Abstract: There is disclosed an ultrasonic shockwave transducer for use in lithotripsy, hypothermia and like treatments for generating ultrasonic shock waves and transmitting them to a concretion or tissue to be destroyed. The transducer is arranged to focus the energy of the ultrasonic shock waves proportionally onto at least two points disposed on a line disposed about the main axis of, and being spaced from the radiation surface of, the transducer, the line being arbitrarily curved in three dimensions.

Abstract: An endoscope provides for the examination of, and fluid delivery to, an operating field located in, for example, paranasal sinuses or the anterior base of the skull, for pressurized delivery of fluid and removal of tissue at a visually identified location. The endoscope includes a tubular shaft having a forward end for viewing the operating field, an optical viewer in connection with the shaft for providing a view of the operating field along an optical-exit axis, and irrigation and aspiration channels placed in connection with the shaft for providing targetted delivery of at least one jet of fluid at a location within the operating field along a fluid-delivery axis which intersects with the optical-exit axis at a distance from the forward end of the shaft, thereby enabling visual confirmation that the jet of fluid has impacted the targetted location simultaneously with the impact.

Abstract: A lithotripsy ultrasound locating device comprises at least one locating transducer having a plurality of focal ranges and which is associated with a therapy transducer and is axially adjustable in relation to its focus; a position indicator which generates a signal representing the distance between the sound head of the locating transducer and the focus of the therapy transducer; a computer; a monitor on which a target mark representing the focus of the therapy transducer is displayed; and an electronic transmitter/receiver arrangement controlled by the computer in order to produce an image of a concretion to be destroyed which image is constantly optimal. The computer, controls, as a function of the signal emitted by the position indicator and by way of the transmitter/receiver arrangement, the focal range of the locating transducer which, at the given distance at that moment between the sound head and the focus of the therapy transducer always lies in the range thereof.

Abstract: The hollow guide is designed as a thin ceramic hollow tube which is guided in an outer tube while leaving a hollow space between the outer tube and the ceramic hollow tube, the outer tube being provided at its proximal end with a connecting part having a gas connection and receiving a focusing optical system. The ceramic hollow tube is guided in the outer tube through at least one mounting part arranged at the proximal end and at least one mounting part at the distal end, which in each case is supported locally with respect to the inner wall of the outer tube. The mounting parts are thus arranged so that free flow cross-sections to conduct the rinsing gas remain in the region of support, these being matched with the internal inner cross-section of the ceramic hollow tube, so that gas flow flowing past the ceramic hollow tube is produced both on the outside and on the inside.

Abstract: The focus of a lithotriptor comprising a transducer for generating focused ultrasonic shock waves is adapted for alignment on a concretion or tissue to be destroyed. The transducer is connected to an image-forming diagnostic X-ray system for locating the concretion or tissue, and comprising an X-ray emitter and an image intensifier disposed on a pivotable frame. The transducer is connected to the X-ray emitter, and the X-ray emitter is disposed at the center of the transducer, so that the emission axes of the transducer and the X-ray emitter coincide.

Abstract: In a resectoscope, the inner barrel situated in the outer barrel, of the resectoscope is provided at the distal end, which projects beyond the outer barrel, with an insulating element to strengthen it, which element is provided in its outer surface for the length of an enlargement of the outer barrel with a part-cylindrical recess which produces at the distal end an enlarged outlet space, to which the liquid from the bladder flows in sufficient quantity via longitudinal slots in the enlargement of the outer barrel and is then extracted at the proximal end of the barrels.

Abstract: An apparatus for automatically regulating a light source for providing light for illuminating an object viewed by means of an endoscope equipped with a video camera, there is provided a signal processing device having a circuit for defining the density value of the video signal of each line of the camera image, by means of which circuit, the video signal emitted is passed to a comparator which compares it with a brightness threshold voltage which can be preset. A control signal for regulating the light source is determined by counting the image lines having a brightness exceeding the threshold voltage and linking the resultant count to a mathematical function. The actual value obtained from the video signal is independent of the area of the bright parts of the image and is, therefore, independent of the diameter of the image circle of the endoscope.

Abstract: A latching device for enabling pieces of tissue or foreign bodies to be held securely by medical forceps during a medical operation comprises two elongate spring members whose opposed ends are secured in closed, telescoping tubes which are hinged to the handles of a forceps. The forceps handles are elastically yielding to some degree and by closing them together the spring members are moved towards one another and are caused to hook together by means of butting faces. Hence the tissue or the like which the forceps has taken hold of is automatically held secure once the manual pressure on the handle has been relaxed. If the handles are pressed closer together, the hooked interengagement is released and the spring-loading in the forceps handles opens them and allows the forceps jaws to release the tissue or the like which is being held.

Abstract: A tubular channel usable in endoscopy for flexible auxiliary instruments such as forceps, electrodes and the like to be passed through, in which structuring of the outer wall face by means of a plurality of radial grooves is employed to obtain high flexibility on the one hand and on the other hand a cross-sectional strength which improves its resistance to collapse when suction is applied and also to internal pressure.

Abstract: A device is disclosed for the disintegration of concretions in body cavities. The device comprises at least one piezoelectric transducer element, for connection to a generator. The transducer element is connected between a reflector and a horn. Ultrasonic waves generated by the transducer element are directed by means of a sonotrode, to a concretion to be destroyed. At least the horn is provided with surface depressions which do not run parallel to its axis of symemtry, for the generation of transverse and rotational oscillations.

