[New trends in extracorporeal shockwave lithotripsy]

Extracorporeal shock wave lithotripsy has become an established and successful treatment modality for urinary and biliary calculi. However, shock wave technology and corresponding device designs are still at an innovative stage. Three trends are discussed in this paper. In shock wave technology the electromagnetic principle seems to win the race. The demands for successful and tissue-protective stone disintegration require shockwave sources with high dynamic range and optimised focal geometry. Electromagnetic shock wave generators meet all these requirements. For stone localisation an isocentric X-ray targeting system combined with integrated shock wave application is accepted as the "gold standard". In ultrasound localisation in-line targeting is superior to out-of-line targeting.