Stryker frame adaptation of the HM3 lithotriptor for treatment of distal ureteral calculi

Treatment of distal ureteral stones with the Dornier HM3 lithotriptor depends on the localization and positioning of the calculus from a transgluteal approach. We found the Stryker frame gantry modification preferable to the standard gantry for treatment of stones in the distal ureter. We report the use of this gantry adaptation in 22 cases of distal ureteral stones. The calculi were localized in 100% of the cases and were fragmented successfully with 1 treatment in 89%. In no case was the procedure aborted secondary to nonvisualization of the calculus. Failure to disintegrate the stone requiring retreatment occurred in 11% of the cases, and was attributed to stone characteristics and not due to difficulty with visualization or placement of the calculus within the F2 focus. The average fluoroscopic time was 45 seconds. The Stryker frame modification to the standard Dornier HM3 lithotriptor allows for improved visualization and easier localization of distal ureteral calculi compared to the standard gantry.