Stone disease therapies include shock wave lithotripsy, which pulverizes a stone with shock waves and ureteroscopy (a stone is destroyed with a device such as the holmium laser or ultrasonic transducer). Open surgery, called nephrolithotomy, is also available to cut into the kidney to remove a stone.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract and pass from the body. The lithotriptor attempts to break up the stone with minimal collateral damage by using an externally-applied, focused, high-intensity acoustic pulse. The sedated or anesthesized patient lies down in the apparatus’ bed, with the back supported by a water-filled coupling device placed at the level of kidneys. A fluoroscopic x-ray imaging system or an ultrasound imaging system is used to locate the stone and aim the treatment. The lithotriptor has a half ellipsoid-shaped piece that opens toward the patient. The acoustic pulse is generated at the ellipsoidal focal point that is furthest from the patient and the stone positioned at the opposite focal point receives the focused shock wave.
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The surgeon removes the stone through the tube. In nephrolithotripsy, he or she breaks the stone up and then removes the fragments of the stone through the tube. You need either general anesthesia or regional or spinal anesthesia during this procedure. A small tube (catheter) inserted into the kidney will drain urine until the kidney heals.
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