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Chaussy CG et al, 2015: Engineering Better Lithotripters.

Chaussy CG, Tiselius HG.
University of Munich, Munich, Germany.

Abstract

Although shock wave lithotripsy (SWL) remains an excellent non-invasive method for active removal of stones from the ureter and kidney, its popularity has decreased during recent years and the arguments for choosing endoscopic procedures rather than the only non-invasive surgical procedure are usually based on the opinion that SWL results are inferior to those obtained with endoscopic methods. It is considered that slow technical progress has not sufficiently met the requirements of disintegration, reduced need of repeated treatments, shorter treatment duration and less negative effects on tissues. This article summarises some recently published articles that address these problems and have the aim of improving the function of lithotripters. Modification of the shock wave geometry, elimination or control of cavitation bubbles, and different techniques of disintegration studied in in vitro and in animal experiments suggest several possible future directions that might provide a basis for development of a new "gold standard" lithotripter.

Curr Urol Rep. 2015 Aug;16(8):524. doi: 10.1007/s11934-015-0524-8.

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Comments 1

Peter Alken on Monday, 31 August 2015 10:15

Two experts present the current situation of ESWL, the recently accepted recommendations to improve the success rates and the news published in the literature.
I missed a comment on: Bhojani N et al. Lithotripter outcomes in a community practice setting: comparison of an electromagnetic and an electrohydraulic lithotripter. J Urol. 2015 Mar;193(3):875-9 because this publication nicely demonstrates that there is quite a difference not only between theory and practice but also between animal experiments and clinical results. Obviously even after 35 years there are physical principles not yet well understood. That leaves room for further improvement.

Two experts present the current situation of ESWL, the recently accepted recommendations to improve the success rates and the news published in the literature. I missed a comment on: Bhojani N et al. Lithotripter outcomes in a community practice setting: comparison of an electromagnetic and an electrohydraulic lithotripter. J Urol. 2015 Mar;193(3):875-9 because this publication nicely demonstrates that there is quite a difference not only between theory and practice but also between animal experiments and clinical results. Obviously even after 35 years there are physical principles not yet well understood. That leaves room for further improvement.
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