TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Several ultrasonic, pneumatic or electro-mechanical lithotrites are used during PCNL for fragmentation and removal of renal calculi. In an in vitro setup we compared different lithotrites or combinations (CyberWand/Olympus, Lithoclast Master/EMS, LUS2/Olympus, Lithobreaker/EMS) regarding their efficacy of lithotripsy and stone removal.
Methods: Bego stone phantoms (14 · 14 mm) were placed in a plastic funnel. The funnel was fixed in a 0,9% NaCl-filled basin. Now lithotripsy (n = 5) was performed through a 26 CH nephroscope (Storz) with different lithotrites. Time of lithotripsy until total stone removal was determined. Balanced irrigation/ suction flow (400 ml/min) was guaranteed. Using Lithoclast Master, after initial pneumatical lithotripsy pneumatic probe was disconnected and fragments removed only with ultrasonic probe (Vario). In another setup 2:30 min disintegration was performed with Lithobreaker, following stone removal was performed with LUS2. Additionally Lithotripsy was performed with LUS 2 only and CyberWand. Mean and standard deviations were computed and statistical analysis was performed.
Results: Mean time until total removal of fragments was 217 sec for Lithoclast, 335 sec for CyberWand and 390 sec for LUS2. The initial disintegration with LithoBreaker did not advantage the results of the LUS2. The outer probe of CyberWand did brake often, probes of Lithoclast and LUS2 did not show any wear.
Conclusions: In this in vitro setup Lithoclast and Cyber-Wand performed the fastest stone removal. Disadvantage of Cyberwand is the low probe durability. Additional disintegration with LithoBreaker does not advantage the efficacy of LUS2.
Source of Funding: EMS - Electro Medical Systems.
|Listen to an interview with one of the authors of this study.|
Presented by Keil Christian, Hegele Axel, Hofmann Rainer, and Olbert Peter at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
Dept. of Urology and Pediatric Urology, University Medical Center, Germany