Advanced Technology in Extracorporeal Shock Wave Lithotripsy: The Dornier MPL 9000 Versus the Upgraded Dornier HM 3

The Dornier HM₃ kidney Iithotripter represents the worldwide accepted standard of extracorporeal stone disintegration. Supplemented with a 40-nF generator (vs 80 nF) and an enlarged ellipsoid (17 cm vs 14 cm), more than 95% of ESWL treatments are possible with only intravenous analgesia (with tramadol). Successful stone disintegration was noted in 98%. The Dornier multipurpose MPL 9000 represents a third-generation lithotripter for both kidney and gallbladder stones with an ultrasound localization system and tubless shock-wave coupling. The MPL 9000 and the upgraded HM₃ were compared, considering success rate, pain intensity, range of indications, and reliability of localization. Although both machines showed similar success rates, the use of the MPL 9000 was limited by ultrasound-guided localization of kidney stones, upper ureteral calculi causing obstruction, and intramural lower ureteral stones. Advantages of the MPL 9000 included treatment in the prone position for lower ureteral stones and treatment of calculi in horseshoe kidneys.