SWL literature
SWL Literature
Reviewer's Choice 

Harper JD. et al., 2020: First In-Human Burst Wave Lithotripsy (BWL) for Kidney Stone Comminution: Initial 2 case studies

Harper JD, Metzler I, Hall MK, Chen TT, Maxwell AD, Cunitz BW, Dunmire B, Thiel J, Williams JC Jr, Bailey MR, Sorensen MDJ.
University of Washington, Department of Urology, 1959 NE Pacific Street, Box 356510, Seattle, Washington, United States.
University of Washington School of Medicine, 12353, Department of Urology, Seattle, Washington, United States.
University of Washington School of Medicine, 12353, Department of Emergency Medicine, Seattle, Washington, United States.
University of Washington, Urology, 1959 NE Pacific St., BB-1121, Box 356510, Seattle, Washington, United States.
Duke University Medical Center, Urology, DUMC 3167, Durham, North Carolina, United States.
University of Washington School of Medicine, 12353, Department of Urology, 1013 NE 40th St, Seattle, Washington, United States.
7University of Washington Applied Physics Lab, Center for Industrial and Medical Ultrasound, 1013 NE 40th ave, Seattle, Washington, United States.
University of Washington, Applied Physics Lab, 1013 NE 40th St, Seattle, Washington, United States.
University of Washington School of Medicine, Radiology, Seattle, Washington, United States.
Indiana Univ Sch Med, Anatomy & Cell Biology, 635 Barnhill Dr MS5035, Department of Anatomy & Cell Biology, Indianapolis, Indiana, United States.
University of Washington, Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, 1013 NE 40th St., Seattle, Washington, United States.
University of Washington, Department of Urology, 1959 NE Pacific Street, Box 356510, Seattle, Washington, United States

Abstract

Purpose: To test the effectiveness (Participant A) and tolerability (Participant B) of urinary stone comminution in the first-in-human trial of a new technology, burst-wave lithotripsy (BWL), Materials and Methods: An investigational BWL and ultrasonic propulsion system was used to target a 7-mm kidney stone in the operating room prior to ureteroscopy (Participant A). The same system was used to target a 7.5 mm ureterovesical junction (UVJ) stone in clinic without anesthesia (Participant B).

Results: For Participant A, a ureteroscope inserted following 9 minutes of BWL observed fragmentation of the stone to <2 mm fragments. Participant B tolerated the procedure without pain from BWL, required no anesthesia, and passed the stone on day 15.

Conclusions: The first-in-human tests of BWL pulses were successful in that a renal stone was comminuted in under 10 minutes, and BWL was also tolerated by an awake subject for a distal ureteral stone.
J Endourol. 2020 Sep 17. doi: 10.1089/end.2020.0725. Online ahead of print. PMID: 32940089

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Comments 1

Hans-Göran Tiselius on Monday, 09 November 2020 08:45

During recent years we had followed the technical achievements with burst wave lithotripsy (BWL) and it is now of great interest and importance to learn that the method also works clinically.

The principle of BWL is to disintegrate stones with a “dusting” approach by application of sinusoidal bursts of ultrasound. In addition to stone disintegration BWL has propulsive properties so that fragments can be repositioned within the calyceal system and eliminated via the ureter.

The device is composed of two parts: one hand-held probe for BWL and another one for ultrasound propulsion.

Two patients were included in this preliminary study, one given anesthesia and the other not.
One 7 mm stone was successfully disintegrated into fragments

During recent years we had followed the technical achievements with burst wave lithotripsy (BWL) and it is now of great interest and importance to learn that the method also works clinically. The principle of BWL is to disintegrate stones with a “dusting” approach by application of sinusoidal bursts of ultrasound. In addition to stone disintegration BWL has propulsive properties so that fragments can be repositioned within the calyceal system and eliminated via the ureter. The device is composed of two parts: one hand-held probe for BWL and another one for ultrasound propulsion. Two patients were included in this preliminary study, one given anesthesia and the other not. One 7 mm stone was successfully disintegrated into fragments
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Sunday, 09 May 2021

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