Urinary stone is one of the common diseases of the urinary system, foreign statistics, in developed countries, its incidence in the adult population for 2% -3%, only the United States each year due to urolithiasis hospitalized for more than 300,000, about 100,000 people receive surgical treatment. Before the birth of extracorporeal shock lithotripsy (Extracorporeal Shock Wave Lithotripsy, EswL) the only effective treatment for urinary tract stones is surgical lithotripsy.
The invention of the machine was inspired by an unexpected phenomenon. A shock wave is a high-energy pressure wave generated in a medium (water, air, etc.) due to a sudden release of energy. In the early sixties, west Germany dornier airlines science and technology personnel found that when the plane through the rain clouds at high speed, can produce a shock wave can make the aircraft internal device damage, while the aircraft shell is intact, this phenomenon caused by physicists attention, in 1963 the company set up a shockwave research laboratory. 1966 the research laboratory of an engineer accidentally contacted the work of the shockwave target, his body produced a shock like an electric shock, and the shockwave was not a shock. His body produced a feeling like an electric shock, the learned engineer immediately realized that this is a shock wave into the human body after the effect. 1969 by the West German Ministry of Defense funding, the company began the "shock wave and animal tissue interrelationships," the subject of research. They found that when the shock wave through the interface of the two media, reflection and refraction will occur, the extent of which depends on the interface with the acoustic impedance difference between the two media. Since the acoustic impedance of most body tissues and water are close to each other, there is no obvious energy loss and no harm caused by shock waves propagating in water and passing through the body, only the lung tissue is particularly sensitive to shock waves due to the high acoustic impedance difference at the interface between the air and the tissue neighboring it. During the course of the study, the researchers discovered an important phenomenon, namely that metal probes used for measurements in the body are easily shattered by shock waves. The news reached Prof. Eisenberger at the Institute of Surgery at the University of Munich. At that time he was studying the treatment of urinary stones, this phenomenon immediately caused him to think, so that he began the shock wave lithotripsy research. Eisenberger and Dornier shock wave effect of the research room staff cooperation, finally in 1972 proved that the water propagation of the shock wave can be crushed isolated kidney stones, this success is the first milestone in the history of extracorporeal shock wave lithotripsy, which opens up a new era of urinary tract stone treatment. Schmidt and Eisenberg hailed this success as a revolution in stone treatment. in January 1974, the ESWL study was officially included in the West German Federal Research and Development Program, which was conducted at the Institute of Surgery of the University of Munich by Schmidt, Eisenberg and Prof. Chaussy in collaboration with researchers from the Daurne Company. In the first year, the research group solved the problem of focusing shock waves. Shock waves are generated by electrode discharges. The solution of the focusing problem gave the lithotripsy system a basic skeleton. After that, it solved the problem of X-ray localization, and successfully developed a new lithotripter with two sets of X-ray systems in early 1978, which proved that the cross-location of kidney stones using two sets of X-ray systems was more accurate than the ultrasonic localization, and a series of experiments laid the foundation of ESWL for use in human body. Finally, in September 1979, the Dornier HM-1 lithotripter with X-ray positioning system was successfully developed. In 1980, West Germany, Munich, Ludwig Maximilian University of urology Jos, etc. will be the first time that the machine is used for clinical treatment of kidney stones patients. After 4000 times the shock wave patient that stubborn stone was completely shattered, a few hours after the urine discharged the stone particles, 2 days after the X-ray examination of the patient's kidney area stone image disappeared, this successful test so that the non-surgical treatment of urolithiasis possible, a major breakthrough in the eighties of the medical technology, urology has become the development of a milestone.
In the next 2 years, 220 patients were treated with the HM-1 lithotripter in Munich, confirming that the majority of urinary stones are safe and effective when treated with shock waves. The dream of urinary tract stone patients to be spared from the pain of surgery was finally realized. Science has no borders, after the introduction of HM-[1] type lithotripter in 1983, ESWL was soon popularized in the world, and many countries in the world, such as Germany, France, the United States, Israel, Italy, and Japan, etc., produced extracorporeal shock wave lithotripters. 1985 China successfully developed the first lithotripter and since then, there have been more than 20 manufacturers. The number of patients treated with ESWL in China has reached as many as 100,000 people. With the accumulation of clinical experience and the improvement of lithotriptic performance, the indications of ESWL are expanding, from simple kidney stones to ureteral and bladder stones, from unilateral single to bilateral double, from small stones to large stones, staghorn stones, all have achieved better results. 75% of urolithiasis can be treated by ESWL alone, 20% need combined treatment of ESWL and cavernous urological techniques, and less than 5% of the patients really need open surgery. Less than 5% of the patients really need open surgery. According to the report of most medical units at home and abroad, the success rate of ESWL is more than 95%, and the follow-up after 3 months of treatment, the stone clearance rate reaches 85% of those who need to undergo further open surgery accounts for about 1%.
While vigorously promoting ESWL treatment, countries have further developed and researched new and better lithotripters. A new type of lithotripter with both X-ray and ultrasound localization system and movable type has been developed. In this way, both light-blocking and non-light-blocking stones can be localized. Most of the lithotripters are mostly tankless, water bladder type lithotripters. In terms of application, extracorporeal shock wave lithotripters for kidney stones, extracorporeal shock wave lithotripters for gallstones and general-purpose extracorporeal shock wave lithotripters have been produced. In terms of its structure, the principle of shock wave generating source is different and different positioning methods are used. Shock wave generation source has liquid electric shock wave, piezoelectric effect, concentrated laser, electromagnetic induction and micro-explosion and other principles of shock wave generated. Strive to make the role of the shock wave on the stone performance is more ideal, stone positioning device, patient monitoring system and treatment of the operating system continues to improve, so that the performance of the extracorporeal shock wave lithotriptic machine is becoming more and more perfect.