Lithoclast(®) Master in Intracorporeal Lithotripsy during Percutaneous Nephrolithotomy : Our Experience

Area of Science:

• Urology
• Surgical Technology
• Nephrolithiasis Management

Background:

• Renal staghorn calculi pose a significant treatment challenge.
• Percutaneous nephrolithotomy (PNL) is a primary treatment modality.
• Comparing intracorporeal lithotripters is crucial for optimizing PNL outcomes.

Purpose of the Study:

• To compare the efficacy of Lithoclast® Master versus a standard pneumolithotriptor.
• To evaluate stone fragmentation and clearance rates during PNL for staghorn calculi.
• To assess the incidence of residual fragments and complications associated with each device.

Main Methods:

• Prospective study of 60 patients with staghorn renal stones.
• Randomized allocation to PNL using either pneumolithotriptor (Group I) or Lithoclast® Master (Group II).
• Evaluation of fragmentation/clearance rates, residual fragments (KUB radiograph/ultrasound), and complications; statistical analysis using Chi-square test.

Main Results:

• Lithoclast® Master demonstrated significantly quicker fragmentation and clearance (58 min vs. 65 min, p<0.01).
• Significantly fewer residual fragments (>4mm) were observed with Lithoclast® Master (4% vs. 53%, p<0.01).
• Complication rates (bleeding, urine leak) were comparable and generally insignificant between the two groups.

Conclusions:

• Lithoclast® Master is an effective intracorporeal lithotripter for PNL in treating renal staghorn calculi.
• The device facilitates efficient stone fragmentation and clearance with minimal residual fragments.
• It offers a safe and effective alternative with comparable complication profiles to standard pneumolithotriptors.