Document Detail

Tissue Damage from Ultrasonic, Pneumatic, and Combination Lithotripsy.
MedLine Citation:
PMID:  25083583     Owner:  NLM     Status:  Publisher    
Purpose: To conduct a comparative evaluation of ultrasonic, pneumatic, and dual ultrasonic lithotripsy to predict the safety of probes on urinary tract tissue. Materials and Methods: The Swiss Lithoclast Ultra (ultrasonic only (US), and ultrasonic-pneumatic combination (US+P)), and the Gyrus ACMI Cyberwand (dual-ultrasonic (DUS)) were evaluated. Fresh porcine ureters, bladders, and renal pelvis tissues were used with a hands-free set-up to vertically apply 0g, 400g, or 700g of force with each probe for duration of 3 seconds, 5 seconds, or 3 minutes (or until perforation occurred). Data collection included whether perforation occurred, and time to perforation. Histological analysis of non-perforated samples was used to compare the anatomical depth to which damage occurred. Results: Total percentage of trials resulting in perforation, for all tissue types, contact durations, and forces was found to be 8.5% (10/117) for US, 13.7% (16/117) for US+P, and 26.4% (31/117) for DUS. No perforations occurred with light contact (0g) of probe force, regardless of tissue type, lithotripsy mode, or contact duration. Overall, renal pelvis was most resistant to perforation (p=0.0004), while no difference was found between bladder and ureter tissue (p=0.32). Force beyond 400g and contact greater than 5 sec increased risk for damage. Conclusions: Mode of lithotripsy, tissue type, probe force, and probe-tissue contact duration all significantly impacted the extent of damage and likelihood for perforation to occur. All devices and tissue types provided a reasonably margin of safety for probe-tissue contact times of 3 and 5 seconds with no more than 400 g of force.
Carl Sarkissian; Yuqing Cui; Kevin Mohsenian; Katherine Watts; Tianming Gao; Sarah Tarplin; Manoj Monga
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-1
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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