.

[0029] Figure 13B shows the transitions of the fundamental frequency, the fifth harmonic, and the approximated square wave (from the 101st harmonic) with different transition times, where the approximated square wave is nearly instantaneous. It is believed that mass removal is improved with faster displacement transition times per unit time. Also expected is a higher displacement output, which is not shown in the figure.

[0030] Another feature is driving the transducer at even harmonics of the fundamental frequency. So, for example, in a system where the fundamental frequency is 20 kHz, the transducer can be driven at 40 kHz. Another example is for the transducer to be driven at 10 kHz or some other multiple of the fundamental frequency (e.g., 30 kHz, etc.). Referring also to FIG. 14, a distal tip 26 is shown bearing against a surface 31 of a target 30. In this example, the distal tip 26 is generally flat. FIG. 15 shows a diagram illustrating tip contact pressure against the surface 31. Referring also to FIGS. 16 and 17, similar diagrams are shown for a different distal tip 126 of a shaft forming a waveguide 124, such as the distal tip of the shaft shown in FIG. 18. The distal tip 126 forms the frontmost surface of the shaft. In this example, the tip 126 includes a recess 128 in the frontmost edge of the tip 126. The recess 128 has a generally wedge or triangular shape, although other shapes may be provided. Larger arrows in FIG. 17 illustrate greater pressure. As seen in FIG. 17, the diagram illustrating tip contact pressure against surface 31 shows areas 130 of increased pressure. Assuming the same force is applied, the reduced area at the leading edge due to recesses 128 causes increased contact pressure. These areas 130 are at the corners or intersections 131 of recesses 128 with the generally flat leading edge of the distal tip. The corners have an approximate wedge shape, but with a curved radius. Thus, each recess 128 terminates at its leading edge at 131, with the leading edge forming a non-zero angle with the generally flat front surface 126. In this example, recesses 128 are located diametrically opposite one another.

[0031] 19A-19G, other shapes at the distal tip of the shaft may be provided, such as having only one recess as shown in FIG. 19A, having an oval or non-circular shape as shown in FIG. 19B, having three or more recesses 128 that are not diametrically opposed as shown in FIG. 19C, having additional teeth 140 as shown in FIG. 19D, having a square or rectangular shape as shown in FIG. 19E, having a triangular shape as shown in FIG. 19F, and having a polygonal shape as shown in FIG. 19G. Also referring to FIG. 19H-19J, other shapes of recesses 128 may be provided, such as a V-shape with a relatively sharp angle as shown in FIG. 19H, a circular shape as shown in FIG. 19I, and a rectangular or square shape as shown in FIG. 19J. These are merely examples and should not be considered limiting.

[0032] With the features described herein, an ultrasonic lithotripsy probe can be provided with concentrated tip contact pressure against a target, such as a stone. Such concentration of tip contact pressure aids in target disintegration, particularly for hard stone masses. While the example shown in FIG. 18 has two generally semicircular recesses and two triangular recesses as a flat surface leading edge, other shapes may be provided, including rectangular, non-flat, protruding tines, more or fewer than two recesses, etc. In the example shown in FIG. 18, the corners do not have sharp angles. The corners are curved with a radius to act as stress relief and prevent damage to the tip. Forming two triangular recesses directly opposite each other also makes it easier to create the recesses simultaneously during manufacturing. Shapes such as those shown in FIG. 14 are good for breaking up stones with relatively soft hardness. However, for breaking up stones with relatively hard hardness, protruding tines are better. With the shape shown in Figure 18, a hybrid design is provided with a substantially curved flat surface 132 (nearly semicircular) that works best for softer targets, and the hybrid shape also includes corners 134 that work better for harder targets. Thus, the tip 126 shown in Figure 18 can be used for both hard and soft targets with faster mass removal rates than traditional flat shapes. This shape also provides an atraumatic leading edge for the patient.

[0033] An example may be provided for an ultrasonic probe comprising a transducer and a shaft configured to form a waveguide for directing ultrasonic waves, wherein a proximal end of the shaft is operably connected to the transducer and a distal end of the shaft is configured to direct the ultrasonic waves towards a target, the shaft comprising a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft comprising a front surface having a generally flat shape, the distal end of the shaft further comprising a first recess, the first recess terminating in at least one front edge, the at least one front edge forming a non-zero angle with the generally flat front surface.

