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New lens design drastically improves kidney stone treatment
Date:3/18/2014

wed the wave's focal width to reduce damage to surrounding tissues. But this power jump also shifted the shock wave's focal point as much as 20 millimeters toward the device, ironically contributing to efficiency loss and raising the potential for tissue damage. The new electromagnetic shock wave generators also produced a secondary compressive wave that disrupted one of the primary stone-smashing mechanisms, cavitation bubbles.

"We were presented with the challenge of engineering a design solution that mitigated these drawbacks without being too expensive," said Zhong. "It had to be something that was effective and reliable, but also something that the manufacturer was willing to adopt. So we decided to focus on a new lens design while keeping everything else in their system intact."

The solution was to cut a groove near the perimeter of the backside of the lens and change its geometry. This realigned the device's focal point and optimized the pressure distribution with a broad focal width and lower peak pressure. It also allowed more cavitation bubbles to form around the targeted stone instead of in the surrounding tissue.

In laboratory tests, the researchers sent shock waves through a tank of water and used a fiber optic pressure sensor to ensure the shock wave was focusing on target. They broke apart synthetic stones in a model human kidney and in dead pigs and used a high-speed camera to watch the distribution of cavitation bubbles forming and collapsinga process that happens too fast for the human eye to see.

The results showed that while the current commercial version reduced 54 percent of the stones into fragments less than two millimeters in diameter, the new version pulverized 89 percent of the stones while also reducing the amount of damage to surrounding tissue. Smaller fragments are more easily passed out of the body and less likely to recur.

"We feel we have exceeded expectations in our evaluation of this n
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Contact: Ken Kingery
ken.kingery@duke.edu
919-660-8414
Duke University
Source:Eurekalert  

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