Abstract
Minimal invasiveness characterizes modern stone therapy. Several years ago, we presented the Swiss Lithoclast, a ballistic system for endoscopic stone therapy. Its disintegrational power is superior to that of the other intracorporeal lithotripsy devices, and it has gained great recognition. Now, special probes (Lithovac) have been developed to combine lithotripsy with suction. These probes differ in width (1.6, 3.5, or 4 mm) and length depending on the intended location of use (kidney, ureter, bladder). The probes were tested in a standardized stone model. The variable suction energy counteracts the propulsive energy of the Lithoclast. Clinical experience could be gained with stones in the urinary bladder, Kock pouches, the ureter, and the kidney. There were no complications related to either the Lithoclast or the Lithovac. In staghorn stones, small (< 2 mm) pieces could be removed easily during lithotripsy. Fragments as large as 3.5 mm could be evacuated with the Lithovac after removing the Lithoclast probe. Using the suction, clear vision could be achieved (especially useful in struvite stones). In the ureter, a learning curve had to be overcome to balance fluid inflow and suction pressure. Otherwise, the ureter may collapse...Continue Reading
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