title: Focused ultrasonic propulsion of kidney stones: review and update of preclinical technology.
abstract: A noninvasive tool to reposition kidney stones could have significant impact in the management of stone disease. Our research group has developed a noninvasive transcutaneous ultrasound device. A review and update of the current status of this technology is provided. DISCUSSION OF TECHNOLOGY: Stone propulsion is achieved through short bursts of focused, ultrasonic pulses. The initial system consisted of an eight-element annular array transducer, computer, and separate ultrasound imager. In the current generation, imaging and therapy are completed with one ultrasound system and a commercial probe. This generation allows real-time ultrasound imaging, targeting, and propulsion. Safety and effectiveness for the relocation of calyceal stones have been demonstrated in the porcine model. ROLE IN ENDOUROLOGY: This technology may have applications in repositioning stones as an adjunct to lithotripsy, facilitating clearance of residual fragments after lithotripsy, expelling de novo stones, and potentially repositioning obstructing stones. Human trials are in preparation.
authors.affiliation: 1 Division of Urology, Department of Veteran Affairs Medical Center , Seattle, Washington.
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Sorensen
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bailey
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Hsi
authors.forename: Bryan W
authors.initials: BW
authors.lastname: Cunitz
authors.forename: Julianna C
authors.initials: JC
authors.lastname: Simon
authors.forename: Yak-Nam
authors.initials: YN
authors.lastname: Wang
authors.forename: Barbrina L
authors.initials: BL
authors.lastname: Dunmire
authors.forename: Marla
authors.initials: M
authors.lastname: Paun
authors.forename: Frank
authors.initials: F
authors.lastname: Starr
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Evan
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Harper
mesh_terms: D000818:Animals; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods; D013552:Swine; D014463:Ultrasonography; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods