dr. sandro varea , fernando santomil, alfredo penida, cristian grillo, jorge quezada
DESCRIPTION
Electromagnetic DSWL Double Shockwave Lithotripsy : Initial experience. Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina. Urología. - PowerPoint PPT PresentationTRANSCRIPT
Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge QuezadaDepartment of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina
Urología
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience
Urología
1- Sokolov DL, Bailey MR and Crum LA: Dual-pulse lithotripter accelerates stone fragmentation and reduces cell lysis in vitro. Ultrasound Med Biol 2003; 29: 1045.2- Sheir KZ, El-Diasty TA and Ismail AM: Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU Int 2005; 95: 389.3- Greenstein A, Sofer M and Matzkin H: Efficacy of the Duet lithotripter using two energy sources for stone fragmentation by shockwaves: an in vitro study. J Endourol 2004; 18: 942.
New design concept for Lithotripters: Double shockwave (1-3).
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience
Double shockwave
Two independent generators/ reflectors
angle of 76 degrees between
generators
Convergence into a single focal
point
Urología
4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009.
Double shockwave (4).
Butterfly Focal area
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience
Urología4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009.
Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience
Double shockwave
Reduce kidney damage
Increase treatments efficacy
Decreased treatment time Results?
• Show our initial experience using an extracorporeal double shockwave lithotriptor (Duet Magna, Direx/Initia).
• Evaluate safety and effectivness .
Urología
Goal
Cross-sectional Cross-sectional studystudy..
Period March-May 2010Period March-May 2010. .
Patients with renal and uretral stones indicated for ESWL Patients with renal and uretral stones indicated for ESWL treatment.treatment.
Treatments performed with intravenous sedation.Treatments performed with intravenous sedation.
Ambulatory procedure.Ambulatory procedure.
Urología
Method and Materials
VARIABLES
Double J catheter.
Treatment side.
Fragmentation.
Complications.
Retreats.
Removal rate
Age.
Sex.
Weight .
Size.
Body mass index.
Stone sizes and location.
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Method and Materials
33 urinary stones in 30 patients
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Patients distribution according to age
Average: 53,1 (31 –
76)
Results
(n= 30)
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Patients distribution according to sex
Results
(n= 33)
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Patients distribution according to side treated
Results
(n= 33)
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Patients distribution according to stone localization
Results
(n= 33)
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Patients distribution according to stone size treated
Results
• Stone fragmentation: 100 %
• Elimination rate: 85%
• There were no complications.
Urología
The double shockwave treatment is a safe and effective procedure.
It is necesary to perform additional prospective trials on a larger number of patients in order to confirm the results.
Urología
Conclusions