Utilization of Swiss LithoClast® Trilogy Lithotripter During Percutaneous Nephrolithotomy
Bibliographic record
Abstract
Percutaneous nephrolithotomy (PCNL) is the gold standard for surgical treatment of large kidney stones. Although there are a variety of commercially available Lithotrites, the objective of this video is to review technical aspects of the EMS Lithoclast Trilogy™ and to discuss tips for troubleshooting as well as set up of the device. PCNL is recommended as first-line therapy for renal pelvic stones that are greater than 2 cm in size. Furthermore, PCNL should also be considered for lower pole stones that are > 1 cm in size. The Trilogy uses a combination of ballistic and ultrasound energy to efficiently fragment stone. It is easy to set up. Tips to maximize efficiency of the device including priming the device and appropriate selection of the probe size. We prefer using lower frequency settings at the initiation of the case to suction out blood clot. Once the stone is identified we increase the frequency and impact settings. The surgeon should not torque on the handle as the probe will not function as efficiently and can even break prematurely. The Trilogy is a dual energy lithotrite available in a wide range of probe sizes. Bench and clinical data suggest it is equivalent or more efficient than other available Lithotrites. The surgeon should take care not to torque on the probe to ensure the probe does not break prematurely and functions at maximum efficiency.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".