title: Extracorporeal lithotripsy. Update on technology.
abstract: The development of shock-wave lithotripsy was a serendipitous event. Fortunately, the significance of this accidental discovery was not overlooked by the engineers at Dornier and their medical counterparts. There are many components that make up a lithotripter, but the heart of the lithotripter is its energy source. These machines often are categorized by the type of shock-wave generator used, and each type of generator has its own advantages and disadvantages. Unfortunately, no quantitative value of a shock-wave generator can be correlated to its qualitative effect. Interestingly, each type of energy source delivers its shock-wave energy with such distinctiveness that even the crater pattern it leaves in a stone is unique. New technology and ideas have transformed lithotripters in form and function so that they bear little resemblance to the original HM-1 prototype. Ongoing research is attempting to improve ESWL in several different ways, and advances in shock-wave generation, shock-wave measurement, and stone localization should result in even more efficient lithotripsy. The application of the time-reversal process to lithotripsy ultimately may enable lithotripters to track stones and electronically steer shock waves toward the target. Advances like these herald a time when ESWL, fortunately or unfortunately, will become automated completely.
authors.affiliation: Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
authors.forename: G K
authors.initials: GK
authors.lastname: Chow
authors.forename: S B
authors.initials: SB
authors.lastname: Streem
mesh_terms: D004867:Equipment Design; D005544:Forecasting; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation*; D014545:Urinary Calculi / Q000628:therapy*