dr. sandro varea , fernando santomil, alfredo penida, cristian grillo, jorge quezada

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Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina Urología Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience

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Electromagnetic DSWL Double Shockwave Lithotripsy : Initial experience. Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge Quezada Department of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina. Urología. - PowerPoint PPT Presentation

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Page 1: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo, Jorge QuezadaDepartment of Urology. Hospital Privado de Comunidad, Mar del Plata, Argentina

Urología

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience

Page 2: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

Urología

1- Sokolov DL, Bailey MR and Crum LA: Dual-pulse lithotripter accelerates stone fragmentation and reduces cell lysis in vitro. Ultrasound Med Biol 2003; 29: 1045.2- Sheir KZ, El-Diasty TA and Ismail AM: Evaluation of a synchronous twin-pulse technique for shock wave lithotripsy: the first prospective clinical study. BJU Int 2005; 95: 389.3- Greenstein A, Sofer M and Matzkin H: Efficacy of the Duet lithotripter using two energy sources for stone fragmentation by shockwaves: an in vitro study. J Endourol 2004; 18: 942.

New design concept for Lithotripters: Double shockwave (1-3).

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience

Double shockwave

Two independent generators/ reflectors

angle of 76 degrees between

generators

Convergence into a single focal

point

Page 3: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

Urología

4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009.

Double shockwave (4).

Butterfly Focal area

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience

Page 4: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

Urología4- Rajash K. Handa et al. Assessment of Renal Injury With a Clinical Dual Head Lithotriptor Delivering 240 Shock Waves per Minute. J Urol. 181, 884-889, February 2009.

Electromagnetic DSWL Double Shockwave Lithotripsy: Initial experience

Double shockwave

Reduce kidney damage

Increase treatments efficacy

Decreased treatment time Results?

Page 5: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

• Show our initial experience using an extracorporeal double shockwave lithotriptor (Duet Magna, Direx/Initia).

• Evaluate safety and effectivness .

Urología

Goal

Page 6: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

Cross-sectional Cross-sectional studystudy..

Period March-May 2010Period March-May 2010. .

Patients with renal and uretral stones indicated for ESWL Patients with renal and uretral stones indicated for ESWL treatment.treatment.

Treatments performed with intravenous sedation.Treatments performed with intravenous sedation.

Ambulatory procedure.Ambulatory procedure.

Urología

Method and Materials

Page 7: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

VARIABLES

Double J catheter.

Treatment side.

Fragmentation.

Complications.

Retreats.

Removal rate

Age.

Sex.

Weight .

Size.

Body mass index.

Stone sizes and location.

Urología

Method and Materials

Page 8: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

33 urinary stones in 30 patients

Urología

Patients distribution according to age

Average: 53,1 (31 –

76)

Results

Page 9: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

(n= 30)

Urología

Patients distribution according to sex

Results

Page 10: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

(n= 33)

Urología

Patients distribution according to side treated

Results

Page 11: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

(n= 33)

Urología

Patients distribution according to stone localization

Results

Page 12: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

(n= 33)

Urología

Patients distribution according to stone size treated

Results

Page 13: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

• Stone fragmentation: 100 %

• Elimination rate: 85%

• There were no complications.

Urología

Page 14: Dr. Sandro Varea , Fernando Santomil, Alfredo Penida, Cristian Grillo,  Jorge Quezada

The double shockwave treatment is a safe and effective procedure.

It is necesary to perform additional prospective trials on a larger number of patients in order to confirm the results.

Urología

Conclusions