The Lithovac: new suction device for the Swiss Lithoclast

Area of Science:

• Urology
• Endourology
• Minimally Invasive Surgery

Background:

• Modern stone therapy emphasizes minimal invasiveness.
• The Swiss Lithoclast ballistic system is a recognized intracorporeal lithotripsy device.
• New Lithovac probes integrate suction with lithotripsy for enhanced stone fragment management.

Purpose of the Study:

• To evaluate the efficacy and safety of Lithovac probes in combination with the Swiss Lithoclast for endoscopic stone removal.
• To assess the performance of Lithovac probes across different urinary tract locations (kidney, ureter, bladder).

Main Methods:

• Standardized stone model testing of Lithovac probes (1.6, 3.5, 4 mm).
• Clinical application in patients with bladder, Kock pouch, ureteral, and kidney stones.
• Evaluation of suction energy's effect on propulsive energy and fragment evacuation.

Main Results:

• Lithovac probes facilitated easy removal of small stone fragments (< 2 mm) during lithotripsy and larger fragments (up to 3.5 mm) post-lithotripsy.
• Clearer vision was achieved, particularly beneficial for struvite stones.
• Successful fragment management and evacuation were demonstrated in bladder, Kock pouch, ureter, and kidney stones without complications.
• A learning curve for balancing suction and fluid pressure was noted for ureteral procedures, but manageable.

Conclusions:

• The Lithovac system, combined with the Lithoclast, is a valuable tool for endoscopic stone therapy.
• It offers improved fragment removal, enhanced visualization, and a safe, effective approach for various stone locations.
• The system aids in managing staghorn stones and provides excellent visibility in the bladder and Kock pouches.