%0 Journal Article
%T Damage of Stone Baskets by Endourologic Lithotripters: A Laboratory Study of 5 Lithotripters and 4 Basket Types
%A Jens Cordes
%A Felix Nguyen
%A Birgit Lange
%A Ralf Brinkmann
%A Dieter Jocham
%J Advances in Urology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/632790
%X Background. In some cases, the ureteral stone is simultaneously stabilized by a stone basket when endourologic lithotripsy is performed. This stabilization can be either on purpose or by accident. By accident means that an impaction in the ureter occurs by an extraction of a stone with a basket. A stabilization on purpose means to avoid a retropulsion of the stone into the kidney during lithotripsy. At this part of the operation, stone baskets have been frequently damaged. This severing of wires can lead to ureteral trauma because of hook formation. Material and Methods. In a laboratory setting, the time and the pulse numbers were measured until breaking the wires from four different nitinol stone baskets by using five different lithotripsy devices. The endpoint was gross visibledamage to the wire and loss of electric conduction. Results. The Ho:YAG laser and the ultrasonic device were able to destroy almost all the wires. The ballistic devices and the electrohydraulic device were able to destroy thin wires. Conclusion. The operating surgeon should know the risk of damagefor every lithotripter. The Ho:YAG-laser and the ultrasonic device should be classified as dangerous for the basket wire with all adverse effects to the patient. 1. Introduction In the past years, the number of endoscopic procedures in western countries has increased [1, 2]. One endoscopic procedure is endourological lithotripsy, in which the stone is destroyed within the ureter. Sometimes the stone is simultaneously stabilized by a stone basket. This stabilization could be on purpose or by accident. By accident means that an impaction in the ureter occurs by an extraction of a stone with a basket. A stabilization on purpose means to avoid a retropulsion into the kidney during a lithotripsy. At this part of the operation, stone baskets have been frequently destroyed [3]. This severing of wires can lead to ureteral trauma because of hook formation [4]. On the other hand, it could release the impacted stone from the basket by serving all wires of the basket [5]. Fragmentation of stone baskets is well known as a result of using the Ho:YAG laser. For other lithotripters, there exists just one study until now [6]. Baskets with a diameter of 3£¿F were destroyed by lasers in 15 to 34 seconds, and tipless baskets (1.8£¿F diameter) were destroyed in 1 to 4 seconds with pulse energy of 0, 8, and 2£¿J at a pulse frequency of 5£¿Hz. The guidance of the optical fiber occurred by means of a cystoscope in a basin filled with water (Honeck et al., 2006) [7]. Cordes et al. [6] confirm these results in an
%U http://www.hindawi.com/journals/au/2013/632790/