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In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models.

Publication ,  Journal Article
Wang, AJ; Baldwin, GT; Gabriel, JC; Cocks, FH; Goldsmith, ZG; Iqbal, MW; Astroza, GM; Simmons, WN; Zhong, P; Preminger, GM; Lipkin, ME
Published in: J Endourol
November 2012

BACKGROUND AND PURPOSE: The EMS Swiss LithoBreaker is a new, portable, electrokinetic lithotripter. We compared its tip velocity and displacement characteristics with a handheld, pneumatic lithotripter LMA StoneBreaker.™ We also evaluated fragmentation efficiency using in vitro models of percutaneous and ureteroscopic stone fragmentation. MATERIALS AND METHODS: Displacement and velocity profiles were measured for 1-mm and 2-mm probes using a laser beam aimed at a photo detector. For the percutaneous model, 2-mm probes fragmented 10-mm spherical BegoStone phantoms until the fragments passed through a 4-mm mesh sieve. The ureteroscopic model used 1-mm probes and compared the pneumatic and electrokinetic devices to a 200-μm holmium laser fiber. Cylindrical (4-mm diameter, 4-mm length) BegoStone phantoms were placed into silicone tubing to simulate the ureter; fragmented stones passed through a narrowing in the tubing. RESULTS: For both 1-mm and 2-mm probes, the electrokinetic device had significantly higher tip displacement and slower tip velocity, P<0.01. In the percutaneous model, the electrokinetic device needed an average of 484 impulses over 430 seconds to fragment one BegoStone, while the pneumatic device needed 29 impulses over 122 seconds to fragment one stone. Both clearance times and number of impulses needed for percutaneous stone clearance were significantly different at P<0.01. Ureteroscopically, the mean clearance time was 97 seconds for the electrokinetic lithotripter, 145 seconds for the pneumatic lithotripter, and 304 seconds for the laser. Comparing the pneumatic device with the electrokinetic device ureteroscopically, there was no significant difference in clearance time, P=0.55. Both the pneumatic and electrokinetic lithotripters, however, demonstrated decreased clearance times compared with the laser, P=0.027. CONCLUSIONS: The portable electrokinetic lithotripter may be better suited for ureteroscopy instead of percutaneous nephrolithotomy. It appears to be comparable to the portable pneumatic device in the ureter. Further clinical studies are needed to confirm these findings in vivo.

Duke Scholars

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Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

November 2012

Volume

26

Issue

11

Start / End Page

1500 / 1505

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteroscopy
  • Phantoms, Imaging
  • Nephrostomy, Percutaneous
  • Lithotripsy
  • Kidney Calculi
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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MLA
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Wang, A. J., Baldwin, G. T., Gabriel, J. C., Cocks, F. H., Goldsmith, Z. G., Iqbal, M. W., … Lipkin, M. E. (2012). In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models. J Endourol, 26(11), 1500–1505. https://doi.org/10.1089/end.2012.0278
Wang, Agnes J., Gregory T. Baldwin, James C. Gabriel, F Hadley Cocks, Zachariah G. Goldsmith, Muhammad W. Iqbal, Gaston M. Astroza, et al. “In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models.J Endourol 26, no. 11 (November 2012): 1500–1505. https://doi.org/10.1089/end.2012.0278.
Wang AJ, Baldwin GT, Gabriel JC, Cocks FH, Goldsmith ZG, Iqbal MW, et al. In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models. J Endourol. 2012 Nov;26(11):1500–5.
Wang, Agnes J., et al. “In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models.J Endourol, vol. 26, no. 11, Nov. 2012, pp. 1500–05. Pubmed, doi:10.1089/end.2012.0278.
Wang AJ, Baldwin GT, Gabriel JC, Cocks FH, Goldsmith ZG, Iqbal MW, Astroza GM, Simmons WN, Zhong P, Preminger GM, Lipkin ME. In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models. J Endourol. 2012 Nov;26(11):1500–1505.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

November 2012

Volume

26

Issue

11

Start / End Page

1500 / 1505

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteroscopy
  • Phantoms, Imaging
  • Nephrostomy, Percutaneous
  • Lithotripsy
  • Kidney Calculi
  • 3202 Clinical sciences
  • 1103 Clinical Sciences