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Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, [1] bezoars [2] or gallstones, which may be done non-invasively. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( litho- + τρίψω [tripso]).
Electrohydraulic Lithotripsy (EHL) is a medical procedure which uses targeted shockwaves to break up kidney stones and gallstones. [1] This form of extracorporeal lithotripsy is unique in that the shockwaves are produced by a vaporization bubble expanding and collapsing repeatedly, creating a pressure wave. [ 1 ]
Some of the passed fragments of a 1-cm calcium oxalate stone that was smashed using lithotripsy. The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones [3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse.
Ultrasound has been used to trigger the release of anti-cancer drugs from delivery vectors including liposomes, polymeric microspheres and self-assembled polymeric. [15] Phonophoresis is a form of soft tissue treatment that involves the use of ultrasound combined with medication gels to enhance drug delivery to the desired area. [16]
Laser lithotripsy (LL) has been evaluated against Extracorporeal Shock Wave lithotripsy (ESWL), finding both to be safe and effective. [3] [4] ESWL may be safer for small stones (<10 mm), but less effective for 10–20 mm stones. [3] A 2013 meta-analysis found LL can treat larger stones (> 2 cm) with good stone-free and complication rates. [5]
In rare cases when surgery is not possible, medication can be used to dissolve the stones or lithotripsy can be used to break them down. [7] In developed countries, 10–15% of adults experience gallstones. [4] Gallbladder and biliary-related diseases occurred in about 104 million people (1.6% of people) in 2013 and resulted in 106,000 deaths.
Lithotomy differs from lithotripsy, where the stones are crushed either by a minimally invasive probe inserted through the exit canal, or by an acoustic pulse (extracorporeal shock wave lithotripsy), which is a non-invasive procedure. Because of these less invasive procedures, the use of lithotomy has decreased significantly in the modern era.
An early lithotrite showing the device in open and closed positions. The Michaab was an early medical device, invented by Al-Zahrawi, [1] a form of lithotrite which was minimally-invasive.