Initial clinical evaluation of a new pneumatic intracorporeal lithotripter

To test the clinical efficacy of the StoneBreaker (LMA Urology, Gland, Switzerland), a novel device which is much more compact and ergonomic than other current intracorporeal pneumatic lithotripters, and more powerful, generating contact pressures of up to 2.9 MPa, thereby enabling better pneumatic fragmentation and removal of stones during percutaneous nephrostolithotomy (PCNL), ureteroscopic stone fragmentation (USF) and vesical stone lithotripsy (VL).

We prospectively evaluated 102 patients, comprising 49 PCNLs, 48 USFs and 5 VLs, treated using the StoneBreaker. The stone size, position, number of shocks required to fragment the stone to effect complete clearance, and degree of retropulsion were documented in each case; any evidence of urothelial trauma was noted.

All stones were satisfactorily fragmented and all patients rendered stone-free. Very few shocks were required, and documented retropulsion was minor. There was no evidence of consequential urothelial trauma at the end of any procedure.

The StoneBreaker appears to be a safe, effective, robust and compact device for intracorporeal lithotripsy.