METHOD FOR REMOTE NEPHROLITHOTRIPSY UNDER ULTRASOUND CONTROL USING FLICKER ARTIFACT Russian patent published in 2024 - IPC A61B17/225 A61B8/08 

FIELD: medicine; urology.

SUBSTANCE: invention can be used for extracorporeal shock wave lithotripsy (ESWL). Ultrasonic examination is performed in gray-scale mode with a convex sensor with frequency of 3.5–7.5 MHz. Hyperechoic inclusion is visualized in Doppler mapping mode, transmitter power is increased by repetition of pulse frequency from 15 to 75 cm/s, and color window is installed in the area of urinary calculus localization. Focal distance is set below localization of calculus and flicker artifact is determined in area of urinary calculus localization, the ultrasonic sensor is fixed in the isocentric aiming unit so that the focus is set 2 mm below the flicker artefact during breath holding, which corresponds to the area of the urinary calculus. After sedation of the patient, the aiming focus is adjusted so that the focus is established in the area of the urinary calculus, remote shock wave lithotripsy is performed at the moment of flicker artifact visualization, in the absence of its visualization, crushing is turned off and the aiming focus of the ultrasonic emitter is corrected until a flicker artifact appears, energy force is increased by 1 unit every 50 strokes, and pulse frequency is reduced, lithotripsy is continued until flicker artefact disappears.

EFFECT: method allows to reduce renal parenchyma traumatization, to reduce development of probable complications of treatment of urolithiasis, reduce length of stay in hospital and duration of rehabilitation in postoperative period due to improved visualization of calculus during ESWL and timely adjustment of aiming focus of shock-wave radiator.

1 cl, 2 dwg, 1 ex