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Lithotripes procedure demonstration

- Jun 21, 2018 -

1. Position.

(1) Kidney and proximal ureteral stones take a supine position.

(2) distal ureteral stones take a prone position.

(3) Bladder stones take a prone or semi-sitting position.

(4) urethral calculi take a semi-sitting position.

(5) Children's patients should be properly fixed after anesthesia and B-ultrasound should be used as far as possible.

2. Positioning. Positive stones with X-ray or B-ultrasound, negative stones with B-positioning.

3. Working potential and number of bombardments. According to the machine's wave source, model, and the stone's location, size, number, composition and other comprehensive decisions. The general voltage is 8~14kV and the number of bombardment is less than 3000 times.

4. Real-time discontinuous use of X-ray or B-ultrasonic monitor to observe the gravel condition.

5. During the operation, the patient's vital signs are monitored, the patient's response is observed, and appropriate treatment is performed in time.

Mechanical lithotripsy editing

ML has a long history and can be traced back to ancient Egypt. According to records, the method used was to fix a piece of diamond or hard stone on the end of a hollow reed rod with glue or asphalt, and then insert the rod into the patient's bladder and allow the patient to walk around and gradually move the stone by the action of diamonds or stones. Crushed. However, this method can only treat soft “trimstone” (magnesium ammonium phosphate stones), and it is incapable of treating hard stones such as calcium oxalate monohydrate. In 1782, Indian doctor Martin designed a metal tweezers that can be inserted into the urethra. He successfully cured his bladder stones with this forceps. In 1824, the French doctor Civiale invented a triple forceps. He can grasp the bladder stones with his tactile sensation, pressurize it with special screws, and finally smash the stones. However, until the 19th century, open surgery (mainly for bladder stones) was prevalent in continental Europe, and internal lithotripsy was less commonly used because of its low success rate. In 1879, the advent of cystoscopy was a milestone in the history of IL development. Since then it has changed the blind operation of doctors and greatly improved the success rate and safety of lithotripsy. Since then, people have designed a variety of mechanical lithotripters and lithotripters, some of which are still in use today. There are two main types of gravel pliers: the clamp type and the punch type. The latter was first designed and applied by Mauermayer and Hartung in 1976. It can rush stones out at the same time as gravel and keep the operative field clear. ML is easy and safe to use. It can break stones with various components less than 3cm in diameter. It is now mainly used for the treatment of bladder stones. In rare cases, it can also be used for the treatment of kidney stones. Special attention should be paid to avoid pinching the kidney tissue, otherwise it will be difficult Controlled bleeding.



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