Innovations in shock wave lithotripsy technology: updates in experimental studies

Area of Science:

• Biomedical Engineering
• Medical Devices
• Urology

Background:

• Shock wave lithotripsy (SWL) is a common procedure for kidney stone treatment.
• Existing SWL technology faces challenges in balancing stone comminution efficiency with potential tissue injury.
• Improvements in SWL technology are needed to enhance treatment efficacy and patient safety.

Purpose of the Study:

• To develop and evaluate technological innovations for shock wave lithotripsy (SWL).
• To modify the lithotriptor shock wave (LSW) profile to minimize tissue damage.
• To enhance stone comminution efficiency through auxiliary shock wave generation.

Main Methods:

• Two technical upgrades were implemented on an original HM-3 lithotriptor.
• An ellipsoidal reflector insert was used to modify the LSW profile.
• A piezoelectric annular array (PEAA) generator produced an auxiliary shock wave to intensify bubble collapse near the stone.

Main Results:

• The upgraded reflector and PEAA generator significantly reduced vessel phantom rupture compared to the original HM-3.
• Stone comminution efficiency was improved with the upgraded HM-3 reflector (90.1%) and the combined PEAA/upgraded HM-3 system (95.2%) compared to the original (81.3%).
• Statistical analysis showed significant improvements in stone comminution (p<0.05).

Conclusions:

• Optimizing LSW pulse profile and sequence improves stone comminution and decreases tissue injury in vitro.
• This novel concept can upgrade existing lithotripters and inform the design of new SWL devices.
• The developed technologies offer potential for improved performance and safety in SWL procedures.