[0034] The distal end of the shaft may further include a second recess within the generally flat front surface adjacent the entrance to the conduit, the second recess terminating in a second at least one forward edge that forms a non-zero angle with the generally flat front surface. The second recess may be located diametrically opposite the first recess. The generally flat front surface may have a circular shape. The generally flat front surface may have a non-circular, generally annular shape. The generally flat front surface may form at least two teeth between the first and second recesses. The generally flat front surface may form a majority of the surface along the front end of the distal end of the shaft. The distal end of the shaft may form teeth at the front end of the distal end of the shaft. The generally flat front surface may have a generally rectangular shape. The generally flat front surface may have a portion that is substantially semicircular. The second recess may be located not diametrically opposite the first recess. The first recess may have a substantially triangular shape. The first recess may have a substantially rectangular shape. The first recess may have a substantially circular shape. A corner may be provided where the first recess terminates at at least one forward-most edge, the corner including an angled corner having an angle of about 100 to 160 degrees.

[0035] An exemplary method may include providing a shaft configured to form a waveguide for directing ultrasound, the shaft having a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft comprising a front surface having a generally flat shape; forming a first recess within the generally flat front surface, the first recess terminating in at least one front edge, the front edge of the first recess forming a non-zero angle with the generally flat front surface; and connecting the proximal end of the shaft to a transducer, the distal end of the shaft configured to contact an anatomical target both at the generally flat front surface and at one or more locations where the first recess terminates at the at least one front edge.

[0036] An exemplary method includes inserting an ultrasound probe into a patient's body, the ultrasound probe comprising a shaft configured to form a waveguide for directing ultrasound waves, the shaft comprising a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends; and placing the distal end of the ultrasound probe against an anatomical target, the distal end of the shaft comprising a front surface having a generally flat shape, the distal end of the shaft further comprising a first recess within the generally flat front surface, the first recess forming at least and vibrating the shaft to vibrate a distal end of the ultrasonic probe against the anatomical target, wherein the distal end of the shaft contacts the anatomical target both at the generally flat front surface and at the one or more locations where the first recess terminates at the at least one front-most edge, and wherein the at least one front-most edge of the first recess forms a non-zero angle with the generally flat front surface, during vibration of the shaft to destroy at least a portion of the anatomical target.

[0037] An exemplary method may be provided for inducing resonance in an anatomical target, thereby disrupting the anatomical target, the method including transmitting a drive signal to drive a transducer of an ultrasonic probe and vibrating a waveguide of the ultrasonic probe based on the drive signal transmitted to the transducer, the drive signal including a plurality of frequencies, at least one of the plurality of frequencies being a resonant frequency of the anatomical target, so as to induce resonance in the anatomical target, thereby disrupting the anatomical target.

[0038] The drive signal may be of variable frequency. The transducer may include a piezoelectric device, and the transmission of the drive signal may include transmitting harmonic frequencies related to a fundamental frequency for resonance of the piezoelectric device. The transmission of the drive signal may include a wave approximating a square wave, and the multiple frequency drive signal causes an accelerated transition time in the shape change of the piezoelectric device. The ultrasonic waveguide may include a distal end that contacts the anatomical target to cause resonance within the anatomical target.

[0039] An example may be provided using an apparatus comprising: an ultrasonic probe comprising a transducer and a waveguide for directing ultrasonic waves, the waveguide having a distal end configured to contact an anatomical target; and a driver configured to transmit a drive signal to drive the transducer, the drive signal including a plurality of frequencies, at least one of the plurality of frequencies being a resonant frequency of an anatomical target so as to induce resonance in the anatomical target, thereby disrupting the anatomical target.

[0040] An example may be provided using a non-transitory program storage device that is machine readable and tangibly embodies a program of instructions executable by the machine to perform operations, the operations including transmitting a drive signal to drive a transducer of an ultrasonic probe, the transducer being configured to vibrate a waveguide of the ultrasonic probe based on the drive signal transmitted to the transducer, the transmitting of the drive signal including transmitting the drive signal at a plurality of frequencies, at least one of the plurality of frequencies being a resonant frequency of an anatomical target to induce resonance in the anatomical target, thereby disrupting the anatomical target.

