Initial Experience with the Second-Generation Lithotripter, Dornier HM-4
In addition to the widely-used first-generation lithotripter (Dornier HM-3), an increasing number of second-generation devices are now in clinical use. We are currently reporting our initial experience with the Dornier HM-4. The main improvements over the previous device with this model are the coupling of the shock waves by means of a water cushion, a modified shockwave generation with an enlarged ellipsoid and decreased generator energy, and computer-assisted handling. Additionally, a system for respirational triggering is installed. Treatment-related technical data are printed out by a small computer. The modification of shock-wave delivery with less energy through a larger-diameter ellipsoid is believed conducive in decreasing the need for anesthesia. However, an increasing number of secondary treatments are being reported from other centers.