Search results for "Lithotripsy"

Uric acid, phosphate and oxalate stones: treatment and prophylaxis.

2004

Medical treatment for the most commonly encountered types of renal stones is described. Nowadays treatment for uric acid stones is well-defined: alkalinizing urine is easy with drugs that are sufficiently active and well enough managed. Relapse is avoided in a high percentage of patients. Medical treatment of phosphate or calcium stones is a more open question as results are far from satisfactory compared with intra- and extra-corporeal approaches which are often minimally invasive and well accepted by both patient and urologist. Relapses are not easy to control because prophylactic measures such as changes in lifestyle and diet are never activated or because they are adopted for a brief pe…

Management of retained bile duct stones: a prospective open trial comparing extracorporeal and intracorporeal lithotripsy.

1996

Abstract Background: Endoscopic management of common bile duct stones has become the approach of choice, especially in patients with high surgical risk. Problems are encountered if there are large stones or a duct stenosis. For these difficult stones, shock wave technology serves as an alternative to surgical intervention. Methods: A total of 125 patients with common bile duct stones in whom conventional endoscopic treatment had failed were selected and treated either by extracorporeal piezoelectric lithotripsy (ESWL, n=79) or intracorporeal electrohydraulic lithotripsy (EHL, n=46). The average age of our patients was 70 years. Results: In the ESWL group visualization of the stones by ultra…

Low-frequency extracorporeal shock wave lithotripsy improves renal pelvic stone disintegration in a pig model.

2009

OBJECTIVE To compare disintegration rates for renal stones treated by 60 vs 120 shock waves (SW)/min at the same energy settings, using standardized validated artificial stones in a pig model. MATERIALS AND METHODS Gypsum artificial stones (13 × 6 mm) were inserted into the renal pelvis on either side of 12 anaesthetized pigs by open surgery. Extracorporeal SW lithotripsy (ESWL) was applied using a new electromagnetic lithotripter (Lithoskop®, Siemens AG Healthcare, Munich, Germany) at 60 and 120 SW/min; 3000 SW were applied to each kidney with the same energy settings. Stone fragments were collected after nephrectomy, passed through calibrated test sieves, and weighed. Fragment size catego…

Surgical aspects of urolithiasis in children.

1991

Operative management of renal calculi has changed radically in the last decade. New operative techniques. the use of intra-operative ultrasound and Doppler sonography have even made possible the removal of complete staghorn calculi in short and kidney-preserving procedures. The introduction of percutaneous nephrolithotomy and stone extraction using a specially designed ureteroscope and, above all, the clinical application of extracorporeal shock wave lithotripsy have made stone surgery less invasive and have provided a higher rate of preservation of kidney function.

Extracorporeal shock wave lithotripsy (ESWL): alternatives and adjuvant procedures

1985

Within a short time, extensive statistics on ESWL have documented its efficiency in the treatment of most renal and ureteral stones. Approximately 20% of all stone patients, however, require additional or other forms of therapy, such as URS, PNL, or surgery. Up to now, the differential indications for these procedures have not been completely established. A crucial factor for successful application of ESWL is stone volume and localization. Large stones with a central stone mass may be successfully treated by combining ESWL and PNL, while surgery is still preferred in those with a peripheral stone mass.

Inkarzeration eines Pankreassteinfragmentes im distalen Pankreasgang nach Therapie durch extrakorporale Stoßwellenlithotripsie (ESWL)

2001

A partial or total absence of stones in pancreaticolithiasis therapy can be reached by using ESWL. We report on a patient who happened to get an incarceration of a fragment in the distal pancreatic duct after having been treated by ESWL without a previous sphincterotomy to the ductus Wirsungianus. This emphasizes the recommendation to carry out a papillotomy of the pancreatic main duct before applying ESWL to pancreatic stones.

Laser fragmentation of pancreatic duct stones using a rhodamine laser with an automatic stone-tissue detection system. Basic in-vitro studies

1997

OBJECTIVES The aim of our study was to examine the suitability of a rhodamine 6G laser with an integrated stone-tissue detection system (STDS) for fragmenting pancreatic stones. METHODS A total of 64 pancreatic duct stones were measured for weight, diameter, main chemical components and in some cases for their computerized tomography density. Recognition of all stones was checked with the standard STDS or a prototype version. Number of fragmentation pulses, total fragmentation energies and correlation with the individual stone parameters were determined. The quality of the tissue-detection mode was evaluated in postmortem pancreata. RESULTS The standard STDS detected only 45% of the pancrea…

Physics of Shock-wave Lithotripsy

2018

Sialolithiasis. Proposal for a new minimally invasive procedure: Piezoelectric surgery

2014

Sialolithiasis is the presence of stones in the ducts of the salivary glands. Most episodes are unique, and 60-80% are located exclusively in the main excretory duct. The main clinical manifestations are swelling and pain typically before, during or after meals that decreases if the obstruction is not complete. The highest prevalence of lithiasis is in the submandibular gland -87%-, whose secretion is more viscous, followed by the parotid gland -10%- and finally the sublingual gland -3%-. The most significant consequences are caused by the prolonged blockage of the duct by a stone, which can produce a persistent ductal dilatation with a swelling that does not subside, and could lead to the …

Assessment of a Modified Acoustic Lens for Electromagnetic Shock Wave Lithotripters in a Swine Model

2013

The acoustic lens of the Modularis electromagnetic shock wave lithotripter (Siemens, Malvern, Pennsylvania) was modified to produce a pressure waveform and focal zone more closely resembling that of the original HM3 device (Dornier Medtech, Wessling, Germany). We assessed the newly designed acoustic lens in vivo in an animal model.Stone fragmentation and tissue injury produced by the original and modified lenses of the Modularis lithotripter were evaluated in a swine model under equivalent acoustic pulse energy (about 45 mJ) at 1 Hz pulse repetition frequency. Stone fragmentation was determined by the weight percent of stone fragments less than 2 mm. To assess tissue injury, shock wave trea…