Laser Induced Shock Wave Lithotripsy—Biologic Effects of Nanosecond Pulses

Hofmann, Rainer; Härtung, R.; Geißdörfer, K.; Ascherl, R.; Erhardt, W.; Schmidt-Kloiber, H.; Reichel, E.

doi:10.1016/s0022-5347(17)42790-x

Cited by 31 publications

(2 citation statements)

References 6 publications

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“…Oscillation of the plasma bubble is induced by expansion and cooling and in turn cavitations occur within the liquid medium. Variable effects of the cavitations on the leading and trailing edges of the stone then cause consecutive disintegration of the stone in manner similar to those of earlier electrohydraulic lithotripters [101]. The mechanism of stone fragmentation of the holmium:YAG (Ho:YAG) laser, the current laser of choice, differs from that of the pulsed dye laser (Figs.…”

Section: Laser Lithotripsymentioning

confidence: 93%

Urological Aspects of Management

Miller

Stoller

2011

Clinic Rev Bone Miner Metab

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Renal colic describes the acute, severe, and paroxysmal pain caused by the obstruction, distension, and resultant increase in intraluminal pressure of the urinary tract. The treatment of renal colic is aimed at relief of symptoms, facilitating urinary drainage to preserve renal function and treat infection and ultimately removal or passage of the obstructing stone. The medical management of renal colic is directed at mitigating, through pharmacologic intervention, one or more of the complex processes contributing to the clinical sequelae of obstruction including pain, nausea, vomiting, and irritative voiding symptoms. Numerous medications and combinations of medications have been employed with varying degrees of clinical success. Urgent interventions are typically directed at bypassing ureteral obstruction in order to palliate the patient until such time as definitive treatment may be accomplished or facilitate drainage to further the treatment of urinary tract infection. Timing and mode of urgent intervention are dependent on clinical factors, clinician expertise, and preference and the availability of specialized equipment. Definitive management of ureteral stones is typically performed in an elective fashion and seeks to balance the risks of intervention with the clinical benefits of the various treatment modalities. Treatment approaches vary according to clinical indications, patient preference, clinician expertise, and the availability of facilities and equipment. This section covers current supporting evidence and rationale, indications and techniques for the medical management, urgent intervention, and definitive management of acute renal colic caused by ureteral stones.

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Section: Laser Lithotripsymentioning

confidence: 93%

Urological Aspects of Management

Miller

Stoller

2011

Clinic Rev Bone Miner Metab

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“…Calculus fragmentation is produced by the combination of direct thermal energy absorption and laser induced shock waves [5][6][7]. During this powerful laser-tissue interaction, the calculus is subject to a strong retropulsive momentum caused by particle ejection or laser induced shock waves [8].…”

Section: Introductionmentioning

confidence: 99%

High-Speed Photographic Evaluation of Retropulsion Momentum Induced by a Laser Calculi Lithotriptor

Lee

Kim

Choi

et al. 2001

Advances in Heat and Mass Transfer in Biotechnology

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Since the mid-1980’s, many reports have demonstrated the clinical feasibility of fragmenting urinary and biliary calculi with high power lasers [1,2]. Several lasers such as pulsed dye, alexandrite and holmium:YAG have been successfully used as intracorporeal lithotriptors[3–5]. Calculus fragmentation is produced by the combination of direct thermal energy absorption and laser induced shock waves[5–7]. During this powerful laser-tissue interaction, the calculus is subject to a strong retropulsive momentum caused by particle ejection or laser induced shock waves[8]. If the stone cannot resist this kinetic momentum, it will recoil away from the laser delivery fiber. Then physicians must reorient the fiber to the stone for additional laser irradiation. This cumbersome process makes the procedure inconvenient and difficult and eventually prolongs the operation time. This study is designed to quantify the retropulsive momentum during pulsed laser lithotripsy.

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