Michel M S, Köhrmann K U, Alken P
Department of Urology, University Hospital Mannheim, Germany.
Curr Opin Urol. 2000 Nov;10(6):571-5. doi: 10.1097/00042307-200011000-00006.
Despite the development of extracorporeal shockwave lithotripsy, endoscopic stone removal, with or without intracorporeal lithotripsy, is still an effective minimally invasive alternative for special indications. There is no defined all-purpose lithotripsy procedure for contact lithotripsy. The choice of the lithotripsy procedure for endoscopic stone disintegration depends on a number of different factors, the main one being stone localization. Small calibre, flexible probes (electrohydraulic, pneumatic, laser) are especially appropriate for ureterorenoscopy, but the speed of stone disintegration is a limiting factor. In contrast, large calibre rigid probes (ultrasound) are clearly more effective, but are unsuitable in size for flexible ureterorenoscopy. This indicates that the type and size of the endoscope decisively influences the choice of devices for endoscopic stone disintegration. Additional inhibiting factors are the flexibility or the rigidity of the instrument and the diameter of the working channel. It must be noted that total costs are not only calculated on the purchase of the equipment, but must also cover disposable materials.
尽管体外冲击波碎石术有所发展，但无论有无体内碎石，内镜下取石对于特殊适应症仍是一种有效的微创替代方法。对于接触式碎石术，尚无明确的通用碎石程序。内镜下结石碎裂的碎石程序选择取决于许多不同因素，主要因素是结石的位置。小口径、可弯曲探头（液电、气动、激光）特别适用于输尿管肾镜检查，但结石碎裂速度是一个限制因素。相比之下，大口径刚性探头（超声）显然更有效，但尺寸不适合可弯曲输尿管肾镜检查。这表明内镜的类型和尺寸决定性地影响内镜下结石碎裂设备的选择。其他抑制因素包括器械的柔韧性或刚性以及工作通道的直径。必须注意的是，总成本不仅要计算设备的购买费用，还必须涵盖一次性材料。