[0041] An example may be provided using an ultrasound probe comprising a transducer and a shaft configured to form a waveguide for directing ultrasound waves, the proximal end of the shaft configured to contact the transducer and the distal end of the shaft configured to contact the anatomical target, the shaft comprising a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft configured to form an ultrasound horn.

[0042] The anatomical target may be a stone, and the distal end of the shaft may be configured to contact the stone. The transducer may be configured to generate ultrasound waves along the length of the shaft from the proximal end to the distal end, and the ultrasound horn may be located after the location of the last steady-state stress node in the shaft formed from the ultrasound. The transducer may be configured to generate ultrasound waves along the length of the shaft from the proximal end to the distal end, and the ultrasound horn may be located spaced apart from the location of the steady-state stress node in the shaft formed from the ultrasound. The ultrasound probe may further include a second ultrasound horn located proximate to the transducer. The shaft may have a uniform outer diameter along the length of the ultrasound horn at the ultrasound horn. The shaft may have a uniform inner diameter along the length of the ultrasound horn at the ultrasound horn. The shaft may have a wall thickness that varies along the length of the ultrasound horn at the ultrasound horn. The ultrasound horn may have a catenoidal shape. The cross-sectional area of ​​the shaft at the ultrasound horn may be smaller than the cross-sectional area of ​​the shaft at another location on the shaft. The shaft may include a tapered region at the transition between the ultrasonic horn and the remainder of the shaft.

[0043] An exemplary method may be provided that includes providing a shaft configured to form a waveguide for directing ultrasound, the shaft having a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft configured to form an ultrasound horn; and connecting the proximal end of the shaft to a transducer.

[0044] An exemplary method may be provided that includes inserting an ultrasonic probe into a patient's body, the ultrasonic probe having a shaft configured to form a waveguide for directing ultrasonic waves, the shaft having a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft configured to form an ultrasonic horn, placing the distal end of the ultrasonic probe against an anatomical target inside the patient, and vibrating the shaft with a transducer to vibrate the distal end of the ultrasonic probe against the anatomical target, the ultrasonic horn at the distal end of the shaft increasing displacement of the distal end of the shaft at the anatomical target. The ultrasonic horn at the distal end of the shaft may be located away from a location of a steady stress node in the shaft formed from the ultrasonic waves from the transducer.

[0045] An example may be provided using an ultrasonic probe comprising a transducer and a shaft configured to form an ultrasonic waveguide, wherein a proximal end of the shaft is connected to the transducer and a distal end of the shaft is configured to contact the stone, the shaft comprising a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft comprising a front surface having a substantially flat shape, the distal end of the shaft further comprising a first recess within the substantially flat front surface adjacent an entrance to the stone, the first recess forming two corners at an intersection of the first recess with the substantially flat front surface.

[0046] The distal end of the shaft may further include a second recess in the substantially flat front surface adjacent the entrance to the conduit, the second recess forming two corners at the intersection of the second recess with the substantially flat front surface. The second recess may be located diametrically opposite the first recess. The first recess may have a substantially triangular shape. The corners may be angled corners having an angle of approximately 100 to 160 degrees.

[0047] An exemplary method may be provided that includes: providing a shaft configured to form an ultrasonic waveguide, the shaft having a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft comprising a front surface having a substantially flat shape; forming a first recess in the substantially flat front surface adjacent an entrance to the stone, the first recess forming two corners at an intersection of the first recess with the substantially flat front surface; and connecting the proximal end of the shaft to a transducer, the distal end of the shaft configured to contact the stone at both the substantially flat front surface and at the two intersections with the first recess.

[0048] An exemplary method may be provided that includes: inserting an ultrasonic probe into a patient's body, the ultrasonic probe comprising a shaft configured to form an ultrasonic waveguide, the shaft comprising a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends; placing the distal end of the ultrasonic probe against a concretion inside the patient, the distal end of the shaft comprising a front surface having a substantially flat shape, the distal end of the shaft further comprising a first recess within the substantially flat front surface adjacent an entrance to the concretion, the first recess forming two corners at an intersection of the substantially flat front surface and the first recess; and vibrating the shaft to vibrate the distal end of the ultrasonic probe against the concretion, the distal end of the shaft contacting the concretion at both the substantially flat front surface and the two corners at the intersection of the first recess with the first recess during vibration of the shaft to break up at least a portion of the concretion.

