Two Year Experience with the Lithoclast for Endolithotripsy

Abstract

The endolithotripsy of ureteral stones that have not responded to extracorporeal in situ treatment has been greatly facilitated by the development of semi-rigid fiberoptic “miniscopes”. With these ureteroscopes of 6 and 7 F tip diameter and a working channel of 3 to 4 F, ultrasonic lithotripsy is no longer possible because of the size of the sonotrode. Alternative methods which have been used to date are Laser and Electrohydraulic Lithotripsy. For the last two years a newly developed endolithotripsy device has been investigated clinically. The Lithoclast (EMS, Le Sentier, Switzerland) is a pneumatically operated device, providing semi-rigid probes between 1.8 and 8 F for the treatment of ureteral as well as bladder stones. Because of the semi-rigid probes the device requires endoscopes with straight working channels. A 7 F semi-rigid ureteroscope and a 21 F lens cystoscope, both with an offset eyepiece, have been designed as special Lithoclast endoscopes (Richard Wolf, Knittlingen, FRG).