Influence of focusing and signal shape on the efficiency of stone fragmentation in vitro under equal energy conditions

Abstract

To investigate the mechanisms of fragmentation in lithotripsy, simulations and experiments were performed. Wave shapes deduced from measurements near the focus of a piezoelectric source were used as input signals for finite element calculations of stresses and strains in spherical stones of different sizes. The effects of strongly and weakly focused sound fields were compared to those of a plane wave assumption representing lithotripters with large focal widths. The energies of the fields were matched. In targets with diameters less than 6 mm the simulated tensile stresses induced by strong and weak focusing exceed those of the plane wave assumption. For in vitro experiments a double‐layered self‐focusing piezoelectric source was used. To represent lithotripters with different sound fields the signal shape was varied by changing the interpulse delay but maintaining the energy. The total number of pulses needed for fragmentation into particles smaller than 2 mm diameter was counted. At usually applied energies experimental results show that the numbers of pulses needed for complete fragmentation are almost independent of the signal shape. In conclusion, the results indicate that strongly focused lithotripters are in principle more effective than those with wide focal widths in breakage of small stones.