[0049] An exemplary method may be provided that includes transmitting a drive signal to a transducer of an ultrasonic probe and vibrating an ultrasonic waveguide of the ultrasonic probe based on the drive signal transmitted to the transducer, the drive signal including multiple frequencies to cause the transducer to vibrate the ultrasonic waveguide with an increasing likelihood of exciting a resonant frequency of a stone in contact with the ultrasonic waveguide.

[0050] The transmission of the drive signal may include a wave approximating a square wave. The transmission of the drive signal may include a frequency sweep. The transducer may include a piezoelectric device, and the transmission of the drive signal may include transmitting harmonic frequencies related to a fundamental frequency for resonance of the piezoelectric device. The multiple frequency drive signal may cause an accelerated transition time in the shape change of the piezoelectric device. The ultrasonic waveguide may include a distal end that contacts the stone to induce resonance in the stone.

[0051] An example may be provided using an apparatus comprising an ultrasonic probe comprising a transducer and an ultrasonic waveguide, the ultrasonic waveguide having a distal end configured to contact a stone, and a driver configured to transmit a drive signal to the transducer, the drive signal including multiple frequencies to cause the transducer to vibrate the ultrasonic waveguide with an increasing likelihood of exciting the resonant frequency of a stone contacting the ultrasonic waveguide.

[0052] An example may be provided using a non-transitory program storage device that is machine readable and tangibly embodies a program of instructions executable by the machine to perform operations, the operations including transmitting a drive signal to a transducer of an ultrasonic probe, the transducer being configured to vibrate an ultrasonic waveguide based on the drive signal transmitted to the transducer, the transmitting of the drive signal including transmitting the drive signal at multiple frequencies to cause the transducer to vibrate the ultrasonic waveguide with an increasing likelihood that the ultrasonic waveguide will excite a resonant frequency of a stone in contact with the ultrasonic waveguide.

[0053] An example may be provided using an ultrasonic probe comprising a transducer and a shaft configured to form an ultrasonic waveguide, the proximal end of the shaft connected to the transducer and the distal end of the shaft configured to contact the stone, the shaft comprising a conduit passing through the shaft between the distal and proximal ends, and the distal end of the shaft comprising an ultrasonic horn.

[0054] The transducer may be configured to generate ultrasonic waves along the length of the shaft from the proximal end to the distal end, and the ultrasonic horn may be located after the location of the last steady-state stress node in the shaft formed from the ultrasonic waves. The transducer may be configured to generate ultrasonic waves along the length of the shaft from the proximal end to the distal end, and the ultrasonic horn may be located away from the location of the steady-state stress node in the shaft formed from the ultrasonic waves. The ultrasonic probe may further include a second ultrasonic horn located proximate to the transducer. The shaft may have a uniform outer diameter along the length of the ultrasonic horn at the ultrasonic horn. The shaft may have a uniform inner diameter along the length of the ultrasonic horn at the ultrasonic horn. The shaft may have a wall thickness that varies along the length of the ultrasonic horn at the ultrasonic horn. The ultrasonic horn may have a catenoidal shape. The cross-sectional area of ​​the shaft at the ultrasonic horn may be smaller than the cross-sectional area of ​​the shaft at other locations on the shaft. The shaft may include a tapered region at a transition section between the ultrasonic horn and the remainder of the shaft.

[0055] An exemplary method may be provided that includes providing a shaft configured to form an ultrasonic waveguide, the shaft having a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft comprising an ultrasonic horn; and connecting the proximal end of the shaft to a transducer.

[0056] An exemplary method may be provided that includes inserting an ultrasonic probe into a patient's body, the ultrasonic probe including a shaft configured to form an ultrasonic waveguide, the shaft including a proximal end, a distal end, and a conduit passing through the shaft between the distal and proximal ends, the distal end of the shaft including an ultrasonic horn; placing the distal end of the ultrasonic probe against a concretion inside the patient; and vibrating the shaft with a transducer to vibrate the distal end of the ultrasonic probe against the concretion, the ultrasonic horn at the distal end of the shaft increasing displacement of the distal end of the shaft at the concretion. The ultrasonic horn at the distal end of the shaft may be located away from a location of a steady stress node in the shaft formed from ultrasonic waves from the transducer.

