Technical modifications of the Dornier HM-3 lithotriptor with an improved anesthesia technique

Pressure-Optimized Lithotripsy with the Siemens Lithostar: Successful and Tissue-Protecting Treatment of Urinary Stones

“…The minimum voltage for clini cal application is usually 14 kV [Muschter, personal commun. ] which already corresponds to a pressure well above 500 bar [1,11], This means that a spark gap lithotripeter is not able to generate low pressure.…”

“…To simplify the three-dimensional graphs, pressure distributions can be cut in an axial direction in order to achieve two-dimen sional pressure curves. Figure 5 shows pressure distributions in axial direc tion (at maximum energy setting) for some different lithotripters [1,[9][10][11]. Unit A characterizes the first gen eration water-bath lithotripter [9,10] and unit B repre sents the modified version of that unit [1,11].…”

“…Figure 5 shows pressure distributions in axial direc tion (at maximum energy setting) for some different lithotripters [1,[9][10][11]. Unit A characterizes the first gen eration water-bath lithotripter [9,10] and unit B repre sents the modified version of that unit [1,11]. A piezo electric lithotripter is described by unit C [1], In compar ison the pressure distribution of the Siemens Lithostar is plotted [4], Obviously different lithotripters show different pres sure maxima.…”

Risk Factors in Outpatient Extracorporeal Shock Wave Lithotripsy

“…At present, technical modifications of the HM-3 lithotriptor allow a reduction in pain perception and improved anesthesia technique with oral medication [10], Second-generation shock wave lithotripsy (lithostar Siemens, Piezolith Wolf, LT-01 EDAP, Sonolith Technomed) makes it even possible to treat patients without anesthesia or with only local anesthesia. Therefore it is important to identify groups of stone patients that can be treated safely as outpatients with a minimal need for anesthesia in absence of pre-ESWL auxiliary measures.…”

ESWL Monotherapy for Large Stones and Staghorn Calculi

“…Nevertheless, the stent has reinitialized a trend to utilize ESWL monotherapy for patients with a large stone burden and this trend has been further enhanced by the availability of anesthesia-free lithotrip sy. This therapeutic modality has been mainly brought about by lithotriptors of the second generation and it certainly represents an important step towards the final goal of efficient, yet comfortable and noninvasive stone therapy [7,18], Despite all improvements of ESWL, several authors continue to consider percutaneous surgery -as mono therapy or in combination with ESWL -being the better treatment for patients with a large stone burden [5,10,11,14].…”