Shock wave lithotripsy

Abstract

This chapter provides a comprehensive review of the primary technologies used for shock wave generation and focusing, followed by an in-depth discussion of the acoustics of shock wave-stone interaction, mechanisms of stone fragmentation and tissue injury during shock wave lithotripsy (SWL). In particular, we introduce the first non-dimensional parameter that correlates closely with stone comminution. The general process of stone comminution in SWL is elucidated with regard to the varying contributions of stress waves and cavitation, as well as the evolving role of intrinsic vs. extrinsic flaw distributions in the target stone. These fundamental understandings provide valuable insights for the rational design of modern shock wave lithotripters. An example of improving the acoustic lens design in electromagnetic lithtoripters is given. Future perspectives in SWL research and development of iLithotripters are outlined.