Urology Clinic, University of Lübeck, University Medical Center Schleswig-Holstein , Lübeck, Schleswig-Holstein, Germany.
J Endourol. 2011 Aug;25(8):1359-62. doi: 10.1089/end.2011.0019. Epub 2011 Jul 11.
Various techniques are available for intracorporeal disintegration of renal and ureteral stones, among them ballistic lithotripsy, ultrasonic lithotripsy and laser lithotripsy. The therapeutic effectiveness of these devices has been sufficiently studied and compared. This does not apply, however, to the risk of destroying the stone basket.
The time until destruction of the wires of various baskets with use of four different lithotripsy devices (LithoClast, EMS; LithoRapid, Olympus; Calcuson 27610029, Storz; Vera Pulse, Coherent) was measured in a model closely aligned with the clinic.
As expected, the direct application of laser pulses (wavelength 2.1 μm) irrespective of thickness and shape led to a melting of all wires of the stone extraction basket in less than 50 seconds (pulse energy: 800 mJ, pulse repetition rate: 8 hertz; fiber diameter: 365 μm). The purely kinetic functioning lithotripters (electrokinetic-ballistic and pneumatic-ballistic) were not able to destroy any wire within the set time limit of one minute. The sonotrode of the ultrasonic device, which is considered to be very tissue-conserving, separated all wires of baskets with a diameter of 1.8F (4 wires), 75% of baskets with a diameter of 2.5F (9 of 12), but only 8.3% of baskets with a diameter of 3.5F (1 of 12). Plaited wires demonstrated a good resistance (0 of 4) in comparison with the sonotrode.
Our study consequently shows that in addition to the laser, the ultrasonic probe can also easily destroy nitinol (nickel titanium) baskets.
目前有多种技术可用于粉碎肾和输尿管结石，包括弹道碎石、超声碎石和激光碎石。这些设备的治疗效果已经得到了充分的研究和比较。然而，对于破坏取石篮的风险，却没有进行过相应的研究。
在与临床密切相关的模型中，测量了四种不同碎石设备（LithoClast，EMS；LithoRapid，Olympus；Calcuson 27610029，Storz；Vera Pulse，Coherent）使用时不同取石篮的金属丝破坏时间。
不出所料，直接应用激光脉冲（波长 2.1μm），无论厚度和形状如何，都会在不到 50 秒的时间内使所有取石篮的金属丝熔化（脉冲能量：800mJ，脉冲重复率：8 赫兹；光纤直径：365μm）。纯粹的动力学碎石机（电动弹道和气动弹道）在设定的一分钟时间限制内无法破坏任何金属丝。被认为对组织损伤较小的超声换能器分离了所有直径为 1.8F（4 根金属丝）的取石篮的金属丝，75%的直径为 2.5F（12 根中的 9 根）的取石篮，而只有 8.3%的直径为 3.5F（12 根中的 1 根）的取石篮。与超声换能器相比，编织金属丝表现出更好的阻力（4 根中无 1 根）。
我们的研究表明，除了激光，超声探头也可以轻易地破坏镍钛诺（镍钛）取石篮。
