Haupt G, Pannek J, Herde T, Schulze H, Senge T
Department of Urology, Ruhr-University Bochum, Germany.
J Endourol. 1995 Oct;9(5):375-7. doi: 10.1089/end.1995.9.375.
Minimal invasiveness characterizes modern stone therapy. Several years ago, we presented the Swiss Lithoclast, a ballistic system for endoscopic stone therapy. Its disintegrational power is superior to that of the other intracorporeal lithotripsy devices, and it has gained great recognition. Now, special probes (Lithovac) have been developed to combine lithotripsy with suction. These probes differ in width (1.6, 3.5, or 4 mm) and length depending on the intended location of use (kidney, ureter, bladder). The probes were tested in a standardized stone model. The variable suction energy counteracts the propulsive energy of the Lithoclast. Clinical experience could be gained with stones in the urinary bladder, Kock pouches, the ureter, and the kidney. There were no complications related to either the Lithoclast or the Lithovac. In staghorn stones, small (< 2 mm) pieces could be removed easily during lithotripsy. Fragments as large as 3.5 mm could be evacuated with the Lithovac after removing the Lithoclast probe. Using the suction, clear vision could be achieved (especially useful in struvite stones). In the ureter, a learning curve had to be overcome to balance fluid inflow and suction pressure. Otherwise, the ureter may collapse. However, this was possible in all patients. Using the single-shot mechanism, stones were broken up fast. The fragments could be dragged to the Lithoclast probe with the Lithovac. No pushback happened. In bladder and Kock pouch stones, suction may not be enough to hold the stone to the probe, but it is of great value to keep a small volume in the bladder/pouch and still have excellent visibility. The Lithovac is a useful tool in all endoscopic applications of the Lithoclast.
微创性是现代结石治疗的特点。几年前，我们推出了瑞士碎石器，这是一种用于内镜下结石治疗的弹道系统。其碎石能力优于其他体内碎石设备，并获得了广泛认可。现在，已经开发出了特殊探头（Lithovac），将碎石与抽吸功能相结合。这些探头的宽度（1.6、3.5或4毫米）和长度因预期使用部位（肾脏、输尿管、膀胱）而异。这些探头在标准化结石模型中进行了测试。可变的抽吸能量抵消了碎石器的推进能量。通过治疗膀胱、回肠膀胱、输尿管和肾脏的结石积累了临床经验。未出现与碎石器或Lithovac相关的并发症。在鹿角形结石中，碎石过程中可轻松取出小（<2毫米）碎片。取出碎石器探头后，Lithovac可吸出直径达3.5毫米的碎片。利用抽吸功能，可以实现清晰的视野（在感染性结石中尤其有用）。在输尿管中，必须克服学习曲线以平衡液体流入和抽吸压力。否则，输尿管可能会塌陷。然而，所有患者都做到了这一点。使用单次发射机制，结石能快速破碎。碎片可被Lithovac拖至碎石器探头处，不会出现回推现象。在膀胱和回肠膀胱结石中，抽吸可能不足以将结石固定在探头上，但对于保持膀胱/回肠膀胱内少量液体并仍能获得极佳视野具有重要价值。Lithovac在碎石器的所有内镜应用中都是一种有用的工具。
