Kidney Stones Clinical Trial
Official title:
Randomized Control Trial Comparing Dual Probe Ultrasonic Lithotripsy to a Single Probe Ultrasonic Lithotripsy
Percutaneous nephrolithotomy (PNL), in conjunction with intracorporeal lithotripsy, allows for the rapid removal of any kidney stone regardless of size. Currently, the choice of intracorporeal lithotripters includes ultrasonic, pneumatic, and combined ultrasonic/pneumatic energy sources. Recently, a novel dual probe design as been introduced by Cybersonics of Erie, Pennsylvania. This dual probe intracorporeal lithotrite is called the Cyberwand, and is composed of a fixed inner probe vibrating at an ultrasonic frequency with an outer probe vibrating at about 1,000 Hz. As this new design has the potential to revolutionize intracorporeal lithotripsy, we intend to compare this novel technology to currently available lithotripsy technology in a randomized clinical trial.
Percutaneous nephrolithotomy (PNL) is used to remove large and complex stones from the upper
urinary tract. Intracorporeal lithotripsy is an integral part of PNL. Commercially available
intracorporeal lithotripsy modalities include ultrasonic, pneumatic, and combined ultrasonic
and pneumatic models. Each modality has its inherent advantages and disadvantages.
Ultrasonic lithotrites are capable of fragmenting stones while concomitantly suctioning out
fragments. Unfortunately some stones are hard enough to resist fragmentation from ultrasonic
lithotripsy. Pneumatic lithotrites are able to fragment all stones regardless of hardness,
but this modality is unable to suction out stone pieces at the same time fragmentation is
occurring. The newest lithotrite which combines both ultrasonic and pneumatic components is
capable of fragmenting any stone, but also has some inherent limitations. The handpiece of
the lithotripsy device is somewhat cumbersome, the suction component can clog, and the
device has overheated at the maximal settings (Kuo et al). Current intracorporeal
lithotrites, while functional, can certainly be improved.
Recently, a novel dual probe design has been introduced by Cybersonics of Erie, PA. This
dual probe intracorporeal lithotrite is called the Cyberwand and is composed of a fixed
inner probe vibrating at an ultrasonic frequency with an outer probe vibrating at about
1,000 Hz. As this new design has the potential to revolutionalize intracorporeal
lithotripsy, we intend to compare this novel technology to currently available lithotripsy
technology in a randomized clinical trial.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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