In the drawings show:
FIG. 1: the complete end portion of the pull string and the catch basket of the lithotriptor in a side view;
FIG. 2: a side view of a first preferred embodiment of the lithotriptor as a whole with a chuck and a tilting screw; and
FIG. 3: a side view of a second preferred embodiment of the complete lithotriptor with a chuck and a worm gear.
As can be derived from FIG. 1 the pull string 1 of the lithotriptor is designed over a considerable length as a twice stranded wire rope 2. At its distal end the pull string 1 has a catch basket 3 which is formed by at least a portion of the rope strands 4 constituting the wire rope 2. The wire rope 2 runs from the proximal end up to a first sleeve 5 in a twice stranded manner. In the shown embodiment the wire rope 2 comprises seven rope strands 4 stranded in itself which consist of nineteen wires respectively. Behind the first sleeve 5 the wire rope 2 is unstranded which means that the rope strands 4 run parallel to each other up to a second sleeve 6 at the foot of the catch basket. On this unstranded part section 7 between the first sleeve 5 and the second sleeve 6 the rope strands 4 are not biased but straightened so that a supple, flexible part section 7 is formed. The part section 7 is about 3 to 15 cm long, preferably 7 to 11 cm. In dependence on the length of the part section 7 it may be useful to provide one or more guiding sleeves 8 which prevent that the rope strands 4 split up on the part section 7 and that possibly due to this effect the capturing of the concrement is complicated.
The first sleeve 5 serves to prevent a further unstranding of the wire rope 2 in direction to its proximal end. For this reason as well, the first sleeve 5 and the second sleeve 6 shall comprise attachment means which guarantee a fixing of the rope strands 4. This can be achieved by clamping, by soldering, by bonding as well as by other suitable fixing means. Behind the second sleeve 6 only those rope strands 4 are carried on which serve to form the catch basket 3. In the embodiment there are five rope strands 4 which are outwardly convex curved behind the wire rope 2 running unstranded. The rope strands 4 forming the catch basket 3 are attached to each other at their free ends. In the shown embodiment this is done by soldering the ends in a conical sleeve 9 which forms the top of the catch basket 3. Attention has to be paid that the strength of the joint of the free ends of the strands with each other and with the conical sleeve 9 is smaller than the admissible ultimate tensile stress.
In principal all rope strands 4 except the core of the wire rope 2 can be used for the formation of the catch basket 3. The core of the wire rope 2 ends either at the first sleeve 5 or at the second sleeve 6. All other rope strands 4 not used for the formation of the catch basket 3 end at the second sleeve 6 where they are preferably soldered.
FIG. 2 shows a side view of a preferred embodiment of the lithotriptor as a whole including a pull mechanism 10 for introducing and retracting the catch basket 3 out of a casing 11 which surrounds the pull string in a Bowden cable like guiding manner. This flexible casing 11 consists, for instance, of a flexible tube made of a helically wound steel wire. The tube is supported at a handle 12 and the pull string 1 runs through it. The catch basket 3 is arranged at the distal end of the pull string 1. The proximal end of the pull string 1 is fixed in a hollow pull rod 15 by means of a clamping mechanism 13 which mainly consists of a chuck 14. The pull rod 15 is in an axial direction slidably arranged within the handle 12. A metal sleeve 16 is provided as an intersection piece between the pull rod 15 which advantageously consists of a synthetic material and the clamping mechanism 13 which preferably consists of a stainless steel, like for instance V2A. By sliding the pull rod 15 into the handle 12 the catch basket 3 is driven out of the distal end of the casing 11 by the pull string 1 whereas the catch basket 3 is driven back into the distal end 17 of the catheter by pulling the pull rod 15 out of the handle 12.
An outside thread 18 with a small pitch is provided on the pull rod 15 so that a threaded rod is formed. An adjusting screw nut 19 is screwable on the threaded rod. In accordance with this embodiment the adjusting screw nut 19 is constructed as a quick slidable nut, which can be disengaged from the outside thread 18 by tilting or canting the nut 19 with its inside thread away from the pull rod 15. In this canted position the screw nut 19 can be freely slided in axial direction. For this purpose the adjusting screw nut 19 has a sloping boring 2o which runs oblique to the thread boring. The diameter of the sloping boring is chosen slightly larger than the outer diameter of the outside thread 18 of the threaded or pull rod 15 for achieving a clearance and a thereby caused easy movability of the adjusting screw nut 19 after being canted.
The clamping chuck 14 is arranged via the metal sleeve 16 at the free end of the pull rod 15. The bottom or base of the chuck 14 has a continuous central opening 21 through which the pull string 1 is led out of the hollow pull rod 15. The clamping mechanism 13 is arranged in such a way that the opening 21 is aligned with the longitudinal axis of the hollow pull rod 15.
The chuck 14 can be designed as a three cheek chuck like a conventional drill chuck of an electric portable drilling machine. However the displacing toothed ring for opening and closing the chuck by means of a key does not need to be provided since a manual operation of the chuck is normally sufficient in the present case.
FIG. 3 shows a partly cut longitudinal view of a second preferred embodiment of a complete lithotriptor. In contrast to the first preferred embodiment shown in FIG. 2 the adjusting screw nut 27 of the pull mechanism 10 is not turned by manipulating with the hand for retracting the catch basket but is turned by an angular gear by means of a handwheel 24. The angular gear consists of a conical pinion 22 which coaxially surrounds the hollow pull rod 15 and which is firmly coupled to the adjusting screw nut 27 and of a toothed conical wheel 23 which engages with the conical pinion 22. The handwheel is firmly fixed to the conical toothed wheel 23 by a shaft 25 which is common to the handwheel 24 and the conical toothed wheel 23. The sleeve-like adjusting screw nut 27, the conical pinion 22 as well as the conical toothed wheel 23 with the handwheel 24 are born in bearings 26 within a housing 28 attached to the handle 12.
The embodiment of FIG. 3 functions as follows: rod 15 is hollow in order to receive pull spring 1, which is fixedly clamped in chuck 14. Rod 15 is slidably received in handle 12 and is provided with an outer thread 18. Adjusting screw nut 27 is provided with an inner thread engaging the outer thread 18 of rod 15 and is axially supported via the lower bearing 26 at handle 12. Now, if the hand wheel 24 is rotated, the toothed wheel 23, conical pinion 22 and screw nut 27 are rotated, resulting in axially displacing the pull rod 15 by virtue of the engaging threads and the axial support of nut 27 against handle 12, thereby resulting in displacement of pull string 1.
Nut 19 (FIG. 2) has the same function as nut 27: if nut 19 is (manually) screwed up until it abuts against handle 12, a further rotation of nut 19 results in a displacement of rod 15 and pull string 2.