Sameer Parmar
@sameerparmar
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Co-founder @endouroacademy and Executive Board @endouroacademy. My views are my owN My passion #ESWL Believer in Personalised Stone Approach (PSA) #askmehow2swl
Munich, Germany
Joined June 2009
A word of thoughtfulness: โAre we moving from external scar to internal scar in modern Endourology ?โ @endouroacademy
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Many thanks to Prof. @drkemalsarica for highlighting why SWL continues to hold its place in endourology. The ๐ต๐ณ๐ถ๐ฆ ๐ฅ๐ช๐ง๐ง๐ฆ๐ณ๐ฆ๐ฏ๐ค๐ฆ ๐ญ๐ช๐ฆ๐ด in the ๐๐๐๐ข๐๐๐๐ฒ ๐จ๐ ๐ญ๐ก๐ ๐ฅ๐ข๐ญ๐ก๐จ๐ญ๐ซ๐ข๐ฉ๐ญ๐๐ซ.
With systems like MODULITHยฎ๏ธSLK SW path-imaging axis are perfectly collinear,ensuring that focal point visualized is the actual therapeutic focus.This alignment enables precise targeting and minimizes energy loss due to misalignment in SWL.LLU/ LLC stones were treated perfectly.
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๐ Prof. Kemal Saricaโs 11 mm stone was zapped in ONE session with @storzmedical MODULITHยฎ SLK ยปinlineยซ lithotriptorโzero residuals on NCCT at 4 wks! Thx, Prof, for showing SWLโs power in stone management! #askmehow2swl
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๐ Picking the perfect lower pole stone for SWL is art & science! ๐ฏ Guidelines say SWL rocks for stones โค10โ15 mm with angle >70ยฐ, width >5 mm, length <30 mm. ๐ฅ High clearance, no invasion, no anesthesia! #askmehow2swl (1/2)
Complete disintegration of a 10 mm stone with SLK inline lithotriptor in 1 session. No stone was present on NCCT after 4 weeks. ZERO invasiveness!!.No need for invasive procedures under anesthesia as the first option.SWL is still alive/active with GL's based certain indications.
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As an expert our job is to simplify the technique we are expert in, keeping in mind that the results can be replicated with minimal complications for the people who are learning from us @endouroacademy
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Avoiding Potent GHGs URS requires general anesthesia which uses powerful greenhouse gases. SWL often requires minimal or no sedation dramatically cutting the procedure's carbon footprint Plus, it skips the invasive devices saving about 4.43 kg CO2โe per case from single-use scope
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๐๏ธ Waste Reduction is Key URS generates a High Volume of surgical waste: drapes, single-use laser fibers, and plastic scopes. ESWL? Minimal to None. It avoids the OR entirely, using only non-sterile items and gel. Less waste = less landfill. #ESWLSaves
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Tweet 1/3: Kidney stone treatment has a carbon footprint! ๐ For eligible stones, Extracorporeal Shock Wave Lithotripsy (ESWL) is the clear winner in the #GreenRace over Ureteroscopy (URS). Here's why you should talk to your urologist about the low-carbon option ๐
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๐ Physics of Shock Waves in Lithotripsy Fragmentation isnโt magicโit's physics in action. Explore the 5 key mechanisms: ๐ Shear & Tear ๐ฅ Spallation ๐งฑ Quasi-static Squeezing ๐ Cavitation ๐ฆ Dynamic Squeezing Each tells a story of how stones break.
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Recent publication Study from Heavy Stone belt region reports only 3 female patients out of 1000 with urinary stones (0.3% incidence). Global rates: 9% female, 11% male. Can we trust this studyโs authenticity? ๐ค @endouroacademy
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SWL for LCS? Too rational when endoscopes beg to play! ๐ Most miss favorable calyceal anatomy. Yet, a 10 mm LCS vanished in 1 SWL session, stone-free on NCCT at 4 wks. Why non-invasive when scopes are sport? SWL still schooling the endoscopy fan. ๐
Optimal Tx of LCS is challenging.If the anatomy allows SWL could be a rational option!!Complete disintegration of a 10 mm stone with SLK inline lithotriptor in 1 session. No stone on NCCT after 4 weeks. Available invasive procedures may not be the first option.SWL is still alive.
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Ever hear about AI in SWL? AI means Acoustic Impedance, not some chatbot! Itโs how sound waves show whatโs hiding underground. Some folks just do the mechanical work in SWL, no clue about the physics or AI. Big mistake! Without AIโs magic,youโre just guessing whatโs down there
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Tonight will the best Superhero ever! #Supermanย โYour Choices, Your Actions Thatโs what makes you! Who you areโ This is how you break the barrier!!!
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If your goal is to "dust" stones effectively during SWL, I invite you to read my latest article. A phased approach makes all the difference. https://t.co/f4JrYOd3DQ
@endouroacademy @drkemalsarica @EndoLuminalEndo @DocGauhar
linkedin.com
In my 20+ years working with Extracorporeal Shock Wave Lithotripsy (SWL), I've developed a structured, patient-centric approach to optimize stone fragmentation while safeguarding kidney function....
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Thanks for amazing results! ๐ 8 mm LUU stone gone after 1 SWL session with SLK lithotriptor. Complete disintegration, no stone on KUB in 3 days, ZERO invasiveness! ๐ SWL shines, no need for invasive procedures. @storzmedical
Patient from "Emergency dept."with "severe colic pain" due to 8 mm LUU stone. Following pain medication only "1 session of SWL" has was performed after 12 hours and "complete disintegration"with highly effective SLK inline lithotriptor. No stone was present on KUB after 3 days.
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Thanks for amazing results! ๐ 8 mm LUU stone gone after 1 SWL session with SLK lithotriptor. Complete disintegration, no stone on KUB in 3 days, ZERO invasiveness! ๐ SWL shines, no need for invasive procedures. @storzmedical
ZERO invasiveness!! What else a patient can expect from a treatment to get rid of the stone in such a quick and practical manner. No need for well-known invasive procedures under anesthesia as the first option.SWL is still alive and active with GL's based certain indications.
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Shockwave lithotripsy is here to stay provided Right Technology Right patient selection and above all Right technique is used for best outcome. My recent lecture in ๐ญ๐ฐ has received an amazing response on how to optimise and how to personalise SWL based on patient and stone
Shockwave Lithotripsy #SWL holds lasting value in #Urology. OPTIMIZING, not abandoning SWL, matters. Are we underestimating its value for our patients, especially where options are limited and resources constrained? Let's discuss experiences from Brazil and beyond. #urosome
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Excited to share 3 sessions in 2 days in Hong Kong on Optimizing & Personalizing SWL for Rad techs, and Optimizing SWL & Ultrasound-Guided SWL for urologists! Honored by the great feedback. @steffiyuen & Prof NG for invitation.
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Mid-flight inspiration! โ๏ธ My latest sketch shows the ureterโs curvy path, a reminder for urologists: go slow with sheaths/scopes to prevent injury
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