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Newly designed solid coupling medium for reducing trapped air pockets during extracorporeal shock wave lithotripsy_ a

Chien-Sheng Wang1, Ching-Chia Li1, Wen-Jeng Wu1

  • 1Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University Hospital, No.100, Shiquan 1st Rd., Sanmin Dist., Kaohsiung City 807, Taiwan.

BMC Urology
|May 15, 2021
PubMed
Summary

The novel icPad significantly improved shock wave lithotripsy (ESWL) by reducing air pockets, leading to higher stone disintegration rates and fewer shocks. This coupling method enhances ESWL efficacy for kidney stone treatment.

Keywords:
Air pocketsCouplingExtracorporeal shock wave lithotripter

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Area of Science:

  • Biomedical Engineering
  • Medical Physics
  • Urology

Background:

  • Air pockets during extracorporeal shock wave lithotripsy (ESWL) coupling compromise acoustic energy transmission and stone disintegration.
  • Conventional gel coupling methods often lead to unavoidable air pockets between the lithotripter head and patient skin.

Purpose of the Study:

  • To investigate the efficacy of a proprietary isolation-coupling pad (icPad) in reducing trapped air pockets during ESWL.
  • To compare stone disintegration rates and efficiency using icPad versus conventional semi-liquid gel.

Main Methods:

  • A phantom study utilizing a Dornier lithotripter with icPads (4mm and 8mm thickness) and conventional semi-liquid gel.
  • Observation of trapped air pockets using an inline camera and the Optical Coupling Control (OCC) system.
  • Measurement of stone disintegration rates and the number of shocks required for complete disintegration.

Main Results:

  • icPad demonstrated significantly higher stone disintegration rates (92.3%, 85.0%) compared to semi-liquid gel (45.5%) after 200 shocks.
  • Fewer shocks were required for complete stone disintegration with icPad (242-249 shocks) versus semi-liquid gel (351 shocks).
  • The icPad significantly reduced the area of trapped air pockets compared to the conventional gel (50.3-120.3 mm² vs. 332.7 mm²).

Conclusions:

  • The icPad offers superior efficacy in ESWL by reducing shock wave count and increasing stone disintegration rates.
  • The icPad effectively minimizes trapped air pockets, enhancing acoustic coupling during ESWL procedures.
  • Further human trials are warranted to confirm these findings before clinical application.