Current role of extracorporeal shockwave therapy in surgery

Abstract

In urology the introduction of extracorporeal shockwave therapy brought a revolutionary change to the management of urinary calculi. This inspired the introduction of shockwave therapy in several fields of surgery; it has been applied as a potential alternative to several operative procedures but is still experimental. So far, the major application of shockwave therapy has been lithotripsy of stones in the gallbladder, common bile duct, pancreatic duct and salivary gland ducts. Other applications are in the non-operative management of bone healing disturbances and in the inhibition of tumour growth. Steps towards selective thrombus ablation and pretreatment of heavily calcified arteries have also been made. In this review, the applications of extracorporeal shockwave therapy in several areas of surgery are discussed. It is concluded that, for selected patients, shockwave treatment may serve as a useful addition to the surgical armamentarium.

Bactericidal effect of extracorporeal shock waves on Staphylococcus aureus

“…The bactericidal effect was obtained with shock wave impulse rates and energy levels equal to and safe for use in man [1,6,7]. Although the experimental set-up of the in-vitro system with bacterial cells sealed into PVC tubing is not completely equivalent to the physiological conditions of micro-organisms embedded in tissues, it has similarities to foreign body infections.…”

“…For treatment purposes, urinary calculi, or in the present study the tubes, have to be brought into this focus F2. In lithotripsy, shock waves with an increasing time of 20±600 ns, a maximum pressure of 400±1000 bar and a mean pressure time of 0.5±1 ms are used [1,6,7].…”

Splenic Rupture following ESWL for a Pancreatic Duct Calculus

“…In selected cases where pancreatic duct calculi are considered to obstruct the duct and aggravate a case of chronic pancreatitis, ESWL has become an established therapy alternative alone or in combination with endoscopic methods [1]. Shock wave therapy has also been introduced in the treatment of several other disease conditions [2]. …”

Extracorporeal shock wave treatment of humeral nonunion: a case report

“…Alternative, minimally invasive technique for treatment of such poorly healing fractures are desirable. The reported high success rate in treatment of nonunions makes ESWT an attractive non-surgical option for these patients [6,7]. Valchanou and Michailov [8] began shock wave treatment for pseudoarthrosis and delayed union in 1988 with 70 successful treatments out of 82 cases.…”