The electromechanical impactor: a new device for intracorporeal stone fragmentation

Area of Science:

• Urology
• Biomedical Engineering
• Nephrology

Background:

• Intracorporeal stone fragmentation is crucial in urological procedures.
• Existing methods may have limitations in efficacy or safety.
• A novel device for minimally invasive stone removal is needed.

Purpose of the Study:

• To evaluate the safety and effectiveness of the Electromechanical Impactor (EMI) for intracorporeal ureteral stone fragmentation.
• To assess the EMI's performance across different types of urinary calculi.
• To document clinical outcomes and identify potential limitations.

Main Methods:

• The Electromechanical Impactor (EMI) utilizes an electrohydraulic (EHL) spark to generate a shock wave.
• The shock wave propels a titanium tip, fragmenting stones upon impact.
• Testing involved bench, animal studies, and clinical trials using ureteroscopes.

Main Results:

• The EMI demonstrated approximately 90% efficacy in clinical studies at Massachusetts General Hospital and the Mayo Clinic.
• The device was particularly effective for cystine, calcium oxalate dihydrate, struvite, and mixed calcium oxalate monohydrate stones.
• No evidence of ureteral wall injury was observed, indicating a high safety profile.

Conclusions:

• The Electromechanical Impactor (EMI) is a safe and effective tool for ureteral stone fragmentation under direct vision.
• Its high efficacy and safety profile make it a valuable option for treating various types of kidney stones.
• Further development for percutaneous and bladder stone applications is underway.