Assessment of a Modified Acoustic Lens for Electromagnetic Shock Wave Lithotripters in a Swine Model
2013; Lippincott Williams & Wilkins; Volume: 190; Issue: 3 Linguagem: Inglês
10.1016/j.juro.2013.02.074
ISSN1527-3792
AutoresJohn Mancini, Andreas Neisius, Nathan Smith, Georgy Sankin, Gastón M. Astroza, Michael E. Lipkin, W. Neal Simmons, Glenn M. Preminger, Pei Zhong,
Tópico(s)Pediatric Urology and Nephrology Studies
ResumoNo AccessJournal of UrologyInvestigative Urology1 Sep 2013Assessment of a Modified Acoustic Lens for Electromagnetic Shock Wave Lithotripters in a Swine Model John G. Mancini, Andreas Neisius, Nathan Smith, Georgy Sankin, Gaston M. Astroza, Michael E. Lipkin, W. Neal Simmons, Glenn M. Preminger, and Pei Zhong John G. ManciniJohn G. Mancini Division of Urologic Surgery, Duke University, Durham, North Carolina , Andreas NeisiusAndreas Neisius Division of Urologic Surgery, Duke University, Durham, North Carolina Department of Urology, Johannes Gutenberg University, Mainz, Germany , Nathan SmithNathan Smith Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina , Georgy SankinGeorgy Sankin Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina , Gaston M. AstrozaGaston M. Astroza Division of Urologic Surgery, Duke University, Durham, North Carolina , Michael E. LipkinMichael E. Lipkin Division of Urologic Surgery, Duke University, Durham, North Carolina , W. Neal SimmonsW. Neal Simmons Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina , Glenn M. PremingerGlenn M. Preminger Division of Urologic Surgery, Duke University, Durham, North Carolina , and Pei ZhongPei Zhong Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.074AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The acoustic lens of the Modularis electromagnetic shock wave lithotripter (Siemens, Malvern, Pennsylvania) was modified to produce a pressure waveform and focal zone more closely resembling that of the original HM3 device (Dornier Medtech, Wessling, Germany). We assessed the newly designed acoustic lens in vivo in an animal model. Materials and Methods: Stone fragmentation and tissue injury produced by the original and modified lenses of the Modularis lithotripter were evaluated in a swine model under equivalent acoustic pulse energy (about 45 mJ) at 1 Hz pulse repetition frequency. Stone fragmentation was determined by the weight percent of stone fragments less than 2 mm. To assess tissue injury, shock wave treated kidneys were perfused, dehydrated, cast in paraffin wax and sectioned. Digital images were captured every 120 μm and processed to determine functional renal volume damage. Results: After 500 shocks, the mean ± SD stone fragmentation efficiency produced by the original and modified lenses was 48% ± 12% and 52% ± 17%, respectively (p = 0.60). However, after 2,000 shocks, the modified lens showed significantly improved stone fragmentation compared to the original lens (mean 86% ± 10% vs 72% ± 12%, p = 0.02). Tissue injury caused by the original and modified lenses was minimal at a mean of 0.57% ± 0.44% and 0.25% ± 0.25%, respectively (p = 0.27). Conclusions: With lens modification the Modularis lithotripter demonstrates significantly improved stone fragmentation with minimal tissue injury at a clinically relevant acoustic pulse energy. This new lens design could potentially be retrofitted to existing lithotripters, improving the effectiveness of electromagnetic lithotripters. References 1 : Extracorporeally induced destruction of kidney stones by shock waves. Lancet1980; 2: 1265. Google Scholar 2 : First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol1982; 127: 417. Link, Google Scholar 3 Rassweiler JJ, Knoll T, Kohrmann KU et al: Shock wave technology and application: an update. Eur Urol; 59: 784. Google Scholar 4 : Shockwave lithotripsy: anecdotes and insights. J Endourol2003; 17: 687. 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Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: Improving the Lens Design and Performance of a Contemporary Electromagnetic Shock Wave LithotripterJournal of Urology, VOL. 192, NO. 5, (1457-1458), Online publication date: 1-Nov-2014.Eisner B (2018) Improvements in Minimally Invasive Stone Treatment: Experimental StudiesJournal of Urology, VOL. 190, NO. 3, (834-835), Online publication date: 1-Sep-2013. Volume 190Issue 3September 2013Page: 1096-1101 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordskidney calculilithotripsyequipment and supplieslenseskidneyMetricsAuthor Information John G. Mancini Division of Urologic Surgery, Duke University, Durham, North Carolina Equal study contribution. More articles by this author Andreas Neisius Division of Urologic Surgery, Duke University, Durham, North Carolina Department of Urology, Johannes Gutenberg University, Mainz, Germany Equal study contribution. More articles by this author Nathan Smith Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina More articles by this author Georgy Sankin Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina More articles by this author Gaston M. Astroza Division of Urologic Surgery, Duke University, Durham, North Carolina More articles by this author Michael E. Lipkin Division of Urologic Surgery, Duke University, Durham, North Carolina More articles by this author W. Neal Simmons Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina More articles by this author Glenn M. Preminger Division of Urologic Surgery, Duke University, Durham, North Carolina More articles by this author Pei Zhong Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina More articles by this author Expand All Advertisement PDF downloadLoading ...
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