Intracorporeal lithotripsy: Which modality is best?

Raymond J. Leveillee, Leonid Lobik

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations

Abstract

Purpose of review: A large number of related articles published within the last year were reviewed. Different types of intracorporeal lithotripter devices were compared according to their advantages, disadvantages, efficacy, safety and clinical applications. General directions of future developments are discussed. Recent findings: Ultrasound lithotripters employed through rigid endoscopes provide high fragmentation rates (97-100%) and stone free rate (94%). Clinical evaluation of a new combination ultrasound and pneumatic lithotripter reported an overall stone free rate of 80-89.7%. No major complications were observed. The holmium:YAG (Yttrium-Aluminum-Garnet) laser lithotripter is able to destroy all compositions of stone. The stone free rate for ureteral stones is close to 100%. Complications are rare and minimal. Newer wavelengths such as erbium:YAG are currently impractical. There are limited clinical data regarding frequency-doubled double-pulse neodymium:YAG laser lithotripsy. Summary: Ultrasound lithotripsy is still the preferable modality applied through rigid endoscopes. A new combination of ultrasound and pneumatic impactor includes the advantages of each mode. The holmium:YAG laser lithotripter is the method of choice for flexible endoscopic procedures. Further development of new lithotripters with different energy sources and their combination is necessary.

Original languageEnglish (US)
Pages (from-to)249-253
Number of pages5
JournalCurrent opinion in urology
Volume13
Issue number3
DOIs
StatePublished - May 1 2003

Keywords

  • Calculi
  • Endoscopic lithotripsy
  • Laser fibers
  • Ureteroscopy

ASJC Scopus subject areas

  • Urology

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