MP33-12 A NOVEL WET COUPLING DESIGN FOR CONTEMPORARY ELECTROMAGNETIC LITHOTRIPTERS: ELIMINATION OF COUPLING DEFECTS AND IMPROVEMENT OF COMMINUTION EFFICIENCY. (2015)

You have accessJournal of UrologyStone Disease: Basic Research I1 Apr 2015MP33-12 A NOVEL WET COUPLING DESIGN FOR CONTEMPORARY ELECTROMAGNETIC LITHOTRIPTERS: ELIMINATION OF COUPLING DEFECTS AND IMPROVEMENT OF COMMINUTION EFFICIENCY. Fernando Cabrera, Richard Shin, Daniel Concha, Jaclyn Lautz, Georgy Sankin, Ramy Youseff, Charles Scales, Michael Lipkin, Glenn Preminger, F. Hadley Cocks, Walter Simmons, and Pei Zhong Fernando CabreraFernando Cabrera More articles by this author , Richard ShinRichard Shin More articles by this author , Daniel ConchaDaniel Concha More articles by this author , Jaclyn LautzJaclyn Lautz More articles by this author , Georgy SankinGeorgy Sankin More articles by this author , Ramy YouseffRamy Youseff More articles by this author , Charles ScalesCharles Scales More articles by this author , Michael LipkinMichael Lipkin More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , F. Hadley CocksF. Hadley Cocks More articles by this author , Walter SimmonsWalter Simmons More articles by this author , and Pei ZhongPei Zhong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.573AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Air bubbles trapped in shockwave lithotripsy coupling gel may contribute to the decreased stone comminution efficacy of contemporary lithotripters compared to the original HM3. We have developed a novel wet coupling technique and evaluated its impact on stone comminution in an electromagnetic lithotripter. METHODS The shockwave source of a Modularis electromagnetic lithotripter was fitted with a custom-designed, open-ended bellow allowing direct water-skin contact while adhering to the patient with a suction seal. The standard coupling was also tested with ultrasound gel applied in a spiral and bolus method. In-vitro comminution was performed in a torso model using hard Begostone phantoms treated at E2.5 for 1000 shocks at 1 Hz pulse repetition frequency. Percent comminution (fragments < 2 mm) was measured, and analyzed using ANOVA and Bonferroni corrected t-tests. RESULTS For each coupling method, 14 trials were performed. Unlike the spiral method, the bolus method produced minimal air defects while wet coupling ensured a perfect acoustic interface. Comminution (mean ± SD) was 30 ± 11% for the spiral method, 65 ± 20% for the bolus method, and 66 ± 15% for the wet coupling. The spiral method was significantly less effective than the bolus and wet coupling (p < 0.001). No statistical difference was observed between the bolus and wet coupling methods (p = 0.82). CONCLUSIONS The performance of contemporary lithotripters depends critically on the quality of shockwave source-patient coupling interface. A novel wet coupling design is developed to overcome the vulnerability and inconsistency of gel coupling, ensuring an effective shockwave transmission through the coupling interface with improved lithotripsy efficacy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e377-e378 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fernando Cabrera More articles by this author Richard Shin More articles by this author Daniel Concha More articles by this author Jaclyn Lautz More articles by this author Georgy Sankin More articles by this author Ramy Youseff More articles by this author Charles Scales More articles by this author Michael Lipkin More articles by this author Glenn Preminger More articles by this author F. Hadley Cocks More articles by this author Walter Simmons More articles by this author Pei Zhong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...