EMS Lithoclast Trilogy™: an effective single-probe dual-energy lithotripter for mini and standard PCNL
| Autor: | Mohankumar Vijayakumar, Ravindra Sabnis, Arvind Ganpule, Mahesh R. Desai, Parag Sonawane, Sudharsan S. Balaji, Abhishek Singh, Rohan Sharma |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Stone clearance Urology medicine.medical_treatment 030232 urology & nephrology Nephrolithotomy Percutaneous Kidney Calculi 03 medical and health sciences 0302 clinical medicine Lithotripsy medicine Humans Single probe Prospective Studies Clinical efficacy Percutaneous nephrolithotomy Device failure Procedure time Dual energy business.industry Equipment Design Middle Aged 030220 oncology & carcinogenesis Female business Energy source Nuclear medicine |
| Zdroj: | World Journal of Urology. 38:1043-1050 |
| ISSN: | 1433-8726 0724-4983 |
| DOI: | 10.1007/s00345-019-02843-2 |
| Popis: | Several energy sources are available to clear stones during PCNL. Required improvements are faster stone clearance, optimized suction and ease of use while maintaining high patient safety standard. EMS LithoClast® Trilogy, is the first device combining electromagnetic impactor with ultrasonic energy and suction, all-in-one probe. Animal studies and in vitro phantom stone studies have proven safety and efficacy of this device. We aim to study safety and clinical efficacy of Trilogy in our patients. 31 patients with renal stones were included. Amplatz sheath sizes/Trilogy probe size was 22–28 Fr/10.2 Fr for standard PNL (n = 20) and 15 Fr./5.7 Fr for mini PNL access (n = 11). Analysis was done with respect to demography, stone characteristics, operation duration (total time and lithotripter activation time), post op Hb drop, clearance rate and adverse events. Stone area/volume was calculated based on CT using 3D doctor. Efficacy was determined by stone volume clearance rate (mm3/min). Male:female ratio was 6:5 and 16:4 for mini (MPNL)/standard PNL (SPNL). Stone densities were 1229 ± 206 vs. 1168 ± 344 HU (MPNL vs. SPNL). Mean stone volumes were 3776.1 ± 2132 mm3 for MPNL and 7096 ± 6441 for SPNL. Mean stone volume clearance ratios were 370.5 ± 171 mm3/min and 590.7 ± 250mm3/min for MPNL and SPNL, respectively. Hb drop was 1.24 ± 0.64 g/dL (MPNL) and 1.23 ± 0.89gm/dL (SPNL). Total procedure time/lithotripter activation time was 53.4 ± 23.8/14.7 ± 12.4 min for MPNL and 65.2 ± 23.5/12.0 ± 8.9 for SPNL. Immediate post-operative/1 month stone clearance rates were 93%/96% with one clinically insignificant residual fragment ( |
| Databáze: | OpenAIRE |
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