[Piezo-electric lithotripsy technic with echographic guidance (EDAP LT 01)].
Piezo-electric extracorporeal lithotripsy with ultrasonographic detection is performed with the following material according to the following technique: 1) A mobile firing head connected to the lumbar region by a simple inflatable cushion filled with sterile water. At the centre of the firing head, a 5 MHz real time transducer is used to locate the stone. 320 piezo-electric elements, arranged around the transducer, can induce, when focussed, a pressure of about 900 bars at the focal point in vitro. The focus is 15 mm X 5 mm. The generators are electronic. 2) The technique requires: understanding of ultrasonography in order to precisely locate the stone which, when it is intrarenal, is only missed in 1% of cases in our experience. Stones of the iliac ureter are not visible. Treatment requires the patient's confidence so that, due to the quality of the piezo-electric wave, no anaesthesia is necessary. The firing time should be relatively long (45 min to 1 hr) in order to ensure good fragmentation. 26% of patients require retreatment. Secondary complications are rare (3% of endoscopic treatments). The technique is now proposed in 90% of cases without admission to hospital. The simplicity of the manipulation of the apparatus must not mask the fact that it is a technique which requires perfect mastery. Only urologists familiar with stone pathology and who are able to treat the complications of lithotripsy by endoscopy or by surgery should perform extracorporeal lithotripsy.
Vallancien
G
G
Département d'Urologie, Centre Médical Chirurgical de la Porte de Choisy, Paris.
Dory
J
J
Veillon
B
B
Munoz
R
R
Defourmestraux
N
N
Charton
M
M
Brisset
J M
JM
D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D011312:Pressure; D014514:Ureteral Calculi / Q000628:therapy; D001744:Urinary Bladder Calculi / Q000628:therapy
Technique de la lithotripsie piézo-électrique avec repérage échographique (EDAP LT 01).