THE DEVELOPMENT OF THE STONEBREAKER®

Paul Van Cangh

Bernard Simon1, Jose Salvado1, Stephan Luyckx1, Sebastien Wese1, Axel Feyaerts1,2 , Thierry Monnier2, Roberto Barreiro2, Alain Lebet2

1Department of Urology, UCL Medical Faculty, Brussels, Belgium

2 LMA Urology Suisse SA, Gland, Switzerland

Introduction

armamentarium, in recognition of its great effectiveness. Amongst the drawbacks of the existing devices

are the high number of shocks required to fragment the hardest stones, the propulsion effect related to

the mechanical action of the probe, and the dependence on external sources of energy. We tested the

?StoneBreaker?, a new intracorporeal pneumatic lithotripter of second generation.: Pneumatic lithotripsy has gained a prominent position in the endourologist

Material and methods:

entirely self contained, independent from an external source of energy and connecting lines. A

disposable highly compressed carbon dioxide gas cartridge stores enough energy for a large size

calculus. The expansion chamber and the hammer have been redesigned to generate a powerful shock

when the CO2 abruptly expands and forcefully project the hammer against the firing pin that transmits

the energy to the probe held in close contact with the stone (see figures below). One major advantage of

this device is the minimal displacement at the tip of the probe, despite the high energy of the mechanical

shock. Typically, large size fragments are generated, expediting their extraction (a short video clip

illustrates the procedure).The StoneBreaker® is a compact device weighing approximately 500 g,

Results:

failed multiple ESWL sessions (50% Calcium oxalate monohydrate and 15% cystine). All stones could

be fragmented in extractable fragments, with minimal trauma to the mucosa. Complications were related

to the percutaneous approach itself, and not to the fragmentation process.We treated percutaneously 56 consecutive cases of large size and hard renal calculi having

Conclusion:

endourological lithotripsy. Our present experience, duplicated by others, is encouraging, and further

developments are already underway.

22nd EUS Annual Meeting, May 19, 2007, Anaheim, CAThis simple and affordable device appears to be a real progress in the field of