1815 Coupling Gel Viscosity - A Relevant Factor for Efficient Shock Wave Coupling in SWL

Bergsdorf, T.; Chaussy, C.; Thueroff, S.

doi:10.1016/j.juro.2010.02.1740

Cited by 6 publications

(3 citation statements)

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“…Second, the Optical Coupling Control (OCC) system, which equipped with an inline camera for air pockets observation, could help operator to repeat the coupling procedure and achieve less air-pockets coupling [ 15 – 17 ]. Third, coupling a solid gel disc would cause less air bubbles as an alternative option [ 18 , 19 ]. Further, a proprietary isolation-coupling pad (“icPad”) had demonstrated its superior efficacy of stone disintegration by markedly reducing trapped air pockets during coupling in a phantom study [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy

Chang

Lin

et al. 2022

BMC Urol

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This study aimed to investigate clinical effectiveness of stone disintegration by using isolation coupling pad (“icPad”) as coupling medium to reduce trapped air pockets during extracorporeal shock wave lithotripsy (ESWL). Patients underwent ESWL between Oct. 2017 and May 2018 were enrolled in this clinical observational study. An electromagnetic lithotripter (Dornier MedTech Europe GmbH Co., Germany) was used in this study. Patients were divided into icPad group P1, P2 and semi-gel group C by different coupling medium. The energy level and total number of shock wave (SW) for group P1 and C was set at level 2 and 3000 and group P2 at level 3 and 2500. The successful stone disintegration rate (SSDR) was determined to evaluate the treatment outcome. All patients were evaluated by KUB film and ultrasonography after 90 days. Complications during ESWL were recorded. A total of 300 patients satisfied the inclusion criteria. There were no significant differences in characteristics of patients and stone among three groups. The corresponding SSDRs for patients in group P1, P2 and C was 73.0%, 73.2% and 55.3%, respectively. The SSDR in group P1 was statistically higher than Group C. Comparing to semi-liquid gel, coupling medium using by icPad could achieve better treatment outcome of stone disintegration in ESWL.

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Section: Introductionmentioning

confidence: 99%

A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy

Chang

Lin

et al. 2022

BMC Urol

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“…Extracorporeal shock wave lithotripsy (ESWL) is the preferred method of treating urinary tract stones [ 3 ]. In ESWL, semi-liquid gel (referred to as “gel”) is used as a coupling medium between the skin and the lithotripsy probe so the shock wave can transmit into the target area [ 4 ]. As for the success rate of ESWL in treating urinary tract stones, the coupling interface is an important factor [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Experimental Observation of Isolative Efficacy of a Solid Coupling Medium in Extracorporeal Shock Wave Lithotripsy—Implications to Nosocomial Infection Prevention

et al. 2022

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Introduction: Extracorporeal shock wave lithotripsy (ESWL) is a well-established, popular treatment choice for renal stones. Traditionally, the semi-liquid gel is used as a coupling medium in ESWL. During ESWL, body fluid or blood might transmit between the patients when the probe or gel used in the procedure is contaminated and cause potential nosocomial infections. To solve this problem, we developed a solid coupling medium (isolation coupling pad, referred to as “icPad”) between the patient’s skin and the probe as a shock wave transmission medium to prevent contamination. This study aimed to investigate the isolative efficacy of the icPad in blocking the permeation of microbes. Method: Rhodamine 6G (a fluorescent dye) was used as a tracer to simulate the microorganisms. The penetration of the fluorescent dye on the longitudinal section of the icPad was observed by a microscope after the dye was placed on the body side of the icPad for 40 min. After the shock wave, icPad was extracted with 75% ethanol, and fluorescence intensity was measured with a fluorescence spectrometer. Results: Our results revealed that the body side of icPad is free of fluorescent dye during lithotripsy. Qualitative analysis results confirmed that icPad has an isolative effect on simulating contaminants such as bacteria or viruses. Conclusion: In this in vitro phantom study, a proprietary icPad can be an isolative coupling medium and is speculated to avoid cross-contamination of bacterial or viral infection during ESWL.

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“…Coupling technique by applying a larger amount of semi-liquid gel to the lithotripter head leads to better coupling [ 8 ]. Bergsdorf et al invented a coupling membrane and demonstrated better efficacy over semi-liquid gel, but not being widely adopted [ 9 ]. Lithotripter equipped with optical coupling control (OCC) system was invented.…”

Section: Introductionmentioning

confidence: 99%

Newly designed solid coupling medium for reducing trapped air pockets during extracorporeal shock wave lithotripsy_ a phantom study

Wang

Liou³

et al. 2021

BMC Urol

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Introduction Air pockets between the lithotripter head and body surface are almost inevitably generated when applying a handful of gel onto the contact portion of the treatment head and that on the patient’s skin during coupling procedure. These air pockets can compromise the transmission of acoustic energy of shock wave and may significantly affect efficacy of stone disintegration. Comparing to conventional gel, this study aims to investigate efficacy of stone disintegration by using a proprietary isolation-coupling pad (“icPad”) as the coupling medium to reduce trapped air pockets during ESWL procedure. Method In this phantom study, Dornier lithotripter (Delta-2 RC, Dornier MedTech Europe GmbH Co., Germany) was used with a proprietary gel pads (icPad, Diameter = 150 mm, Thickness = 4 mm and 8 mm). The lithotripter was equipped with inline camera to observe the trapped air pockets between the contact surface of the lithotripter head. A testing and measuring device were used to observe experimental stone disintegration using icPad and semi-liquid gel. The conventional semi-liquid gel was used as control for result comparison. Results The stone disintegration rate of icPad 4 mm and 8 mm after 200 shocks of energy at level 2 were significantly higher than that of the semi-liquid gel (disintegration rate 92.3%, 85.0% vs. 45.5%, respectively, p < 0.001). The number of shocks for complete stone disintegration by icPad of 4 mm and 8 mm at the same energy level 2 were significantly lower than that of the semi-liquid gel (the number of shocks 242.0 ± 13.8, 248.7 ± 6.3 vs. 351.0 ± 54.6, respectively, p = 0.011). Furthermore, quantitative comparison of observed air pockets under Optical Coupling Control (OCC) system showed that the area of air pockets in semi-liquid group was significantly larger than that of the group using icPad (8 mm) and that of the group using icPad (8 mm) after sliding (332.7 ± 91.2 vs. 50.3 ± 31.9, 120.3 ± 21.5, respectively, p < 0.05). Conclusion The advantages of icPad includes: (1) reduced the numbers of shock wave and increased stone disintegration rate due to icPad’s superior efficacy; (2) significantly reduce trapped air pockets in ESWL coupling. Due to the study limitation, more data are needed to confirm our observations before human trials.

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1815 Coupling Gel Viscosity - A Relevant Factor for Efficient Shock Wave Coupling in SWL

Cited by 6 publications

References 0 publications

A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy

A clinical observational study of effectiveness of a solid coupling medium in extracorporeal shock wave lithotripsy

Experimental Observation of Isolative Efficacy of a Solid Coupling Medium in Extracorporeal Shock Wave Lithotripsy—Implications to Nosocomial Infection Prevention

Newly designed solid coupling medium for reducing trapped air pockets during extracorporeal shock wave lithotripsy_ a phantom study

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