[0057] It should be understood that the above description is merely illustrative. Various alternatives and modifications may be devised by those skilled in the art. For example, features recited in the various dependent claims may be combined with each other in any suitable combination. In addition, features from different examples described above may be selectively combined into novel examples. Accordingly, the present description is intended to embrace all such alternatives, modifications, and variations that fall within the scope of the appended claims.

[0058] Various notes and examples Each of these non-limiting examples may stand alone or may be combined in various permutations or combinations with one or more of the other examples.

[0059] Example 1 may include a device for acoustic lithotripsy comprising: an acoustically transparent elongated probe body extending between a distal portion and a proximal portion; and an acoustically transparent probe tip coupled to the probe body, the probe tip comprising a front surface extending distally from the probe body toward a target stone mass, the front surface including at least one recess.

[0060] Example 2 can include example 1, wherein the recess forms a non-zero angle with the front surface.

[0061] Example 3 can include any of Examples 1-2, wherein the recessed portion extends inward from the front surface along the front edge.

[0062] Example 4 can include any of Examples 1-3, further including at least two recesses facing each other at a front edge.

[0063] Example 5 can include any of Examples 1-4, where the front surface includes teeth between the recesses.

[0064] Example 6 can include any of Examples 1-5, wherein the leading edge has a circular, semicircular, or elliptical wall profile.

[0065] Example 7 can include any of Examples 1-6, where the leading edge has a triangular or square wall profile.

[0066] Example 8 can include any of Examples 1-7, wherein the leading edge has a polygonal wall profile.

[0067] Example 9 can include any of Examples 1-8, where the front surface includes a ring-like shape.

[0068] Example 10 can include any of Examples 1-9, further comprising at least one corner between the recess and the leading edge, wherein the at least one corner defines a non-zero angle.

[0069] Example 11 may include a device for stone fragmentation, comprising: means for applying an acoustic probe to a targeted stone mass, the probe comprising a probe tip, the probe tip comprising one or more recesses such that a front surface of the probe tip has one or more pressure points for coming into contact with the targeted stone mass; and means for transmitting acoustic energy through the probe to the targeted stone via the probe tip to induce vibration of the probe tip and one or more pressure points of the probe tip against the stone mass.

[0070] Example 12 may include example 11, further comprising: means for disintegrating the stone mass through acoustic energy provided to one or more pressure points.

[0071] Example 13 can include any of Examples 11-12, wherein the one or more pressure points include a first pressure point and a second pressure point, and the first pressure point is sharper than the second pressure point.

[0072] Example 14 may include a method for stone fragmentation, the method including the steps of applying an acoustic probe to a targeted stone mass, the probe having a probe tip, the probe tip having one or more recesses such that a front surface of the probe tip has one or more pressure points for coming into contact with the targeted stone mass, and transmitting acoustic energy through the probe to the targeted stone via the probe tip to induce vibration of the probe tip and one or more pressure points of the probe tip that impinge on the stone mass.

[0073] Example 15 may include example 14, further including disintegrating the stone mass through acoustic energy provided to one or more pressure points.

[0074] Example 16 may include any of Examples 14-15, where transmitting acoustic energy through the probe to the targeted stone via the probe tip to induce vibration of one or more pressure points includes vibrating one or more equally spaced pressure points around a front surface of the probe tip.

[0075] Example 17 may include any of Examples 14-16, where transmitting acoustic energy through the probe to the targeted stone via the probe tip to induce vibration of one or more pressure points includes vibrating one or more unevenly spaced pressure points about a leading edge of the probe tip.

[0076] Example 18 may include any of Examples 14 to 17, wherein transmitting acoustic energy through the probe to the targeted stone via the probe tip to induce vibration of one or more pressure points includes vibrating a first pressure point and a second pressure point, and the first pressure point is sharper than the second pressure point.

[0077] Example 19 can include any of Examples 14-18, further including the step of applying pressure to one or more pressure points against the targeted stone mass.

[0078] Example 20 can include any of Examples 14-19, further including the step of abutting the front surface against the targeted stone mass.

[0079] Each of these non-limiting examples may stand alone or may be combined in various permutations or combinations with one or more of the other examples.

