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He KJ. et al., 2023: Experience of high polymer gel pad assisted ultrasound monitoring in the treatment of infant urolithiasis during extracorporeal shock wave lithotripsy.

He KJ, Jin LL, Hu LZ, Yan X.
Pediatric Urolith Center, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.
Department of Urology, Pediatric Urolith Center, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.
Department of Urology, Pediatric Urolith Center, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.

Abstract

In the extracorporeal shock wave lithotripsy for infants, we used a medical polymer gel pad to assist ultrasonic positioning, so that the ultrasonic probe could be far away from the shock wave energy field. Although not affecting the ultrasonic positioning and monitoring effect, we discussed the protective effect of this method on the ultrasonic probe. A retrospective analysis was made on 21 infants (0-3 years old) who received ESWL in our hospital from June 2021 to February 2023. After the stones were accurately located by B-ultrasound before surgery, a 4 * 5 * 10 cm medical polymer gel pad was placed between the skin and the ultrasonic probe to keep the ultrasonic probe away from the shock wave energy field. The B-ultrasonic wave source locked the target stone through the gel pad, and the lithotripter Dornier Compact Delta II was used for lithotripsy. The extracorporeal shock wave lithotripsy was completed under the whole process of B-ultrasonic monitoring. All patients completed the surgery under ultrasound monitoring, and there were no abnormalities in the ultrasound probe during the surgery. The average stone size was 0.60 ± 0.21 cm, the surgical time was 39.8 ± 13.8 min, and the total energy of lithotripsy was 7.41 ± 4.35 J. There were no obvious complications in all patients after the surgery. After 2 weeks of ultrasound examination, the success rate of lithotripsy in 21 patients reached 85.7%. We believe that the use of the gel pad increases the distance between the ultrasonic probe and the skin, leaving the probe away from the shock wave energy field, avoiding the damage of the shock wave source to the ultrasonic probe, and does not affect the monitoring effect of ultrasound on stones and the success rate of lithotripsy, which is worthy of further promotion in the field of children's urinary stones.

Urolithiasis. 2023 Sep 20;51(1):114. doi: 10.1007/s00240-023-01488-6.PMID: 37728800

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Comments 1

Peter Alken on Thursday, 07 March 2024 10:00

It seems to work. However, I can imagine that it is not easy to keep the loose gel cushion constantly in a stable position in relation to the patient's body and the ultrasound probe which can rotate isocentrically 360° around the focus of the lithotripter. Especially when the position of the latter needs to be adapted/ repositioned because of movement of the body during coupling or fragments moving. My experience with sonography is that image quality has an inverse relation to the distance between ultrasound probe and scanned object. I wonder if, with the change in localisation and targeting technology, the responsibility of the manufacturer in case of malfunction is lost.

Peter Alken

It seems to work. However, I can imagine that it is not easy to keep the loose gel cushion constantly in a stable position in relation to the patient's body and the ultrasound probe which can rotate isocentrically 360° around the focus of the lithotripter. Especially when the position of the latter needs to be adapted/ repositioned because of movement of the body during coupling or fragments moving. My experience with sonography is that image quality has an inverse relation to the distance between ultrasound probe and scanned object. I wonder if, with the change in localisation and targeting technology, the responsibility of the manufacturer in case of malfunction is lost. Peter Alken
Monday, 20 May 2024