Skip to main content
SpringerLink
Log in

Comparison of stone elimination capacity and drilling speed of endoscopic clearance lithotripsy devices

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the fragmentation capacity, clearance time, and drilling speed of combined ultrasonic with impact dual-energy and single energy ultrasonic lithotripter devices.

Methods

Stone fragmentation and clearance tests were performed under direct view in an underwater layered hemisphere by four different operators using artificial stones (n = 10/operator). Time for complete clearance was measured. Drilling tests were performed using an underwater setup, consisting of a mounting rack for fixing the lithotripter handpiece with the probe in vertical position and in contact with the stone phantom placed on one side of a balance for defined and constant contact application pressure equivalent to 450 g load. Time until complete perforation or in case of no perforation, the penetration depth after 60 s into the stone sample was recorded. Four devices, one single energy device (SED), one dual-energy dual probe (DEDP), two dual-energy single probe (DESP-1, DESP-2), with different parameters were tested.

Results

Stone fragmentation and clearance speed were significantly faster for dual-energy device DESP-1 compared to all other devices (p < 0.001). Using DESP-1, the clearance time needed was 26.0 ± 5.0 s followed by DESP-2, SED and DEDP requiring 38.4 ± 5.8 s, 40.1 ± 6.3 s and 46.3 ± 11.6 s, respectively. Regarding the drilling speed, DESP-1 was faster compared to all other devices used (p < 0.05). While the drilling speed of DESP-1 was 0.69 ± 0.19 mm/s, compared to 0.49 ± 0.18 mm/s of DESP-2, 0.47 ± 0.09 mm/s of DEDP, and 0.19 ± 0.03 mm/s of SED.

Conclusions

The dual-energy/single-probe device combining ultrasonic vibrations with electromechanical impact was significantly faster in fragmentation and clearing stone phantoms as well as in drilling speed compared to all other devices.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482. https://doi.org/10.1016/j.eururo.2015.07.041

    Article  PubMed  Google Scholar 

  2. Matlaga BR, Chew B, Eisner B, Humphreys M, Knudsen B, Krambeck A, Lange D, Lipkin M, Miller NL, Monga M (2018) Ureteroscopic laser lithotripsy: a review of dusting vs fragmentation with extraction. J Endourol 32(1):1–6

    Article  Google Scholar 

  3. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, Sarica K, Turk C, Wolf JS (2007) 2007 guideline for the management of ureteral calculi. J Urol 178(6):2418–2434. https://doi.org/10.1016/j.juro.2007.09.107

    Article  PubMed  Google Scholar 

  4. Carlos EC, Wollin DA, Winship BB, Jiang R, Radvak D, Chew BH, Gustafson MR, Simmons WN, Zhong P, Preminger GM, Lipkin ME (2018) In vitro comparison of a novel single probe dual-energy lithotripter to current devices. J Endourol 32(6):534–540. https://doi.org/10.1089/end.2018.0143

    Article  PubMed  Google Scholar 

  5. Olbert P, Weber J, Hegele A, Varga Z, Heidenreich A, Hofmann R (2003) Combining lithoclast and ultrasound power in one device for percutaneous nephrolithotomy: in vitro results of a novel and highly effective technology. Urology 61(1):55–59. https://doi.org/10.1016/s0090-4295(02)02256-2(discussion 59)

    Article  PubMed  Google Scholar 

  6. Geraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31(6):547–556. https://doi.org/10.1089/end.2016.0895

    Article  PubMed  Google Scholar 

  7. Chew BH, Matteliano AA, de Los RT, Lipkin ME, Paterson RF, Lange D (2017) Benchtop and initial clinical evaluation of the ShockPulse stone eliminator in percutaneous nephrolithotomy. J Endourol 31(2):191–197. https://doi.org/10.1089/end.2016.0664

    Article  PubMed  Google Scholar 

  8. Bader MJ, Pongratz T, Khoder W, Stief CG, Herrmann T, Nagele U, Sroka R (2015) Impact of pulse duration on Ho:YAG laser lithotripsy: fragmentation and dusting performance. World J Urol 33(4):471–477. https://doi.org/10.1007/s00345-014-1429-8

    Article  PubMed  Google Scholar 

  9. Sroka R, Pongratz T, Scheib G, Khoder W, Stief CG, Herrmann T, Nagele U, Bader MJ (2015) Impact of pulse duration on Ho:YAG laser lithotripsy: treatment aspects on the single-pulse level. World J Urol 33(4):479–485

    Article  Google Scholar 

  10. Tokas T, Herrmann TRW, Skolarikos A, Nagele U (2019) Pressure matters: intrarenal pressures during normal and pathological conditions, and impact of increased values to renal physiology. World J Urol 37(1):125–131. https://doi.org/10.1007/s00345-018-2378-4

    Article  PubMed  Google Scholar 

  11. Strittmatter F, Eisel M, Brinkmann R, Cordes J, Lange B, Sroka R (2020) Laser-induced lithotripsy: a review, insight into laboratory work, and lessons learned. Transl Biophoton. https://doi.org/10.1002/tbio.201900029

    Article  Google Scholar 

  12. Auge BK, Lallas CD, Pietrow PK, Zhong P, Preminger GM (2002) In vitro comparison of standard ultrasound and pneumatic lithotrites with a new combination intracorporeal lithotripsy device. Urology 60(1):28–32. https://doi.org/10.1016/s0090-4295(02)01624-2