Abstract: A means for checking the iluminating means of an endoscope allows both the lamp of the endoscope and the light-guide cable to be checked for their operating conditions. For this purpose, the checking means has a beam splitter positioned in the beam path from the lamp which conveys part of the quantity of light emitted by the lamp to a detecting means. A detecting means provided with a device to receive the distal end of the light-guide cable picks up the quantity of light coming from the cable. From the signal derived therefrom and the signal generated by the detecting means, the transmission factor is found in a calculating circuit by quotient formation and is shown on a display. In this way it is possible to determine whether the transmission factor of the light-guide cable will allow the objects which are going to be viewed to be adequately illuminated or whether the cable needs to be replaced.

Abstract: An organ manipulator is described for exposing an organ situated in a body cavity to be investigated or treated. The manipulator has a retractor body comprising a multi-joint lever system of articulated arms connected to one another, to be pivotally movable and which can be transformed from a axial position for introduction into the body cavity into an open position, in which is possible for the articulated arms to assume a flat triangular shape.

Abstract: Apparatus for shock wave therapy comprises an electroacoustic therapeutic transducer for generating ultrasonic shock waves, which are transmitted by way of a coupling medium shock wave transmission section of the transducer, bounded by a membrane, to the body of a patient reclining on a therapy table. In the interest of hygiene the membrane is releasably attached by its marginal area to the therapy table, being thereby exchangeable so that a new membrane can be provided for each patient. The extraction of gas from the coupling medium following exchange of the membrane is provided for.

Abstract: A retrograde cutting hook punch for arthroscopy is so designed that two ends of a fixed and a pivotable jaw member which are remote from the axis of pivot of the pivotable jaw member are laterally positioned at an angle to the longitudinal axis of the forceps, the pivotable jaw member, which is pivotable between limits set by two abutments, having an axially directed part which is guided to pivot in a longitudinal slot in the fixed jaw member, said axially directed part being provided with a downwardly open longitudinal slot to receive a traction and thrust rod for actuating the pivotable jaw member.

Abstract: The invention relates to a trocar sleeve for guiding endoscopes and instruments which can be exchanged for a trocar, the tube of the trocar sleeve being connected proximally to a handle part and being closable. The proximal end face of the handle part is covered by a closure part which can be adjusted by hand transversely to the tube axis and has at least one hole with an introduction support connected to it. The or each hole of the closure part can be covered by the tube channel as a result of appropriate rotation of the closure part.

Abstract: There is disclosed, a piezoelectric transducer for generating focussed ultrasonic shock waves for use in lithotripsy. The ultrasonic shock waves are emitted in pulsed form and can be transmitted by way of a coupling medium to the body of a patient to be treated. The transducer comprises a substantial member of individual piezoelectric transducer elements of ceramic or like material which are connected to the poles of a pulse generator and are fixed to a support in mosaic form and with their sides electrically insulated from one another. The acoustic termination of the transducer elements is essentially free from reflection. An intermediate medium of at least one layer, the acoustic impedance of which lies between that of the ceramic of the transducer element and that of the coupling medium, is provided between the transducer elements and the coupling medium. The thickness d of the layer is chosen in accordance with the relationship d>.tau..sub.k .multidot.c.sub.LA, where .tau..sub.

Abstract: An ultrasonic transducer for lithotripsy has piezoelectric transducer elements fixed to a backing and connected on the front side to first electrodes and on the rear side to second electrodes which can be connected to an electrical pulse generator. In order to avoid the danger of tissue damage in the focal area, especially for focusing transducers, the electrodes are designed such that an homogeneous field is produced in the front-side part of the transducer elements and a non-homogeneous field is produced in the opposite, rear-side part of the transducer elements. The amplitude of the negative pulse occurring in addition to the positive pressure pulse is thus reduced, the negative pulse being responsible for the danger of this tissue damage. In one way of achieving this effect each transducer element is provided with a pot-shaped electrode which surrounds the rear-side part of the transducer element.

Abstract: An instrument set comprises an outer tube and an inner tube projecting distally over the outer tube, between which at least two channels for retaining forceps extend, an observation optical system which can be introduced through the inner shaft, dilators to widen the opening in the organs, wounds or the like, a working optical system having a channel for instruments to be introduced and which can be exchanged for the observation optical system, and a clip applicator having a clip which can be pushed onto the clip applicator and can be pushed off in the distal direction for closing a dilated opening in organs, wounds and the like.

Abstract: A insufflation unit for distending a body cavity such as a uterus which is to be examined or treated endoscopically has a gas control circuit which connects a gas supply unit to the endoscope via a flowmeter, a shut-off valve and a filter. Associated with this gas control circuit is an extractor circuit which comprises a pump whose suction end is coupled up to the output of the flowmeter. A pressure-measuring transducer logs the pressure at the suction end of the pump and its measurements, together with those from the flowmeter, are made use of in analyzer electronics by switching off the pump before a pressure likely to put the patient at risk occurs should there be a fault in the extractor circuit.

Abstract: An apparatus is described for locating objects within the body, and particularly concretions situated in body cavities, in three dimensions and for destroying them. The point of departure for this is an electro-acoustic treatment transducer for generating shock waves to be emitted to focus on the object concerned and a B-scanner connected to the treatment transducer to act as a locating transducer for locating the object, the locating transducer being adjustable relative to the treatment transducer co-focally therewith. The design proposed envisages the locating transducer being integrated into the treatment transducer so that the sound fields of both transducers travel the same distances through the same media and it is thus the correct position of the focus relative to the concretion seen in the image which is in fact shown.