Abstract
Objectives:
To describe a novel modification of the lithotriptor to make intracorporeal lithotripsy for hard calculi fast, safe, and cheap.
Methods:
The spear-headed lithotriptor was fabricated, patented, and used for percutaneous nephrolithotripsy at our Institute of Urology.
Results:
The dynamics were studied at the impact setting of the generator at 4 bars under two circumstances: (a) impact force on first stroke (contact hit); (b) impact force during subsequent strokes (follow-up hits). The spear head generated an impact force of >575 bars, whereas the conventional flat-end probe generated 16 bars. The technical advantages are creation of highly focused impact force, centrifugal vectors of force, graduated impact force, augmented mechanical separation of the fragments, decreased lateral displacement of the probe, and reduced generator pressure settings. Spear head cracks the calculus into larger fragments as compared to the chipping in the conventional probe. It is easy to learn. Prospective study results are awaited. The video elaborates the physics, mechanics, and demonstration.
Caution:
As with any other lithotripsy equipment, the spear head should be used only under direct vision.
Conclusions:
The spear-headed lithotripter is safe, fast, effective, and cheap. It is easy to learn and use. It generates highly focused impact force at a low pressure during the contact hit and graduated impact force during follow-up hits. It is the instrument of first choice to pulverize hard calculi at our institute.
No competing financial interests exist.
Runtime of video: 6 mins 29 secs
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