    Article  PubMed  Google Scholar 

  13. Pietrow PK, Auge BK, Zhong P, Preminger GM (2003) Clinical efficacy of a combination pneumatic and ultrasonic lithotrite. J Urol 169(4):1247–1249. https://doi.org/10.1097/01.ju.0000049643.18775.65

    Article  PubMed  Google Scholar 

  14. Esch E, Simmons WN, Sankin G, Cocks HF, Preminger GM, Zhong P (2010) A simple method for fabricating artificial kidney stones of different physical properties. Urol Res 38(4):315–319. https://doi.org/10.1007/s00240-010-0298-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kuo RL, Paterson RF, Siqueira TM Jr, Evan AP, McAteer JA, Williams JC Jr, Lingeman JE (2004) In vitro assessment of lithoclast ultra intracorporeal lithotripter. J Endourol 18(2):153–156. https://doi.org/10.1089/089277904322959789

    Article  PubMed  Google Scholar 

  16. Haupt G, Sabrodina N, Orlovski M, Haupt A, Krupin V, Engelmann U (2001) Endoscopic lithotripsy with a new device combining ultrasound and lithoclast. J Endourol 15(9):929–935. https://doi.org/10.1089/089277901753284161

    Article  CAS  PubMed  Google Scholar 

  17. Louie MK, Lowe G, Knudsen BE (2008) Comparison of the lithoclast ultra and cyberwand in a cystolitholapaxy model. In: Proceedings volume 6842, photonic therapeutics and diagnostics IV; 684215. https://doi.org/10.1117/12.762891

  18. Krambeck AE, Miller NL, Humphreys MR, Nakada SY, Denstedt JD, Razvi H, Preminger GM, Nadler RB, Matlaga BR, Paterson RF, Chew BH, Munch LC, Handa SE, Lingeman JE (2011) Randomized controlled, multicentre clinical trial comparing a dual-probe ultrasonic lithotrite with a single-probe lithotrite for percutaneous nephrolithotomy. BJU Int 107(5):824–828. https://doi.org/10.1111/j.1464-410X.2010.09567.x

    Article  PubMed  Google Scholar 

  19. Khoder W, Strittmatter F, Alghamdi A, Seitz M, Stief C, Bader MJ (2019) Comparative evaluation of tissue damage induced by ultrasound and impact dual-mode endoscopic lithotripsy versus conventional single-mode ultrasound lithotripsy. World J Urol. https://doi.org/10.1007/s00345-019-02747-1

    Article  PubMed  Google Scholar 

  20. Sabnis RB, Balaji SS, Sonawane PL, Sharma R, Vijayakumar M, Singh AG, Ganpule AP, Desai MR (2019) EMS lithoclast trilogy: an effective single-probe dual-energy lithotripter for mini and standard PCNL. World J Urol. https://doi.org/10.1007/s00345-019-02843-2

    Article  PubMed  Google Scholar 

  21. Nottingham CU, Large T, Cobb K, Sur RL, Canvasser NE, Stoughton CL, Krambeck AE (2019) Initial clinical experience with Swiss LithoClast trilogy during percutaneous nephrolithotomy. J Endourol. https://doi.org/10.1089/end.2019.0561

    Article  PubMed  Google Scholar 

  22. York NE, Borofsky MS, Chew BH, Dauw CA, Paterson RF, Denstedt JD, Razvi H, Nadler RB, Humphreys MR, Preminger GM, Nakada SY, Krambeck AE, Miller NL, Terry C, Rawlings LD, Lingeman JE (2017) Randomized controlled trial comparing three different modalities of lithotrites for intracorporeal lithotripsy in percutaneous nephrolithotomy (2017). J Endourol 31(11):1145–1151. https://doi.org/10.1089/end.2017.0436

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Mr. Wolfgang Merkle for his scientific support for this study.

Author information

Author notes

  1. Markus J. Bader and Maximilian Eisel shares first authorship.

Authors and Affiliations

  1. UroClinic München, Residenzstraße 18, Munich, Germany

    Markus J. Bader

  2. Department of Urology, University Hospital of Munich, Munich, Germany

    Markus J. Bader, Maximilian Eisel, Frank Strittmatter, Christian G. Stief, Thomas Pongratz & Ronald Sroka

  3. Department of Urology and Andrology, General Hospital Hall in Tirol, Hall in Tirol, Austria

    Udo Nagele

  4. Laser-Forschungslabor, LIFE-Zentrum, University Hospital of Munich, Munich, Germany

    Maximilian Eisel, Thomas Pongratz & Ronald Sroka

Authors
  1. Markus J. Bader
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maximilian Eisel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Frank Strittmatter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Udo Nagele
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian G. Stief
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Pongratz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ronald Sroka
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group

  • Markus J. Bader
  • , Frank Strittmatter
  •  & Udo Nagele

Contributions

MJB: protocol/project development, data collection and management, data analysis, manuscript writing, ME: protocol/project development, data collection, manuscript writing, FS: protocol/project development, manuscript editing, UN: protocol/project development, manuscript editing, CGS: protocol/project development, manuscript editing, TP: protocol/project development, data analysis, RS: protocol/project development, data analysis, manuscript editing.

Corresponding authors

Correspondence to Markus J. Bader or Maximilian Eisel.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest related to this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bader, M.J., Eisel, M., Strittmatter, F. et al. Comparison of stone elimination capacity and drilling speed of endoscopic clearance lithotripsy devices. World J Urol 39, 563–569 (2021). https://doi.org/10.1007/s00345-020-03184-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-020-03184-1

Keywords

Search

Navigation