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Intracorporeal lithotripsy

- Jun 19, 2018 -

Intracorporeal lithotripsy (IL) refers to the treatment of gravel in the human body using special instruments, including mechanical, electrohydraulic, ultrasound, laser and pneumatic lithotripsy. In the past 20 years, with the improvement of equipment and operation technology in the urological cavity, IL has made considerable progress. Although extracorporeal shock wave lithotripsy (ESWL) has become the preferred treatment for upper urinary tract calculi, ESWL is difficult to locate or treat stones and shock wave lithotripsy for lower urinary tract calculi, ureteral incarcerated stones, and massive kidney stones. After the serious Stone Street, IL is still an essential treatment. For more than 10 years, we have used mechanical, hydroelectric, ultrasonic and pneumatic ballistic lithotripters to treat urinary tract stones and have investigated various laser lithotripters abroad. Now with our experience and experience, according to the chronological order of the appearance of various lithotripters, a brief introduction of its principles and applications.Laparoscopic Instruments


1. Kidney stones

(1) Individual stones ≤ 2cm.

(2) stones 2 ~ 3cm, can be placed before the gravel double J tube.

(3) cast or multiple stones, comprehensive treatment, namely, percutaneous nephrolithotomy (PCNL) + extracorporeal shock wave lithotripsy (ESWL) + transurethral ureteroscopic lithotripsy (URS).

(4) Infrarenal fistula stones ≤ 1cm.

(5) Hard stones (permeabilized calcium, cystine, calcium hydrooxalate stones) <1.5cm.

(6) Isolated kidney stones> 1.5cm, double J tube before surgery.

2. Ureteral stones <1cm.

3. Bladder stones, the condition does not allow surgery or the patient refused surgical treatment.

4. Urethral stones cannot be pushed into the bladder or intraluminal lithotripsy device and the patient refuses surgery.


1. Stone distal urinary tract obstruction.

2. Matrix stones.

3. Renal diverticulum stones.

Relative contraindications

1. Kidney spasm stones> 2cm.

2. Obese people (weight more than 1 times the standard body weight).

3. Patients with spinal deformity or limb contracture can not be placed in position as required.

4. Stone incarceration in patients.

5. Accompanied by an incurable bleeding disorder.

6. Heart and liver function are severely impaired.

7. Serum creatinine ≥ 265 μmol/L.

8. Infectious disease activity period.

9. Diabetes is not controlled.

10. Pregnancy.

11. Infertile women in the lower ureteral stones, to avoid damage to the ovary; male urinary tract stones without education, pay attention to protect the testis.



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