[0080] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific examples in which the present devices or techniques may be practiced. These examples are also referred to herein as "embodiments." Such examples may include elements in addition to those shown or described. However, the present invention also contemplates examples in which only the elements shown or described are provided. Furthermore, the inventors also contemplate examples that use any combination or permutation of the elements shown or described (or one or more aspects thereof), with respect to either the particular example (or one or more aspects thereof), or any other example (or one or more aspects thereof) shown or described herein.

[0081] In the event of conflicting usage between this document and other documents incorporated by reference, the usage in this document will control.

[0082] As used herein, the terms "a" or "an" are used to include one or more, regardless of any other occurrence or use of "at least one" or "one or more," as they appear in patent documents. As used herein, the term "or" is used to refer to non-exclusion, unless otherwise indicated, or such that "A or B" includes "A but not B," "B but not A," and "A and B." As used herein, the terms "including" and "in which" are used as the plain English equivalents of the terms "comprising" and "wherein," respectively. Also, in the following claims, the terms "including" and "comprising" are open-ended, i.e., systems, devices, articles, compositions, formulations, or processes that include elements in addition to those listed after such terms in a claim are still considered to be within the scope of that claim. Moreover, in the following claims, the terms "first," "second," and "third," etc. are used merely as labels and are not intended to constrain numerical requirements to their objects.

[0083] The example methods described herein may be at least partially machine- or computer-implemented. Some examples may include computer-readable or machine-readable media encoded with instructions that configure an electronic device to perform the methods described in the examples above. An implementation of such methods may include code, such as microcode, assembly language code, higher-level language code, or the like. Such code may include computer-readable instructions for implementing various methods. The code may form part of a computer program product. Further, in examples, the code may be tangibly stored on one or more volatile, non-transitory, or non-volatile tangible computer-readable media, such as during execution or at other times. Examples of these tangible computer-readable media may include, but are not limited to, hard disks, removable magnetic disks, removable optical disks (e.g., compact disks and digital video disks), magnetic cassettes, memory cards or sticks, random access memory (RAM), read-only memory (ROM), and the like.

[0084] The above description is intended to be illustrative, not limiting. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other examples may be used, for example, by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow the reader to quickly ascertain the nature of the technical disclosure. The Abstract is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. The following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined in various combinations and permutations. The scope of the present device or technique should be determined with reference to the appended claims, along with the full range of equivalents to which such claims are entitled.

Claims

1. 1. A device for acoustic lithotripsy, comprising: an acoustically transparent elongated probe body extending between a distal portion and a proximal portion; an acoustically transparent probe tip coupled to the handle section; the probe tip includes a passageway extending distally therein; the probe tip includes a distal end having a front surface; the passageway extends through the probe tip to the front surface; the distal end includes at least two recesses that are cutouts in the distal end; Each of the at least two recesses extends proximally from the front surface and has a generally triangular tapered shape in a side view of the distal end; the front surface comprises two generally semicircular surfaces; the two substantially semicircular surfaces are surfaces along a direction perpendicular to the direction in which the probe tip extends, the distal end further includes a plurality of boundary regions, each boundary region of the plurality of boundary regions being between the generally semicircular surface and the recess; A device characterized by:

2. 10. The device of claim 1, wherein the plurality of boundary regions have curved radii that act as stress relief to prevent damage to the probe tips.

3. 3. The device according to claim 1 or 2, characterized in that at least two of the recesses face each other.

4. 4. The device of claim 3, wherein the distal end includes teeth between the recesses.

5. A device according to any one of claims 1 to 4, characterized in that the distal end has a circular, semi-circular or elliptical wall profile.

6. The device of any one of claims 1 to 5, wherein the distal end comprises a ring-like shape.

7. 1. A device for lithotripsy, comprising: a means for contacting an acoustic probe tip with a targeted stone mass, the probe tip comprising: a passageway extending distally within the probe tip; and a distal end, the distal end comprising a front surface, the passageway extending through the probe tip to the front surface, the distal end comprising one or more recesses that are cutouts of a portion of the front surface such that the front surface of the distal end has one or more boundary regions for coming into contact with the targeted stone mass, each of the one or more recesses extending proximally from the front surface and having a generally triangular tapered shape in a side view of the distal end; means for transmitting acoustic energy through the probe tip to the targeted stone mass to induce vibration of the probe tip and the one or more interface regions of the probe tip relative to the stone mass; The one or more boundary regions include a first boundary region having a substantially curved flat surface and a second boundary region having a corner.

Images