Multi-Institutional Prospective Randomized Control Trial of Novel Intracorporeal Lithotripters: ShockPulse-SE vs Trilogy Trial

Tim Large, Charles Nottingham, Ethan Brinkman, Deepak Agarwal, Andrea Ferrero, Michael Sourial, Karen Stern, Marcelino Rivera, Bodo Knudsen, Mitchel Humphreys, Amy Krambeck

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: Currently, there are multiple intracorporeal lithotripters available for use in percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the efficiency of two novel lithotripters: Trilogy and ShockPulse-SE. Materials and Methods: This is a prospective multi-institutional randomized trial comparing outcomes of PCNL using two novel lithotripters between February 2019 and June 2020. The study assessed objective measures of stone clearance time, stone clearance rate, device malfunction, stone-free rates, and complications. Device assessment was provided through immediate postoperative survey by primary surgeons. Results: There were 100 standard PCNLs completed using either a Trilogy or ShockPulse-SE lithotrite. Using quantitative Stone Analysis Software to estimate stone volume, the mean stone volume was calculated at 4.18 ± 4.79 and 3.86 ± 3.43 cm 3 for the Trilogy and ShockPulse-SE groups, respectively. Stone clearance rates were found to be 1.22 ± 1.67 and 0.77 ± 0.68 cm 3/min for Trilogy vs ShockPulse-SE ( p  = 0.0542). When comparing Trilogy to ShockPulse-SE in a multivariate analysis, total operative room time (104.4 ± 48.2 minutes vs 121.1 ± 59.2 minutes p  = 0.126), rates of secondary procedures (17.65% vs 40.81%, p  = 0.005), and device malfunctions (1.96% vs 34.69%, p  < 0.001) were less, respectively. There was no difference in final stone-free rates between devices. Conclusion: Both the Trilogy and ShockPulse-SE lithotripters are highly efficient at removing large renal stones. In this study, we noted differences between the two devices including fewer device malfunctions when Trilogy device was utilized. Clinical Trial ID number: NCT03959683.

Original languageEnglish (US)
Pages (from-to)1326-1332
Number of pages7
JournalJournal of endourology
Issue number9
StatePublished - Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
This study was possible because of an unrestricted research grant from Boston Scientific. In all cases, the equipment used for lithotripsy, including the individual probes, was purchased by the health system supporting the primary surgeon.

Publisher Copyright:
© Tim Large et al., 2021; Published by Mary Ann Liebert, Inc. 2021.


  • lithotripter
  • nephrolithiasis
  • percutaneous nephrolithotomy


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