Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2020 Apr;38(4):1043-1050.
doi: 10.1007/s00345-019-02843-2. Epub 2019 Jun 8.

EMS Lithoclast Trilogy™: an effective single-probe dual-energy lithotripter for mini and standard PCNL

Ravindra B Sabnis  1 , Sudharsan S Balaji  2 , Parag L Sonawane  3 , Rohan Sharma  3 , Mohankumar Vijayakumar  3 , Abhishek G Singh  3 , Arvind P Ganpule  3 , Mahesh R Desai  3
Affiliations
Clinical Trial

EMS Lithoclast Trilogy™: an effective single-probe dual-energy lithotripter for mini and standard PCNL

Ravindra B Sabnis et al. World J Urol. 2020 Apr.

Abstract

Purpose: Several energy sources are available to clear stones during PCNL. Required improvements are faster stone clearance, optimized suction and ease of use while maintaining high patient safety standard. EMS LithoClast® Trilogy, is the first device combining electromagnetic impactor with ultrasonic energy and suction, all-in-one probe. Animal studies and in vitro phantom stone studies have proven safety and efficacy of this device. We aim to study safety and clinical efficacy of Trilogy in our patients.

Methods: 31 patients with renal stones were included. Amplatz sheath sizes/Trilogy probe size was 22-28 Fr/10.2 Fr for standard PNL (n = 20) and 15 Fr./5.7 Fr for mini PNL access (n = 11). Analysis was done with respect to demography, stone characteristics, operation duration (total time and lithotripter activation time), post op Hb drop, clearance rate and adverse events. Stone area/volume was calculated based on CT using 3D doctor. Efficacy was determined by stone volume clearance rate (mm3/min).

Results: Male:female ratio was 6:5 and 16:4 for mini (MPNL)/standard PNL (SPNL). Stone densities were 1229 ± 206 vs. 1168 ± 344 HU (MPNL vs. SPNL). Mean stone volumes were 3776.1 ± 2132 mm3 for MPNL and 7096 ± 6441 for SPNL. Mean stone volume clearance ratios were 370.5 ± 171 mm3/min and 590.7 ± 250mm3/min for MPNL and SPNL, respectively. Hb drop was 1.24 ± 0.64 g/dL (MPNL) and 1.23 ± 0.89gm/dL (SPNL). Total procedure time/lithotripter activation time was 53.4 ± 23.8/14.7 ± 12.4 min for MPNL and 65.2 ± 23.5/12.0 ± 8.9 for SPNL. Immediate post-operative/1 month stone clearance rates were 93%/96% with one clinically insignificant residual fragment (< 3 mm) and no necessity for auxiliary procedures. No device failure occured and three Clavien grade I and one grade II complications were observed.

Conclusion: Swiss LithoClast® Trilogy provides fast stone clearance in standard/mini-PCNL procedures. Ease of use, high tissue safety and optimized suction that avoids fragment blockings are other key features.

Keywords: Dual-energy lithotripter; Endourology; Lithoclast; Percutaneous nephrolithotomy; Renal stone; Trilogy; Urolithiasis.

PubMed Disclaimer

References

    1. Korean J Urol. 2010 Nov;51(11):783-7 - PubMed
    1. Urology. 2007 Jan;69(1):22-5; discussion 25-6 - PubMed
    1. Urology. 2014 Apr;83(4):726-31 - PubMed
    1. J Urol. 1995 Feb;153(2):535-7 - PubMed
    1. J Endourol. 2017 Feb;31(2):191-197 - PubMed

Publication types

LinkOut - more resources