Lithotripsy device for breaking up calculi with a control sleeve, and method for accelerating a projectile of a lithotripsy device

1 . A lithotripsy device for breaking up calculi, wherein the lithotripsy device comprises:

a support unit,

a guide tube with a cavity, with a proximal end, and with a distal end,

a movable projectile,

a proximal stop element,

a distal stop element for the movable projectile, wherein the guide tube is arranged at least partially in the support unit, and the lithotripsy device is configured to be assigned a drive device for supplying and/or discharging a pressure medium into an interior of the support unit and/or the guide tube, to move the projectile back and forth between the proximal stop element and the distal stop element, and a sonotrode, wherein the guide tube has at least one proximal through-opening and at least one distal through-opening for supplying and/or discharging the pressure medium into and/or out of the guide tube cavity, and the sonotrode can be connected directly or indirectly at its proximal end to the support unit and/or the guide tube and can be excited to vibrate by a mechanical impact of the projectile on the distal stop element, and

a control sleeve is arranged in the cavity of the guide tube, wherein the control sleeve has a cavity along a control sleeve longitudinal center axis, a proximal end, a distal end, at least one proximal opening and at least one distal opening for the pressure medium, and in the cavity of the control sleeve the movable projectile is arranged with a driver element for driving the control sleeve, so that when the control sleeve is moved by means of the driver element of the projectile, a first valve-opening position exists for the flow of the pressure medium through the at least one proximal through-opening of the guide tube and the at least one proximal opening of the control sleeve into and/or out of the cavity of the control sleeve, to move the projectile towards the distal stop element, and a second valve-opening position exists for the flow of the pressure medium through the at least one distal through-opening of the guide tube and the at least one distal opening of the control sleeve into and/or out of the cavity of the control sleeve, to move the projectile back to the proximal stop element.

2 . The lithotripsy device according to claim 1 , wherein the control sleeve has a second proximal opening, a third proximal opening, a fourth proximal opening and/or further proximal openings and/or a second distal opening, a third distal opening, a fourth distal opening and/or further distal openings.

3 . The lithotripsy device according to claim 2 , wherein the proximal through-openings, the distal through-openings, the proximal openings and/or the distal openings are arranged axially symmetrically to the longitudinal center axis of the control sleeve.

4 . The lithotripsy device according to claim 1 , wherein the guide tube has a second proximal through-opening, a third proximal through-opening, a fourth proximal through-opening and/or further proximal through-openings and/or a second distal through-opening, a third distal through-opening, a fourth distal through-opening and/or further distal through-openings.

5 . The lithotripsy device according to claim 1 , wherein the distal opening, the given distal opening, and/or the distal openings is or are arranged at the distal end and/or in an outer surface of the control sleeve, and/or the proximal opening, the given proximal opening, and/or the proximal openings is or are arranged at the proximal end and/or in the outer surface of the control sleeve.

6 . The lithotripsy device according to claim 1 , wherein the guide tube has in a guide tube inner surface an at least partially radially circumferential recess or a plurality of at least partially radially circumferential recesses for guiding the pressure medium around the control sleeve.

7 . The lithotripsy device according to claim 1 , wherein two or more separate chambers for passing pressure medium to and/or from the at least one proximal through-opening or the proximal through-openings and/or the at least one distal through-opening or the distal through-openings are arranged between an outer surface of the guide tube and an inner surface of the support unit.

8 . The lithotripsy device according to claim 1 , wherein the distal stop element and/or the proximal stop element has/have a spring element for repulsing the projectile.

9 . The lithotripsy device according to claim 1 , wherein the projectile and the control sleeve form a spring element, comprising a pneumatic spring, on the distal end and/or the proximal end.

10 . The lithotripsy device according to claim 1 , wherein the lithotripsy device has at least one connection port for connecting to the drive device and for continuously supplying or discharging the pressure medium.

11 . The lithotripsy device according to claim 1 , wherein the lithotripsy device further comprises the sonotrode and/or the drive device.

12 . The lithotripsy device according to claim 11 , wherein, by means of the drive device, a negative pressure and/or an overpressure can be impressed on the cavity or a part of the cavity of the guide tube and/or the cavity or a part of the cavity of the control sleeve.

13 . The lithotripsy device according to claim 1 , wherein the driver element has an at least partially annular friction element on and/or in a surface of the projectile and/or a medium for viscous friction.

14 . The lithotripsy device according to claim 1 , wherein the driver element has a magnetic element and the control sleeve has a counter-magnetic element.

15 . The lithotripsy device according to claim 1 , wherein the lithotripsy device and/or the support unit comprises an operating unit for starting, stopping and/or individually triggering a movement of the projectile.

16 . The lithotripsy device according to claim 1 , further comprising a counter bearing and a horn, and at least one piezo element arranged and mechanically coupled between the counter bearing and the horn as a vibration exciter, wherein the horn has the distal stop element and/or the horn can be connected to the distal stop element and/or the sonotrode, and the at least one piezo element is configured to be electrically connected to an assignable ultrasound generator, so that a combined vibration excitation of the sonotrode can be realized by means of the drive device and the at least one piezo element.

17 . A method for accelerating a projectile of a lithotripsy device, wherein the lithotripsy device has a guide tube with a cavity and a control sleeve in the cavity of the guide tube, wherein the projectile, movable between a proximal stop element and a distal stop element, is arranged in a cavity of the control sleeve, and the movable projectile has a driver element for driving the control sleeve, the lithotripsy device is configured to be assigned a drive device for supplying and/or discharging a pressure medium, the guide tube has at least one proximal through-opening and at least one distal through-opening for supplying and/or discharging the pressure medium into and/or out of its cavity, and the control sleeve has at least one proximal opening and at least one distal opening for the pressure medium, the method comprising the following steps:

supplying and/or discharging the pressure medium into the cavity of the guide tube by means of the drive device,

flowing the pressure medium through the at least one proximal through-opening of the guide tube and the at least one proximal opening of the control sleeve into the cavity of the control sleeve and moving the projectile towards the distal stop element, and

moving the control sleeve by means of the driver element of the projectile, and/or

repulsing the projectile on the distal stop element, and/or

flowing the pressure medium through the at least one distal through-opening ( 128 ) of the guide tube and the at least one distal opening of the control sleeve into the cavity of the control sleeve and moving the projectile back to the proximal stop element, and

moving the control sleeve by means of the driver element of the projectile, and/or

repulsing the projectile on the proximal stop element.

18 . The method according to claim 17 , wherein the supply and/or discharge of the pressure medium is carried out continuously.