Lithotripter Technology: Present and Future

Rassweiler, Jens; Henkel, Thomas; Köhrmann, K. U.; Potempa, D.; Jünemann, K. P.; Alken, P.

doi:10.1089/end.1992.6.1

Cited by 65 publications

(25 citation statements)

References 20 publications

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“…The general principle in lens modification and associated implementation strategy described in this work are also applicable to design improvement of other EM lithotripters equipped with either convex lenses (37) or parabolic reflectors (38). The design and technical refinements of EM lithotripters from the late 1980s to middle 1990s were largely driven by empirical experience, practical concern for user convenience, and multifunctionality of the lithotripter system (39,40). The transition of SWL technology during this period from EH to predominately EM was carried out by lithotripter manufacturers with an incomplete understanding about the mechanisms of tissue injury and stone comminution in SWL (41).…”

Section: Discussionmentioning

confidence: 99%

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter

Neisius

Smith

Sankin

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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The efficiency of shock wave lithotripsy (SWL), a noninvasive firstline therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens design for a contemporary electromagnetic (EM) shock wave lithotripter, based on recently acquired knowledge of the key lithotripter field characteristics that correlate with efficient and safe SWL. The new lens design addresses concomitantly three fundamental drawbacks in EM lithotripters, namely, narrow focal width, nonidealized pulse profile, and significant misalignment in acoustic focus and cavitation activities with the target stone at high output settings. Key design features and performance of the new lens were evaluated using model calculations and experimental measurements against the original lens under comparable acoustic pulse energy (E + ) of 40 mJ. The −6-dB focal width of the new lens was enhanced from 7.4 to 11 mm at this energy level, and peak pressure (41 MPa) and maximum cavitation activity were both realigned to be within 5 mm of the lithotripter focus. Stone comminution produced by the new lens was either statistically improved or similar to that of the original lens under various in vitro test conditions and was significantly improved in vivo in a swine model (89% vs. 54%, P = 0.01), and tissue injury was minimal using a clinical treatment protocol. The general principle and associated techniques described in this work can be applied to design improvement of all EM lithotripters. electromagnetic lithotripter | lens modification | stone fragmentation

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Section: Discussionmentioning

confidence: 99%

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter

Neisius

Smith

Sankin

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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“…New machines are more user-friendly (for patient and clinician), but have lower efficacy than the original HM3 lithotriptor [5,6]. The poorer treatment outcome which is observed with latest lithotriptors may be due to various factors including changes in power source, coupling mechanism, focal zone size and peak pressure.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and treatment outcome of patients requiring additional intravenous analgesia during extracorporeal shockwave lithotripsy with Dornier Compact Delta Lithotriptor

Thompson

Tolley

2007

Int Urol Nephrol

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“…In 25 patients further measures had to be performed. The calculated efficiency quotient (EQ) at the time of the last follow-up was 52 (modified EQ 46) [6].…”

Section: Resultsmentioning

confidence: 99%

An Innovative Mobile Lithotripter for Extracorporeal Shock Wave Lithotripsy and Therapy

Küfer

Volkmer²,

Nesslauer³

et al. 2002

Urol Int

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Introduction: To assess the performance of a new mobile device for extracorporeal shock wave lithotripsy (ESWL) and therapy (ESWT). Materials and Methods: 278 patients underwent 399 treatment for stone disease. 28 patients received 64 treatments for orthopaedic issues such as pseudarthrosis or enthesiopathies resistant to conservative treatment. Results: During ESWL, minor pain symptoms were well resolved with analgesics intravenously. 45% of patients were stone-free and 50% had irrelevant fragments at the time of discharge. 66% of patients underwent a single treatment. Auxiliary measures after ESWL were necessary in 5%. After ESWT, pain symptoms of all patients were reduced on average to 5.2 points on a numerical rating scale from 1 to 10. Patients with bony nonunions produced callus if the bone scan before ESWT showed activity. No complication related to either form of treatment was observed. Conclusions: This innovative mobile lithotripter fulfils all expectations a user can have in an upt-to-date equipment: good disintegration, low side effects, easy handling, fast installation, dual imaging and suitability for ESWL and ESWT.

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Lithotripter Technology: Present and Future

Cited by 65 publications

References 20 publications

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter

Characteristics and treatment outcome of patients requiring additional intravenous analgesia during extracorporeal shockwave lithotripsy with Dornier Compact Delta Lithotriptor

An Innovative Mobile Lithotripter for Extracorporeal Shock Wave Lithotripsy and Therapy

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