No single transurethral operation has undergone quite such a fundamental change in the last two decades as litholapaxy. As recently as the 1940s and 1950s blind litholapaxy by the Bigelow lithotrite was a common procedure in a number of clinics. Nowadays both instrument and method are known only to a few older urologists and their pupils. A variety of technical factors are responsible for this development: destruction of bladder calculi by the Urat-I instrument has had a particularly revolutionary effect. Ultrasonic litholapaxy has only recently reached technical maturity. Subdivision and extraction from the bladder of calculus debris has been so simplified by the introduction of the punch lithotrite that the latter is likely to remain the standard technique for many years to come. Only the basic concept just outlined will be further discussed in this operating manual.
KeywordsDirect Vision Grain Stone Operating Element Bladder Base Bladder Calculus
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